McGill University — Department of Otolaryngology
Head and neck oncology service
Adult sites — MGH, RVH, JGH
Clinical activity
Patient volumes
The following table is a reflection of clinical activity in head and neck oncology at McGill RUIS hospitals, both in the outpatient and operating room settings for the year 2004-2005. The figures are itemized by hospital site.
2004-2005
|
RVH |
MGH |
JGH |
|
1,649 212
301
60
|
1,344
225
-
|
3,819 561
567
218
39 |
Available equipment resources & radiotherapy techniques
State of the art computerized C02 laser (RVH, JGH)
3-dimensional navigational unit for skull base surgery (RVH, JGH)
CT/MRI/PET_CT and radiological diagnosis and radiotherapy planning (MGH, JGH)
Intensity-modulated radiotherapy
High dose rate brachytherapy
3-dimensional conformal radiotherapy
Resource allocation
The Department of Otolaryngology allocates more than 50% of its resources (outpatient clinics and OR time) towards its head and neck oncology service.
Resources not available
Maxillofacial prosthetic devices are not available to head and neck oncology patients within the McGill RUIS. Patients must go to the CHUM to receive these services under a government program.
Staff qualifications
Dr. Martin Black (JGH) Fellowship training, Washington University, St. Louis, Missouri (This is one of the leading programs in head and neck oncology in the U.S.)
Dr. Michael Hier (JGH) Head and Neck oncology fellowship, University of Chicago
Dr. Karen Kost (RVH/MGH) Head and neck/laryngology fellowship, Royal National Throat, Nose and Ear, London, England
Dr. Anthony Zeitouni (RVH) Fellowship in skull base surgery, New York and Switzerland
Dr. Richard Payne (JGH/RVH) Fellowship in head and neck oncology, University of Toronto
Current Positions held by departmental staff
Dr. Martin Black Director, McGill Head and Neck Oncology Program
Chief of Surgery, Jewish General Hospital
Former President, Canadian Society of Otolaryngology — Head and Neck Surgery
Dr. Michael Hier, Fellow, American Head and Neck Society
Dr. Karen Kost, Executive, Canadian Society of Otolaryngology — Head and Neck Surgery
Dr. Anthony Zeitouni, Executive, Quebec Association of Otolaryngology — Maxillofacial surgery
Dr. Saul Frenkiel, President elect, Canadian Society of Otolaryngology - Head and Neck Surgery
Multidisciplinary teams
RVH site: This is the oldest multidisciplinary clinic at the MUHC.
Surgeons: Dr. Karen Kost, Dr. Anthony Zeitouni
Radiation oncology: Dr. George Shenouda
Medical oncology: Dr. Peter Kavan
Endocrinology: Dr. Juan Rivera
Dental & oral maxillofacial surgery: Dr. Antoine Chehade, Dr. Eric Lessard, Dr. Hilal Sirham
Nursing: Elizabeth Blouin (Inf. Pivot), Jeanne Côté
Speech pathologist: Esther Lando, MSc
Social services: Norma Fox, B.S.W.
Clinical nutrition: Joan Blair, P.Dt.
Pathology: Dr. G. Domanowski
Secretary: Franca Racanelli
MGH site:
Surgeon: Dr. Karen Kost
Radiation oncology: Dr. Te Vuong
Medical oncology: Dr. Gouttebel, Dr. Rajan
Palliative care team: Dr. Anna Towers
Nurse: Kryska Zucchet
JGH site: This multidisciplinary team was established approximately 20 years ago.
Surgeons: Dr. Martin Black, Dr. Michael Hier
Radiational oncologist: Dr. Khalil Sultanem, Dr. Boris Bahoric
Medical oncologist: Dr. David Melnychuk
Clinical dietician: Anna Aguzzi
Speech pathologist: Gina Mills
Head & neck pathologist: Dr. Louise Rochon
Coordinator/secretary: Maria Ciccone
Tumor boards
These tumor boards are attended by members of the multidisciplinary team and invited specialty services whenever necessary. They also serve as an educational vehicle for training of residents and fellows at McGill University. They are held as follows:
RVH: weekly (every Thursday)
JGH: weekly (every Monday)
Thyroid rounds
JGH: combined rounds with otolaryngology and endocrinology are held on a monthly basis to discuss thyroid oncological cases.
