53 results match your criteria: "1904 Taubman Center[Affiliation]"
Otolaryngol Clin North Am
February 2025
Otolaryngology-Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1904 Taubman Center, 1500 East Medical Center Drive, SPC 5312, Ann Arbor, MI 48109-5312, USA. Electronic address:
The middle ear and mastoid spaces contain delicate and functionally important structures. Safe cholesteatoma surgery requires mastery of otologic anatomy as well as thorough preoperative investigation. Cholesteatoma can damage otologic structures on its own; however, there is also an opportunity for an iatrogenic complication given the distortion of anatomy by the disease process.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
May 2023
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA.
Facial skin defects pose unique challenges for the reconstructive surgeon. Aesthetically complex areas involving a free margin-such as the ear, eyelid, columella, columella-lobule interface, soft tissue triangle, alar rim, and internal nasal lining-are particularly demanding, as secondary soft tissue contracture in these locations can lead to a very poor cosmetic outcome. In these cases, composite grafts offer an ideal combination of soft tissue coverage and structural rigidity, all accomplished in a single-stage surgery.
View Article and Find Full Text PDFOtolaryngol Clin North Am
April 2022
Department of Otolaryngology and Neurosurgery, 1904 Taubman Center, Reception Area A, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; University of Michigan, Ann Arbor, MI, USA.
Interdisciplinary teams have many potential and proven benefits, including decreased burnout, decreased medical errors, increased quality, and leveraging of competing values and skills. Pituitary Tumor Centers of Excellence must have adequate volumes and high-functioning teams in order to provide exceptional, high-value care. Organizational logistics, attentive operations management, facilitated collaboration, and clear communication are key teamwork tools in delivering that care.
View Article and Find Full Text PDFOtolaryngol Clin North Am
February 2022
Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Quality, Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, TN, USA.
At the foundation of clinical medicine is the relationship among patients, families, and health care professionals. Implicit to that social contract, professionals pledge to bring clinical excellence to advance their patients' wellness and healing-and to prevent harm. Patients trust that those privileged to deliver care will do so unwaveringly in service of patients' best interests; however, the incentives and infrastructure surrounding health care delivery can promote or undermine individual performance, teamwork, and patient safety.
View Article and Find Full Text PDFOtolaryngol Clin North Am
April 2021
Department of Otolaryngology-HNS, University of Michigan Medical School, 1904 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5321, USA. Electronic address:
Sentinel lymph node biopsy is the most precise and accurate staging technique for malignant melanoma. This resulted from international collaborations and technical innovations across subspecialties and systematic and methodical study of real-time clinical problems. This article describes sentinel node biopsy from conception to current techniques.
View Article and Find Full Text PDFJ Cancer Surviv
June 2021
Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA.
Purpose: The purpose of this study is to understand physician management of thyroid cancer-related worry.
Methods: Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed 2018-2019 (response rate 69% (448/654)) and asked to rate in general their patients' worry at diagnosis and actions they take for worried patients. Multivariable-weighted logistic regressions were conducted to determine physician characteristics associated with reporting thyroid cancer as "good cancer" and with encouraging patients to seek help managing worry outside the physician-patient relationship.
Otolaryngol Clin North Am
December 2020
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1904 Taubman Center, 1400 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address:
This article summarizes major and minor complications following transoral robotic surgery in the head and neck. Overall, transoral robotic surgery is extremely safe; however, surgeons must recognize inherent risks associated with major and severe bleeding, dysphagia, and minor complications, including injury to nerves, mucosal surfaces, teeth, and the eyes. This article briefly discusses prevention and management strategies for common complications.
View Article and Find Full Text PDFOtolaryngol Clin North Am
August 2019
Department of Otolaryngology - Head & Neck Surgery, Michigan Medicine, 1904 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5312, USA. Electronic address:
Laryngeal mucosal precursor lesions represent a challenging clinical entity. Updated classification systems allow for grade-based categorization. Multiple management options exist, with treatment decisions made jointly by physician and patient and focused on both appropriate lesion treatment and preservation of laryngeal structure and function.
View Article and Find Full Text PDFOtolaryngol Clin North Am
June 2019
2033 Norfolk Street, Ann Arbor, MI 48103, USA.
Reprocessing a flexible endoscope is a complex multistep process. Attention to detail is essential for patient safety. Physicians need to empower their staff to function as guardians and advocates for best practices in endoscope reprocessing.
View Article and Find Full Text PDFOtolaryngol Clin North Am
June 2019
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, 714 Kellogg Eye Center, Ann Arbor, MI 48109, USA.
Facial reconstruction may be effectively performed in an office setting using a variety of techniques. Careful patient selection is paramount for achieving successful outcomes in this setting. The most common reconstructive techniques used in the office setting include local flaps and skin grafts.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
February 2019
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA.
Nasal reconstructive techniques have advanced significantly over the past 50 years. Modern techniques in nasal reconstruction are based on the nasal aesthetic subunits. In order to achieve ideal outcomes, reconstructive surgeons must consider differences in tissue qualities across the nasal aesthetic subunits and formulate reconstructive plans based on these differences.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
February 2019
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive Northwest, Atlanta, GA 30332, USA.
Three-dimensional (3D) printing has transformed craniofacial reconstruction over the last 2 decades. For cutaneous oncologic surgeons, several 3D printed technologies are available to assist with craniofacial bony reconstruction and preliminary soft tissue reconstructive efforts. With improved accessibility and simplified design software, 3D printing has opened the door for new techniques in anaplastology.
View Article and Find Full Text PDFCancer Immunol Immunother
February 2019
Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, 48109-0602, MI, USA.
