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ASPO NEWSLETTERPresident’s ReportMarci Lesperance, MD

For the 3rd time in as many weeks, our neighborhood lost power for over 24 hours. Putting aside the question of WHY this occurs so frequently in a city like Ann Arbor, where all of our services are above average—I was struck by how quiet and dark my neighborhood was. It appeared deserted, even though there were probably a lot of people at home, maneuvering around by flashlight or candlelight, and reading on their IPads until their batteries ran out. “Lights off, somebody’s home.”

Sometimes, organizations may seem like a house without electricity. They exist, but what are they doing? What difference do they make? Do they have more officers than accomplishments?

I am happy to say that ASPO is a thriving and brightly lit enterprise, powered by the engagement, commitment, and expertise of its members. I am proud to serve as your ASPO President as we prepare for our 30th anniversary meeting in 2015 in Boston. At this year’s meeting, ASPO reached the milestone of over 500 members – impressive growth since the inaugural meeting in 1985. We would like the many graduates of pediatric otolaryngology fellowships who have not yet joined ASPO to consider joining this year-the application process is now completely electronic, thanks to the efforts of Membership Chair Jim Thomsen and our administrator, Bernadette Trubatisky. (Continued on next page.)

Officers & CommitteesPRESIDENT Marci Lesperance, MDPRESIDENT ELECT Kenny Chan, MDSECRETARY Anna Messner, MDTREASURER Bruce Maddern, MDDIRECTORS AT LARGE David White, MD Ron Mitchell, MD Chris Hartnick, MDBY LAWS: Joe Kerschner, MDAD HOC YOUNG MEMBERS Bob Chun, MDAD HOC AWARDS Judith Lieu, MDAUDIT Udayan Shah, MDBOARD OF GOVERNORS Udayan Shah, MDDEVELOPMENT Sanjay Parikh, MDEDUCATION/CURRICULUM Kenny Chan, MDFELLOWSHIP Chris Hartnick, MDFINANCE Ron Mitchell, MDINFORMATION/TECHNOLOGY David White, MDLONG RANGE PLANNING Daniela Carvalho, MDMEMBERSHIP/CREDENTIALS James Thomsen, MDNOMINATING Bob Ward, MDPATIENT SAFETY & QUALITY Rahul Shah, MDPROGRAM Nira Goldstein, MDRESEARCH Alan Cheng, MDNEWSLETTER EDITOR Samantha Anne, MD

Newsletter Table of Contents

Pages 1-4 ! ! Board member reports

Pages 5-9! ! ! Committee reports

Pages 10-11! ! Research committee & Grant awardees

Pages 12-13! ! Perspectives

Pages 14-15! ! Fellow highlights

Pages 16-20! ! Announcements

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ASPO NEWSLETTERPRESIDENT’S REPORT CONTINUED..

Our website serves as the front door and the windows by which the public sees signs of activity. David White as IT Chair oversaw a major redesign of the ASPO website, launched around the time of the annual meeting. The Education Committee, chaired by President-elect Kenny Chan, is considering topics to educate public on pediatric otolaryngological disorders. The Young Members Committee will be reviewing and updating our mission statement.

Now stepping inside the house--in recent years, ASPO leadership has also taken steps to engage members and provide transparency. The board actions and decisions are listed in the newsletter. Our Bylaws are posted on the website in the password-protected area. (Do all the organizations you belong to follow a set of bylaws that are accessible to all members?) This year, the majority of new committee members were drawn from applications solicited from an open process. (Hint—we need people to apply to IT, Development, Finance, and Young Members—not just the Education Committee and Quality and Safety Committee.) Nominations were solicited for the Nominating Committee ahead of time, instead of at the Business Meeting, allowing more time for thoughtful consideration, preparation of a statement, and confirmation of willingness to serve.

The Young Members Committee is an ad hoc committee started by Joe Kerschner 2 years ago. The Bylaws Committee is drafting a bylaws change to make this a permanent committee. It has proven to be a great way to engage our young members and tap into their energy and talent.

It has been several years since ASPO examined the workforce needs of pediatric

otolaryngology. In the next 1-2 years, an Ad Hoc Workforce Committee, chaired by George Zalzal, will collect data on the projected manpower needs and the projected number of graduates from pediatric otolaryngology fellowship programs.

I have also formed an Ad Hoc Awards Committee which is charged with creating a new type of award for pediatric otolaryngology fellows. Our fellows are conducting impressive research and other types of scholarly work, but it is difficult to prepare that work for submission after only 3-4 months of fellowship, and to showcase that work in only 250 words. The committee will work on a process to accept and review manuscripts (<10 pages) with a tentative deadline of January 1.