RVH: A new thyroid oncology clinic has been established and meets on a monthly basis.
Academic program
Teaching
Residency training: The Department of Otolaryngology serves as an important vehicle to train otolaryngology residents in head and neck surgery/oncology. This follows the worldwide trend for otolaryngology departments to be the training ground of head and neck surgeons and it is an expectation for the Royal College of Physicians and Surgeons of Canada. All residents who graduate from our program are deemed qualified head and neck surgeons.
Fellowship training: The following fellows have been trained in head and neck oncology by our department in recent years:
Dr. Khalid Al-Sebeih (Kuwait)
Dr. Fardin Eghtedari (Iran)
Dr. Udi Cinammon (Israel)
Dr. Mohammed Al-Garni (Saudi Arabia)
Dr. Ameen Al-Herabi (Saudi Arabia)
McGill-trained otolaryngology residents currently holding major external positions in head and neck oncology:
Dr. Danny Enepekides — Associate Director, Head and Neck Oncology, UC Davis, California. This is one of the premier programs in head and neck oncology/skull base surgery in the U.S.
Dr. Nader Sadeghi — Director, Head and Neck Oncology, National Cancer Institute, Washington, D.C.
Dr. Amine Haddad — Director, Head and Neck Surgery/Oncology, University of Beirut, Lebanon
Dr. Saleh Al-Dhahri — Director, Head and Neck Surgical Oncology, King Saud University, Riyadh, Saudi Arabia
Dr. Khalid Al-Sebeih — Director, Head and Neck/Maxillofacial surgery, University of Kuwait
Dr. Spiros Manolidis — Associate Director, Head and Neck/Skull Base Surgery, Columbia University, New York, NY
Research
Current clinical trials:
Phase III randomized clinical trial of Radiotherapy and Cisplatin with or without Tirapazamine in patients with stage III and IV squamous cell cancer of the Head and Neck
Phase II randomized trial of Surgery and post-operative Cituximab and Radiotherapy with concomitant chemotherapy in patients with high-risk squamous cell cancer of the Head and Neck
Salivary gland transfer for patients receiving post-operative adjuvant radiotherapy for Head and Neck cancer (National multi-institutional clinical trial, Cross Cancer Institute, Alberta)
Correlative studies of growth factor receptors expression in biopsy specimens from patients with squamous cell carcinoma of the oral cavity and its importance as a pathological prognostic factor.
Electroporation therapy (Multi-national clinical trial, Genetronics)
Intra-operative PTH monitoring for parathyroid surgery
Studies related to evaluation of monitoring for same day discharge of post thyroidectomy patients
Basic research projects in head and neck oncology and related fields
Anatomic study of the transverse cervical artery: suitability in microsurgical head and neck reconstruction
Dr. Beth Mizerny, Supervisors: Drs. L. Lessard & M. J. Black
A murine model for the immunotherapy of head and neck squamous cell carcinoma
Dr. Michael Hier, Supervisors: Drs. M. J. Black & S. Karp
Generation of cytotoxic T-lymphocytes of antigen specific properties for murine oral squamous carcinoma
Dr. Nader Sadeghi, Supervisors: Drs. M. J. Black & S. Karp
Prospective determination of markers which predict for cisplantinum resistance in squamous cell Carcinoma in the upper aerodigestive tract
Dr. Alden Pearl, Supervisors: Drs. L. Panasci & M. J. Black
Identification of genes regulated by cis-retinoid acid in squamous cell carcinoma
Dr. Hilel Swerdlin, Supervisors: Drs. J. White & M. J. Black
The independent and combined effects of RAR-, RXR-, VDR-selective ligands on the growth of squamous cell carcinoma in vitro
Dr. Danny Enepekides, Supervisors: Drs. J. White & M. J. Black
Skin metastases in squamous cell carcinoma of the head and neck
Dr. Adi Yoskovitch, Supervisor: Dr. M. Black
New modalities to measure the subglottic lumen
Dr. Chantal Giguère, Supervisors: Drs. J. J. Manoukian, Y. Patenaude, K. L. Watkin and C. Bernard
In-vivo growth inhibition of murine SCCA cell line by vitamin D analogue EB1089
Dr. José Prudencio, Supervisors: Drs. J. White, M. Black
HPV analysis in Schneiderian papillomas
Dr. Adi Yoskovitch, Supervisors: Drs. S. Frenkiel, E. Franco
Early endoscopic percutaneous tracheostomy vs. prolonged endotracheal intubation in ICU patients.
