Our otolaryngologists play an integral role in The James Graham Brown Cancer Center’s Multidisciplinary Head and Neck Clinic. The team meets regularly to monitor the patient’s progress carefully and to adjust the treatment plan as necessary. This approach ensures that patients receive the ideal combination of treatments and therapies.

In 2001, the Division of Otolaryngology began a serious collaborative effort with Radiation Oncology and Medical Oncology in the establishment of a Head and Neck Multidisciplinary Clinic located at the James Graham Brown Cancer Center. This clinic allows access to all three medical specialties under one roof at the same time in one location. The clinic offers state-of-the-art diagnostic and treatment approaches for advance head and neck cancers. Patients seen in this clinic are afforded the most contemporary options in the care of their head and neck cancers such as:

• Image Modulated Radiation Therapy (IMRT)
• Concomitant Chemoirradiation for Organ Preservation
• Minimally Invasive Surgical Techniques and Protocols
• Intra-operative Radiation Therapy
• Comprehensive speech and swallowing rehabilitation therapy
• Advanced diagnostic imaging such as CT/PET fusion imaging

The clinic also has served as a portal of entry for patients to participate in national protocols for advanced malignancy. We offer patients an advanced array of protocols as participants in the national Radiation Therapy Oncology Group (RTOG) and have been one of the highest accruing centers in the United States for such protocols. We are also an integral part of the James Graham Brown Cancer Center's progressive plan and initiative to become a National Cancer Institute (NCI) designated cancer center.

Members of the Otolaryngology Division are part of a multispeciality team that comes together to treat skull base tumors. This approach that includes ENT (rhinology/neurotology) and neurosurgery, as well as neuroradiology, radiation oncology, medical oncology and pathology.

Endoscopic endonasal surgery is performed by a team that includes both an Otolaryngologist and a Neurosurgeon. This is the binarial, four-hands technique developed at the University of Pittsburgh. Training for ENT and neurosurgical residents includes collaborative didactics focused on the radiology and endoscopic anatomy of the nose, paranasal sinuses, orbit, pituitary fossa and ventral skull base. Fresh tissue cadaver dissection is also performed collaboratively, allowing the trainees to learn to function as a team. A systematic progression from basic to more complex approaches reinforces the development of essential endoscopic skills and familiarization with endoneurosurgical instrumentation including navigation systems. We have a state-of-the art operating suite and experienced personnel to improve both the quality of care given to our patients and the resident experience.

The Voice Center is directed by Louisville native Dr. Swapna Chandran, a voice fellowship-trained ENT who joined the faculty of the University of Louisville School of Medicine with the goal of addressing these problems for patients throughout the community and region. The center offers the following services:

• Treatment of voice, swallowing and other upper aerodigestive disorders
• Office Videostrobolaryngoscopy
• Office-based procedures of the larynx, including vocal fold injection medialization and Botox
• Microlaryngeal surgery
• Endoscopic and open treatment of airway stenosis
• Four-channel electromyography of the larynx
• Multidisciplinary approach to the diagnosis and management of disorders of the upper aerodigestive tract

UofL Department of Surgery otolaryngogists were the first in Kentucky to use the daVinci Robot to treat head and neck patients. The Robot enables surgeons to perform delicate operations with breakthrough precision. It provides the surgeons with exceptional vision, precision, dexterity and improved access to the treatment site. As a result, patients experience less pain and quicker recovery.

In April 2010, otolaryngolgists Drs. Jeffrey Bumpous and Kevin Potts teamed up to complete the first daVinci TransOral Robotic Surgery (TORS) in Kentucky and surrounding region. They were able to remove the cancerous tissue without any major incisions.

TORS is a minimally invasive surgery where the surgeons can access the cancerous area through the throat. As with all minimally invasive procedures the goals are to minimize incisions, preserve function, reduce pain and facilitate quicker recoveries.

Operating through the mouth is not new, but doing it using the daVinci opens up new possibilities. Previously, surgeons had to use long instruments, over one foot in length, which can magnify hand tremors. Older procedures also carry visibility limitations.

The daVinci eliminates those complications with smooth movements and a 3D HD camera.

Drs. Arun K. Gadre and David R. Cunningham (links to their bios) lead The Center for Hearing Loss & Balance Disorders. Dr. Gadre is fellowship trained and has special expertise in Otology, Neurotology and Skull Base Surgery. Dr. Cunningham is an expert with decades of experience in the non-surgical management of hearing loss. They have been joined by two top-notch audiologists Dr. Lynzee Alworth, who was a Alexander Graham Bell Fellow and is a specialist in Cochlear Implant Research and Programming, Dr. Jeffrey Weihing, who is an expert in electrophysiology and balance disorders, and Barbara Eisenmenger, who has several decades of experience in adult clinical audiology services. The center provides top-notch clinical care, education, and research related to deafness, hearing loss, and balance disorders. It offers the following services:

• Acoustic Neuroma Surgery
• Surgery of the Skull Base for Benign and Malignant Lesions
• Cochlear Implantation and Bone Anchored Hearing Aids
• Ear Surgery including Surgery for Chronic Otitis Media and Cholesteatoma
• Ossiculoplasty
• Surgery of the Facial Nerve
• Management of Vertigo
• Temporal bone Trauma and Fractures
• Adult amplification and auditory rehabilitation
• Superior Semicircular canal dehiscence syndrome, perilymph fistulas, and Vestibular Neurectomies
• Genetic hearing loss in collaboration with the Weisskopf Center at the University of Louisville
• Auditory brainstem response testing
• Pediatric hearing evaluations
• Amplification
• Auditory processing disorders testing

For more than three decades, Department of Surgery surgical oncologists and otolaryngologists have collaborated to provide the best possible treatment and care for patients with hyperparathyroidism.

This includes using the most advanced, sophisticated technology and techniques to diagnose and treat each patient, as well as maintaining a comprehensive database of all patients treated. Many patients are candidates for minimally invasive parathyroid surgery.