Background: Recurrent laryngeal squamous cell carcinomas (LSCCs) are associated with poor outcomes, without reliable biomarkers to identify patients who may benefit from adjuvant therapies. Given the emergence of tumor-infiltrating lymphocytes (TIL) as a biomarker in head and neck squamous cell carcinoma, we generated predictive models to understand the utility of CD4, CD8 and/or CD103 TIL status in patients with advanced LSCC.
Methods: Tissue microarrays were constructed from salvage laryngectomy specimens of 183 patients with recurrent/persistent LSCC and independently stained for CD4, CD8, and CD103 TIL content.
Otolaryngol Clin North Am
February 2019
Department of Otolaryngology-Head and Neck Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA. Electronic address:
There have been reports of successful quality-improvement initiatives surrounding tracheostomy care for more than a decade, but widespread adoption of best practices has not been universal. Five key drivers have been found to improve the quality of care for tracheostomy patients: multidisciplinary synchronous ward rounds, standardization of care protocols, appropriate interdisciplinary education and staff allocation, patient and family involvement, and use of data to drive improvement. The Global Tracheostomy Collaborative is a quality-improvement collaborative dedicated to improving the care of tracheostomy patients worldwide through communication, dissemination, and implementation of proven strategies based on these 5 key drivers.
View Article and Find Full Text PDFOtolaryngol Clin North Am
February 2019
Strategic Partnerships and Innovation, Healthcare Quality and Affordability, Blue Shield of California, 50 Beale Street, San Francisco, CA 94105, USA.
Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures.
View Article and Find Full Text PDFOtolaryngol Clin North Am
February 2019
Department of Otolaryngology, University of Pittsburgh School of Medicine, The Eye & Ear Institute, 200 Lothrop Street, Suite 500, Pittsburgh PA 15213, USA; Department of Neurological Surgery, University of Pittsburgh School of Medicine, The Eye & Ear Institute, 200 Lothrop Street, Suite 500, Pittsburgh PA 15213, USA.
Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar.
View Article and Find Full Text PDFJ Bioeth Inq
June 2018
University of Michigan Medical School, 1904 Taubman Center, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical options, and cultural disparities.
View Article and Find Full Text PDFPatient
April 2018
Department of Otolaryngology - Head and Neck Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI, 48109-5312, USA.
Otolaryngol Clin North Am
October 2017
Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, University of Michigan, 1904 Taubman Center, 1500 East Medical Center Drive, SPC 5312, Ann Arbor, MI 48109-5312, USA. Electronic address:
Simulation is rapidly expanding across medicine as a valuable component of trainee education. For procedural simulation, development of low-cost simulators that allow a realistic, haptic experience for learners to practice maneuvers while appreciating anatomy has become highly valuable. Otolaryngology has seen significant advancements in development of improved, specialty-specific simulators with the expansion of three-dimensional (3D) printing.
View Article and Find Full Text PDFOtolaryngol Clin North Am
August 2017
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, 533 Bolivar Street, 5th Floor, New Orleans, LA 70112, USA. Electronic address:
Survivorship encompasses the entire therapeutic, psychosocial, functional, and financial experience of living with and through a cancer diagnosis. The period of survivorship starts on the day of the cancer diagnosis and lasts until the end of the survivor's life, regardless of the cause of death. The National Cancer Institute's Office of Cancer Survivorship expands the term "survivor" to include, importantly, caregivers, family, and friends close to the survivor who also live through this period.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
August 2017
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA. Electronic address:
Successful reconstruction of the cheek following excision for cutaneous malignancy requires careful consideration of defect location, size, and depth in relation to the anatomic properties of the affected cheek unit. Various reconstructive options are available to the surgeon, ranging from simple excisions to complex cervicofacial advancements to meet the needs for functional and aesthetically pleasing reconstructive outcomes. The surgeon must prevent distortion of mobile structures, such as the eyelid, nose, and lips; respect aesthetic subunits; and avoid blunting natural creases.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
August 2017
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA.
Skin and composite grafting provide effective resurfacing and reconstruction for cutaneous defects after excision of the malignancy. The goal is to restore a natural appearance and function while preventing distortion of the eyelid, nose, or lips. With careful planning and attention to aesthetic subunits, the surgeon can camouflage incisions and avoid blunting aesthetically sensitive sulci.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
May 2017
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 East Medical Center Drive, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA; Center for Facial Cosmetic Surgery, 19900 Haggerty Road, Suite 103, Livonia, MI 48152, USA. Electronic address:
Osteotomies are critical techniques in rhinoplasty. There are a variety of approaches, trajectories, and tools used with no widely standardized classification or nomenclature. Percutaneous osteotomies are gaining in popularity, and picture framing the nasomaxillary bone is crucial for predictable fracture and reproducible results.
View Article and Find Full Text PDFEar Nose Throat J
December 2016
Department of Otolaryngology-Head and Neck Surgery, 1904 Taubman Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
We conducted a retrospective study to assess the efficacy of using a nasopharyngeal airway in lieu of a tracheotomy or prolonged intubation for the diversion of airflow to prevent tension pneumocephalus after an open resection of anterior skull base tumors. Our study population was made up of 120 patients-74 males and 46 females, aged 12 to 84 years (mean: 48.7)-who had undergone an anterior skull base resection with documented nasopharyngeal airway placement from 1996 through 2009.
View Article and Find Full Text PDFEar Nose Throat J
June 2016
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, 1904 Taubman Center, 1500 E. Medical Center Dr., SPC 5312, Ann Arbor, MI 48109-5312, USA.
We describe the clinical presentation, management, and pathologic findings in a case of osteosarcoma of the petrous apex with an atypical metastasis to the lower abdominal wall. We retrospectively reviewed the record of a 49-year-old man who was diagnosed with a right petrous apex lesion, which biopsy identified as a high-grade osteoblastoma. After two attempts at en bloc resection were not curative, radiation and chemotherapy were recommended.
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