Dr. Paolo Campisi, Supervisor: Dr. K. Kost
Expression of bone morphogenetic proteins during rabbit mandible distraction osteogenesis
Dr. Paolo Campisi, Supervisors: Drs. L. Lessard, R. C. Hamdy, M. D. Schloss
Endoscopic medial maxillectomy for inverting papilloma: Technique and indications
Dr. Saleh Al-Dhahri Supervisor: Dr. N. Sadeghi
Ultrasound and video-bronchoscopy to assess the subglottic diameter in the pediatric population: A first look
Dr. Murad Husein, Supervisors: Drs. J. J. Manoukian, R. Platt, Y. Patenaude
Minimally invasive parathyroid surgery: PTH assay confirmation of parathyroid adenoma excision
Dr. Kristina Zakhary, Supervisors: Drs. M. J. Black, M. Hier
The effect of BMP-7 on distraction osteogenesis of the rabbit mandible
Dr. Kristina Zakhary, Supervisors: Drs. Lessard and Schloss
Post-operative parathyroid hormone level as a predictor of post-thyroidectomy hypocalcemia
Dr. Richard Payne, Supervisors: Drs. Hier, Black, Tamilia, and MacNamara
Studies on upper airway dysfunction and sensory impairment in obstructive sleep apnea: immunohistochemical identification of cytokines and clinical applications
Dr. Richard Payne, Supervisors: Drs. Frenkiel, Hier, Kost, Black, and Kimoff
Detection of human papilloma virus in primary site of oral/oropharyngeal cancer and in lymph node: Correlation with clinics and pathological parameters and prognostic significance
Dr. Khalid Al-Qahtani, Supervisors: Drs. Kost, Hamid, Domanowski, Hier,Black, and Franco
Orthotopic transplantation of human oral squamous cell carcinoma with serum screening for novel proteins
Dr. Richard Balys, Supervisors: Drs. Aloui-Jamali, Hier, and Black
Publications — 2001-2004 (Selected publications from the McGill Department of Otolarygnology related to head and neck oncology and related fields).
Black MJ: (Prudencio J*, Akutsu N, Wong T, Bastien Y, Lin R, Black MJ, Alaoui-Jamali M, and White JH) Action of low calcemic 1,25-dihydroxyvitamin D3 analog EB1089 in head and neck squamous cell carcinoma. J. Nat. Cancer Inst. 93:10:745-753, 2001.
Black MJ (Akutsu, N, Lin R, Bastien Y, Bestawros A, Enepekides DJ*, Black, M.J. and White JH) Regulation of gene expression by 1?,25-dihydroxyvitamin D3 and its analog EB1089 under growth inhibitory conditions in squamous carcinoma cells. Molecular Endocrinology 15:1127-1139, 2001.
Dufour JJ (Browning S, Mohr G, Dufour JJ, Rappaport JM, Zeitouni A, Provencal C, Hernandes Y, Surkis S, Druker S, Davis NL.) Hearing preservation in acoustic neuroma surgery. J Otolaryngol 30:307-315, 2001.
