Head and Neck Surgery
Summary
The Division of Head and Neck Oncologic and Reconstructive Surgery has continued its growth and trajectory as the highest volume head and neck cancer program in the state of Indiana and among the busiest in the nation. With expansion of clinical sites, new faculty additions, development of formal multidisciplinary services in the outpatient setting, and continued innovative research and technological developments, the head and neck program has also become a sought after training destination for fellows across the country and beyond.
This collaborative effort allowed more than 750 new cancer patients to be seen at the Multidisciplinary Head and Neck Tumor Conference in 2021, continuing a significant growth trajectory in what was already the busiest head and neck program in the state of Indiana and among the highest-volume programs in the nation. The surgical volume also continued its expansion, as head and neck faculty performed more than 260 free tissue transfers in 2021.
Clinical Mission
The head and neck program continued to expand its clinical footprint in 2022, with further development of services at the IU Health Joe and Shelly Schwarz Cancer Center at IU Health North Hospital. This site also serves as the primary location for the Transoral Robotic Surgery (TORS) program, led by Associate Professor Michael Sim, MD. Michael Moore, MD, the Arilla Spence DeVault Professor of Otolaryngology—Head and Neck Surgery, continues to serve as the Medical Director of Oncology Services for the IU Health Indianapolis Suburban Region. In this role, he has also directed the expansion of cancer services at IU Health West Hospital. Assistant Professor David Campbell, MD, joined the Division and has helped lead the clinical expansion to the western suburbs of Indianapolis at this site.
The Academic Health Center (AHC) in downtown Indianapolis has served as the primary Head and Neck clinical site for the group, with continued growth in all clinical programs. The multidisciplinary head and neck tumor board saw the presentation of 740 new tumor patients. The development of a formal multidisciplinary clinic allows both new and established patients to be evaluated in the same visit by their surgeon, physical therapy, speech therapy and nutrition and research coordinators. The Head and Neck Division performed more than 285 free tissue transfers in 2022, placing it among the busiest reconstructive programs in the country. The recruitment of Assistant Professor Diane Chen, MD, brings to the division the only dually-trained Pediatric-Head and Neck/Microvascular surgeon in the United States, making Riley Hospital a destination center for pediatric head & neck and endocrine surgery. Associate Professor Avinash Mantravadi, MD, continues to serve with the team behind the IU Health 3-D Innovations Laboratory, a multidisciplinary group of engineers, educators and clinicians dedicated to improving patient care and reducing costs and inefficiencies through in-house innovation and 3-D printing solutions. The growth of the lab has allowed the group to transition from IU Health University Hospital to a new and expanded lab space in the 16-Tech Innovation District, greatly expanding its capabilities and ability to scale.
Research and Clinical Trials
The research efforts of the Head and Neck Division continued to grow in 2022, with numerous peer-reviewed publications and contributions to domestic and international textbooks. All faculty physicians are active members of the American Head and Neck Society and routinely serve on committees and panels at the national level throughout the year and at international meetings. The dedicated efforts of faculty members and the department research coordinator have facilitated ongoing interdisciplinary basic science work on cancer cachexia, its mechanisms and the impact on free tissue transfer in the head and neck population.
Faculty members in the Division of Head and Neck Surgery have also continued accrual in two investigator-initiated clinical trials through the Simon Cancer Center. Michael Sim, MD, has continued his ongoing study examining adjuvant treatment deintensification after transoral surgery for human papillomavirus-positive (HPV+) squamous cell carcinoma of the oropharynx. This study is a prospective phase II trial, designed to assess the efficacy and feasibility of adjuvant treatment deintensification approaches for subjects with HPV+ disease who undergo transoral surgery and neck dissection.
Jessica Yesensky, MD, assistant professor, serves as the principal investigator for a clinical trial examining the role of sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck, a prospective single-arm trial. This study is being performed in coordination with the multidisciplinary cutaneous malignancy group, including head and neck surgical oncology and dermatology. Patients with clinically and radiographically staged tumors of cT2-T4N0 will be eligible for the trial and undergo sentinel lymph node biopsy at the time of tumor resection. This study aims to identify the clinical and tumor characteristics associated with occult, regional metastatic disease and determine the recurrence and disease-free survival.
Xue Yuan, PhD, who joined Indiana University School of Medicine faculty in 2021, received funding from the National Institute of Dental and Craniofacial Research (NIDCR) for her ongoing research in adult oral epithelial stem cells and the role for hypo- and hyperactive stem cells in wound repair and head and neck cancer development.