Having been involved in ASPO for several years, the view from the President’s seat is still quite impressive. Being ASPO President is like being at Center Court at Wimbledon watching a lot of balls in the air, and trying to watch all the games at once. If the action starts going out of bounds, I am happy to get involved and get the ball back in play. (Being ASPO Secretary was rewarding in a different way—it was more like being shown a grassy field and being asked to pave a tennis court!)

Many of you may have seen the discussion of the AAO-HNS member portal called ENTConnect regarding pediatric subcertification. A rugby match or perhaps rollerball might be a more apt sports analogy than tennis in this case….The ASPO view point has been well-articulated by Rich Rosenfeld and Joe Kerschner over the past 6 years, in venues such as the Board of Governors Assembly, previous ASPO newsletters, and other articles. I encourage you to read the thoughtful response posted by Rich

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ASPO NEWSLETTERPRESIDENT’S REPORT CONTINUED

Waguespack, President of AAO-HNS, and co-authored by Peter Abramson, the Chair of the BOG, as well as the white paper on the ABOto website (see related article on subcertification). These issues have been discussed for many years at the Pediatric Otolaryngology Panleadership meeting, which occurs twice a year with our otolaryngology neighbors.

Thank you again for the privilege of serving as your President, and I hope to hear from you—we want to hear about corrections to the directory and typos on the website--but also to hear your ideas for enhancing the value of your ASPO membership!

With warm regards,

Marci Lesperance

UPDATE ON SUBCERTIFICATION

Marci Lesperance, MD & Richard Rosenfeld, MD

Discussion forum on Subcertification in Advanced Pediatric Otolaryngology (APO) 5:00-6:00pm on Saturday, September 20, 2014, Hyatt Regency

In spring 2013, the ASPO Board sent a letter to the American Board of Otolaryngology (ABOto), requesting that ABOto consider development of subcertification in Advanced Pediatric Otolaryngology (APO). The ABOto Board of Directors has discussed this issue extensively with many stakeholders, and now seeks input from all diplomates. A survey is now available on the ABOto website (www.aboto.org) In addition, the ABOto has produced a white

paper on APO which is available on the ABOto website that provides background information and a summary of meetings on APO. Dr. Joe Kerschner and Dr. Rich Rosenfeld represented ASPO at these meetings. ABOto has determined that subcertification would benefit the public, would be important to do, and is feasible. The exact process and indeed even the name of a potential subcertification remain to be determined. The survey feedback will be used to assist the ABOto in its continued deliberations on subcertification in advanced pediatric otolaryngology. Dr. Rich Rosenfeld will be hosting an open forum for ASPO members to discuss subcertification. This will be held from 5:00pm-6:00pm on Saturday, September 20, 2014, in Orlando, Florida, at Hyatt Regency Columbia 35 meeting room prior to the AAO-HNS Annual Meeting.

American Society of Pediatric Otolaryngology (ASPO) exists to foster excellence in the care of children with otolaryngologic disorders

through education and research and thereby enhance the profession of Pediatric Otolaryngology

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Several of you approached me during the ASPO Meeting in Las Vegas about your wishes to contribute to the Society. I am following the lead of President Lesperance in asking the Young Members Committee to nominate potential committee members to the President-Elect in order to fill the many vacancies for the following year. All ASPO committees with the exception of the Audit Committee have one or more vacancies for 2015. The past cycle suggests that the odds of serving on the IT, Finance, Audit & Development Committees are much higher. For the ASPO members (voting members only) that are interested in serving in this capacity, please use the soon-to-be updated form in the ASPO website (under Committees tab and Opportunities option to find the new link) to send the completed form to Dr. Robert Chun (rchun@mcw.edu) no later than February 6, 2015. Dr. Kenny Chan & Dr. Robert Yellon ASPO Vegas, 2014

SECRETARY’S REPORTAnna Messner, MDPlease be sure to review your profile in the online Membership Directory, where you can confirm your membership type, update your contact information as well as a photo.