Frenkiel S (Yoskovitch A*, Frenkiel S, Franco E, Coutlée F, Nachtigal D*, Rochon L.) Analysis of human papillomavirus in Scheiderian papillomas as compared to chronic sinusitis and normal nasal mucosa. J Otolaryngol, 2001:30(3): 167-172.
Frenkiel S (Campisi P*, Frenkiel S, Glikstein R, Mohr G.) Unilateral sixth nerve palsy caused by skull base mass lesions: Case series. J Otolaryngol, 2001:30(3):184-186.
Hier MP (Yoskovitch A*, Hier MP, Okrainec A, Black MJ, Rochon L) Skin metastasis in squamous cell carcinoma of the head and neck. Otolaryngol Head and Neck Surg 2001: 124:248-252.
Hier MP (Al-Dhahri S*, Al-Sebeih K*, Hier MP, Black MJ) An aggressive approach to the surgical management of suspicious thyroid nodules. J Otolaryngol 2001:30:4:203-207.
Kost K. Percutaneous treacheostomy: the optimum technique, International J of Critical Care 8(2)282-88, 2001.
Manoukian JJ (Sobol SE*, Manoukian JJ) Acute airway obstruction from a laryngeal lymphangioma in a child. Int J Pediatr Otorhinolaryngol 58(3): 255-257, 2001.
Manoukian JJ (Campisi P*, Manoukian JJ, Bernard C) Hyalinizing travecular adenoma versus papillary thyroid carcinoma in a child. Int J Pediatr Otorhinolaryngol 60(2): 173-177, 2001.
Sweet R (Haben MC*, Campisi P*, Sweet R) Sequential parapharyngeal abscesses. International J of Ped Otorhinolaryngol 57:255-258, 2001.
Tewfik TL (Yoskovitch A*, Tewfik TL, Duffy C, Moroz B) Common presenting head and neck symptoms of Kawasaki Disease. Otolaryngology-Head and Neck Select 1:9, 1-2, 2001.
Zeitouni A (Al-Sebeih K*, Al-Dhahri S, Zeitouni AG, Moola F, Leblanc R, Lessard L) Skull Base Meningiomas: delayed extra cranial presentation. Skull Base. An interdisciplinary approach. 11(2):105-108, 2001.
Kost K. Expert Guide to Head and Neck Masses (Chapter 20) Calhoun KH (editor) American Academy of Otolaryngology H&N Surgery Foundation, Versa Press pp:383-428, 2001.
Tewfik TL (Tewfik TL, Karsan N, Lessard ML) Congenital malformations, mouth and pharynx. In: Arlen Meyers (ed), Emedicine Textbook of Otolaryngology and Facial Plastic Surgery, (http:///www.emedicine.com) - August 2001.
Tewfik TL (Tewfik TL, Yoskovitch A) Congenital malformations, neck. In: Arlen Meyers (ed), Emedicine Textbook of Otolaryngology and Facial Plastic Surgery, (http:///www.emedicine.com) - August 2001.
Hier MP (*Hussein M, Hier MP, *Abdulhadi K, Black MJ.) Predicting calcium status post-thyroidectomy with early calcium levels. Otolaryngol Head Neck Surg 127:4:289-93, 2002.
Manoukian JJ (Amar YG, Nguyen LH, Manoukian JJ, Nguyen VH, O’Gorman A, Shapiro R) Granular cell tumor of the trachea in a child. Int J Pediatr Otorhinolaryngol 62(1):75-80, 2002.
Manoukian JJ (*Hussein M, Manoukian JJ, Platt R, Patenaude Y, Drouin S, Giguere C.) Ultrasonography and videobronchoscopy to assess the subglottic diameter in the pediatric population: A first look. J Otolaryngol 31(4):220-226, 2002.
Samaha M (Samaha M, Metson R.) Image-guided Resection of Fibro-osseous Lesions of the Skull Base. American Journal of Rhinology. 17 :115-118, 2003.
Tewfik TL (Liberman M, Kay S, Emil S, Flageole H, Nguyen LT, Tewfik TL. Oudjhane K. Laberge JM.) Ten years of experience with third and fourth branchial remnants. [Article] Journal of Pediatric Surgery. 37(5):685-690, 2002.
Zeitouni AG (Nader R., *Al-Abdulhadi K., Zeitouni AG) Acoustic neuroma Outcomes 31(4) 207-210, 2002.
Tewfik TL (Tewfik TL, *Sobol SE) Congenital Anomalies of the Larynx. In: John Rubin, Robert T. Sataloff, and Gwen Corovin (Eds.) Diagnosis and Treatment of Voice Disorders, 2nd edition. Singular Publications Inc., New York, 2002, pp 322-344
Black MJ (Nguyen HP, Black MJ, Hier MP, Chauvin P, Rochon L) HER2/neu and Ki-67 as prognostic indicators in mucoepidermoid carcinoma of salivary glands. J Otolaryngol 32:5:328-331, 2003.
Daniel SJ (Daniel SJ, Al-Sebeih K, Al-Ghamdi SA, Manoukian JJ.) Surgical management of nonmalignant parotid masses in the pediatric population: The Montreal Children’s Hospital Experience. J Otolaryngol 32(1) 2003.
Hier MP (Payne RJ, Hier MP, Tamilia M, Young J, MacNamara E, Black MJ) Postoperative parathyroid hormone level as a predictor of post-thyroidectomy hypocalcemia. J Otolaryngol 32:6:362-367, 2003.
Hier MP (Nyquist G, Hagr A, Sobol SE, Hier MP, Black MJ) Octreotide in the medical management of chyle fistula. J Otolaryngol H&NS 128;6:910-911, 2003.
Samaha M (Samaha M, Metson R) Image-guided resection of fibro-osseous lesions of the skull base. Amer J of Rhinol 17:115-118, 2003.
Zeitouni A (Souaid JP, Nguyen VH, Zeitouni AG, Manoukian J) Intraparotid facial nerve solitary plexiform neurofibroma: A first pediatric case report. Pediatric Otol 67(10:1113-1115, 2003.
Tewfik TL, Karsan, Laberge JM: Congenital malformations, esophagus. In: Arlen Meyers (ed), Emedicine Textbook of Otolaryngology an Facial Plastic Surgery, March 2003 v. 4, no. 3 (http:///www.emedicine.com)
Black MJ (Allison PJ, Nicolau B, Edgar L, Archer J, Black MJ, Hier MP.) Teaching head and neck cancer patients coping strategies: results of a feasibility study. Oral Oncology 2004:40:538-544.
Daniel SJ (Rotenberg BW, Daniel SJ, Nish IA, Ngan BY, Forte V.) Myxomatous lesions of the maxilla in children: a case series and review of management. Int J Pediatr Otorhinolaryngol. 2004 Oct;68(10):1251-1256.
Daniel SJ (Lin V, Daniel S, Forte V.) Is a plexiform neurofibroma pathognomonic of neurofibromatosis type I? Laryngoscope. 2004 Aug;114(8):1410-4.
Hier MP (Mouadeb D, Campisi P, Rochon L, Hier MP, Black, MJ.) Tongue necrosis, temporal arteritis, and esophageal carcinoma: Is there a connection? J Otolaryngol 2004:33:1:50-52.
Hier M (Gornitsky M, Shenouda G, Sultanem K, Katz H, Hier M, Black M, Velly A.) Double-blind randomised, placebo-controlled study of pilocarpine to salvage salivary gland function during radiotherapy of patients with head and neck cancer. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology 2004:98:1:45-52.
Kost KM (Payne RJ, Kost KM, Frenkiel S, Hernandez L, Naor N, Kimoff RJ.) Upper airway sensation and laryngopharyngeal reflux in obstructive sleep apnea, Am J of Resp & Critical Care Med, 2004: 169 supplement 7).