PRESIDENT-ELECT REPORTKenny Chan, MD

Item # of action

Motion/Action Item Result Responsible party

ITEM A MOTION: Ratification of electronic votes and approval of minutes

Approved (8-0)

ITEM #5 ACTION: Membership campaign to update/correct the directory

No vote Secretary, Bernadette

ITEM #5 ACTION: Dues collection campaign No vote Treasurer, Bernadette

ITEM #9 ACTION: Review investment policy and present updated policy for Board approval in Fall 2014

No vote Finance Committee

ITEM #11

ACTION: Update each committee area of website

No vote IT Committees, all Committee

chairsITEM #12

ACTION: Submit recommendations for CORE grant funding for Board consideration and approval

No vote Research Committee,

BOD

ITEM #13

ACTION: Develop new certificates for ASPO members

No vote Membership Committee

Summary of Decisions and actions, Spring 2014 Board meeting:

COSM and ASPO Future meetings:

COSM, April 22-26, 2015 Sheraton Boston, Boston, MA

COSM, May 18-22, 2016Hyatt Regency Chicago, Chicago,

Illinois

COSM, April 26-30, 2017Manchester Grand Hyatt, San

Diego, CA

ASPO Breakout Meeting 2017 May 18-21, 2017

Austin, Texas

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PROGRAM UPDATE

Nira A. Goldstein, MD, MPH, Chair After an outstanding meeting in Las Vegas thanks to the hard work of Program Chair Dr. Paul Krakovitz, Past President Dr. Bob Ward, ACS/ASPO Administrator Bernadette Trubatisky and the 2014 Program Committee, it is time to look toward 2015. The 2015 Annual Meeting (our 30th Anniversary Meeting!) will be held April 24-26 at Hynes Convention Center & Sheraton Boston in Boston, MA. The Kerschner lecture will be given by Dr. Mary Sue Coleman, the current President of the University of Michigan and the Bluestone lecture will be given by Paul Sieving, MD, PhD, Director of the National Eye Institute of the NIH. The Storz lecturer will be Dr. Donald Taylor, a pediatric anesthesiologist and president of ‘Wake-Up Safe,’ a patient safety organization. We are looking forward to outstanding Mini -Seminars /Panels , Podium and Pos ter presentations. Thanks to all who have submitted Mini-Seminar applications. Notification to those selected will be made in early October. Important Dates to remember:-Call for Abstracts:Submission Opens: 8/1/2014 Submission Closes: 10/27/2014, 11:59PM, PDTSubmission Site:www.aspoabstracts.org or link on the ASPO website-Meeting Registration Info available in 12/2014Housing Registration reservation site: https://w w w . s t a r w o o d m e e t i n g . c o m / B o o k /COSMSpringmeetingDeadline for Meeting Rate March 26, 2015Looking forward to seeing you in Boston!

AD HOC YOUNG MEMBERS

Robert Chun, MD, Chair The ad hoc Young Members Committee was organized two years ago with a primary objective to serve as a platform for young members (<10 years in our society) to become involved early in ASPO. Over the last 2 years under Gresham Richter’s leadership, the committee surveyed its young members to assess what their primary needs and concerns were as young members. The survey indicated that they wanted to become more engaged in ASPO and seek mentorship. From this an application of interest (AOI) for the ASPO committees became available as well as a link to senior mentors in areas of academic and research interests.

This year our committee will continue to collect AOI, reviews applications, and present the president elect, Dr Kenny Chan, with nominees for posted committee vacancies. This will allow all members an opportunity to apply to committees that they have an active interest in participating. For the ASPO members (voting members only) that are interested in serving in this capacity, please use the ASPO website (under opportunities and then the committees tab, where there is a link for application of interest) or send email of interest form to me at rchun@mcw.edu, no later than February 6, 2015.

Another goal for this year is improve the mentorship program. The need of the mentorship program was based on young ASPO members who sought senior member guidance in areas of administration, leadership, education, and research. On ASPO website under the education tab, members can search “ASPO members” and there is a listing of volunteer mentors in each field with Email contact.

Our committee would like to serve as an open venue for young members to share their thoughts and ideas for our society. Please feel free to contact anyone in the YMC at your convenience with your ideas.

Dr. Paul Krakovitz, Dr. Nira Goldstein, & Dr. Bob Ward ASPO Vegas 2014

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MEMBERSHIP COMMITTEE

Jim Thomsen, MD, Chair The membership committee is gearing up for another busy year. We have made a few changes in the application process in that we have changed the period to apply from June 30th to December 15th. This allows almost 6 months for applicants to go online and submit their materials. In addition as means of clarification those ASPO members who have joined as fellow members need to be aware that their fellow membership ends after three years and they must then apply for full membership. There is no automatic transition to full membership from fellow membership as the criteria for full membership are more advanced. We are grateful as always for the assistance we have received from American College of surgeons and in fact their representative Bernadette Trubatisky btrubatisky@facs.org is the first point of contact for membership related inquiries. The committee and I remain available as well for any additional questions or if guidance is needed with the application.

FINANCE COMMITTEERon Mitche", MD, Chair The finance committee has worked closely with the Treasurer, President and Board of Directors to transfer assets form UBS to Oppenheimer. This was completed on June 30, 2014. The finances of the society are strong and we have a clear strategy moving forward. We have confidence in our new financial advisors and feel the future needs of ASPO are being met through the present investment portfolios. I would like to thank Kay Chang, the previous Chair of the finance committee, on working closely with the committee and facilitating transition to Oppenheimer.