Kost KM (Payne RJ, Kost KM, Frenkiel S, Hernandez L, Naor N, Kimoff RJ.) Upper airway sensation and laryngopharyngeal reflux in obstructive sleep apnea, Am J of Resp & Critical Care Med, 2004: 169 supplement 7).
Manoukian JJ (Al-Abdulhadi K, Burezq H, Nguyen VH, Bernard C, Manoukian JJ) Extensive tongue hemangiopericytoma in a child: Modified combined modality of treatment to preserve well functioning tongue. Int J Pediatr Otorhinolaryngol 68(2): 211-219, 2004.
Manoukian JJ (Amar YG, Manoukian JJ) Intraoral drainage: recommended as the initial approach for the treatment of parapharyngeal abscesses. Otolaryngol Head Neck Surg 130(6): 676-680, 2004.
Manoukian JJ (Al-Sabah B, Bin Salleen H, Hagr A, Choi-Rosen J, Manoukian JJ, Tewfik TL) Retropharyngeal abscess in children: 10-year study. J Otolaryngol 33(6): 352-355, 2004.
Zeitouni AG (Brousseau VJ, Zeitouni AG, Zakhary K, Leblanc R.) Pneumocephalus secondary to a posterior fossa epidermoid tumor. Otolaryngol Head Neck Surg. 2004 Mar;130(3):386-7.
Departmental presentations
The head and neck oncology service frequently presents scientific work at national and international meetings. It has received a numerous honors and awards.
Listed below is one example of the academic presence of the McGill Department of Otolaryngology at the Annual Scientific Meeting of the Canadian Society of Otolaryngology - Head and Neck Surgery, Quebec City, 2004. The McGill Department of Otolaryngology was the most represented Canadian university department at this convention.
High prevalence of obstructive sleep apnea among patients with head and neck cancer (Payne R, Hier M, Black M, Kost K, Zeitouni A., Frenkiel S, Naor N, Kimoff, R.)
Workshop of laryngopharyngeal reflux - Chair, Dr K. Kost
Age as a prognostic factor in squamous cell carcinoma of the head and neck (Cinnamon U, Hier M, Black M)
Endoscopic management of sinonasal neoplasms (Panelist: S. Frenkiel)
Percutaneous vs. open tracheotomy in the intensive care unit (Young Y, Payne R, Tewfik T, Kost K)
Post-operative parathyroid hormone levels in conjunction with corrected calcium values as a predictor of post-thyroidectomy hypocalcemia (Payne R, Hier M. Tamilia M. Black MJ)
Workshop on recent advances in the management of head and neck oncologic problems for the practicing otolaryngologist (Freeman J, Gullane P, Kerr P, Yoo J, Black M)
Head & Neck Surgery session - Chair, Dr Michael Hier
A giant cystic parapharyngeal space tumor (Abou-Chacra Z, Baig K, Al-Dhahri S, Zeitouni AG)
Supraglottic edema and vocal cord paralysis following NG tube placement (Brousseau V, Hagr, Kost K)
A prospective investigation of nutritional status in oropharyngeal cancer patients (Jia H, Allison P, Morais J, Golfman J, Hier M, Black M)
The life course approach to studying the etiology of head and neck cancer (Nicolau BF, Allison PJ, Archer J, Kowalski LP, Hier M, Black M, Franco E)
Coping with head and neck cancer: Results of a feasibility study comparing test and control groups (Vilel L, Allison P, Nicolau B, Archer J, Hier M, Black M, Edgar L)
SUMMARY
The McGill Department of Otolaryngology provides an excellent service to the population of Quebec in the area of head and neck oncology.
The quality of clinical service is of the highest standard, it uses a multidisciplinary approach, and there are modern infrastructure resources available.
The contribution of head and neck oncology at the JGH as a McGill RUIS institution should be recognized.
The academic component with respect to education and research is of world-class caliber and is of utmost importance to McGill University.
Respectfully submitted,
Saul Frenkiel, MD, FRCSC
Chairman, Department of Otolaryngology
McGill University
Chief, MUHC and JGH
November 2, 2005