LONG RANGE STRATEGIC PLANNING

Daniela Carvalho, MD, Chair The LRSP has just sent out a survey to our recent pediatric otolaryngology fellow graduates. We are trying to find out how can ASPO best serve our young members as well as gather some information about their experience with the fellowship and how that impacted their career. Keep tuned for the results of this survey soon!

We are now in the 4th year of the ASPO Mini-Mentoring program. This program was started in the fall of 2010 and continues to help increase the number of residents who are exposed to an active, tertiary care Pediatric Otolaryngology practice and educate more ENT residents about the wide range of complex care that is provided by Pediatric Otolaryngologists. We encourage all ASPO members to reach out to residents and residency programs that would likely benefit from the Mini-Mentorship.

The ASPO database for international observers has been up and running and has provided essential information for foreign physicians to be exposed to Pediatric Otolaryngology centers in the US. Please contact me if there were any changes to your institution’s information in the database.

As always, if you have any ideas or suggestions for the LRSP committee, please contact us at dcarvalho@rchsd.org.

Dr. Anita Jeyakumar &

Dr.Stacey Ishman, ASPO Vegas, 2014

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GUIDELINE DEVELOPMENT TASKFORCE OF AAO-HNS

David Tunkel, MD, ASPO Representative The AAOHNS Guideline Taskforce continues to develop clinical practice guidelines and consensus statements and encourages topic submissions from individuals and societies. Please consider possible areas in pediatric otolaryngology that would benefit from guideline development, and contact me at dtunkel@jhmi.edu so I can assist with the process.

INFORMATION/TECHNOLOGY COMMITTEEDavid White, MD, Chair The IT committee has implemented several changes over the last year. Most visibly, the ASPO website has been updated in both style and content. The previous site served multiple functions for years but had become antiquated. ASPO contracted with a private website designer to assist with the site update. Numerous improvements have occurred in overall functionality with the implementation of these sites including functionality on phone/tablet based platforms, a searchable directory, improved electronic access to meeting information, and the ability to update member profiles and pay dues online. At present, along with Bernadette Trubatisky from ACS, we manage the gateway and public site http://aspo.us/ and the member site http://www.aspo.wildapricot.org/.

Additional steps over the last year include:

• IT committee members have been assigned as liaisons to each committee within ASPO to assist with website information management.

• Page-by-page review of the website is ongoing to maintain functionality.

• Automated web-based applications for posting job

openings, committee applications and ASPO fellowship applications, and other programs have been implemented to increase efficiency of application process.

WEBINAR SERIES

Kenny Chan, MD Earn CME Credits through 2014 Pediatric Otolaryngology Webinar series

ASPO in collaboration with the American Academy of Otolaryngology – Head & Neck Surgery Foundation successfully completed the 2013 Pediatric Otolaryngology Continuing Education Webinar Series recently. We would like you to consider registering for the 2014 series (www.aspo-cme.us).

The purpose of this CME activity is to provide pertinent pediatric otolaryngologic topics relevant to the practicing otolaryngologist addressed by an expert faculty using a robust webinar format. The learning objectives clearly spell out a systematic learning methodology based on evidence-based medicine. A maximum of 10.0 AMA PRA Category 1 Credit(s)TM can be obtained through this webinar series.

This CME product is packaged so that the registrant can enter the series at anytime during the cycle of the series after registration. It has been discounted for AAO-HNS members to $695 and further discounted if you are also an active ASPO member to $550. Non-member tuition is $850. Registration details are available through the following website: www.aspo-cme.us

New since the launch of the 2014 series is an attempt to widen the audience base to attract physician assistants and nurse practitioners interested in pediatric otolaryngology. Their respective professional organizations will be advertising this product on behalf of ASPO and AAO-HNSF. A discounted registration fee will be offered.

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FELLOWSHIP COMMITTEEChris Hartnick, MD, ChairJames W. Schroeder, Jr., MD, FACS, FAAPCarol J. MacArthur, MDSurvey of Pediatric Otolaryngology Program Directors – Preliminary Results

The ASPO Fellowship committee was asked to survey the current Pediatric Otolaryngology Fellowship programs regarding their educational structure, attitudes pertaining to ACGME accreditation and their plans for growth. We emailed surveys the program directors, program coordinators and Department Heads for all the 36 programs registered with SF match.

We have preliminary results from the 20 program directors who have responded so far. 55% of the programs are ACGME accredited. Of the programs that are accredited 47% indicate that accreditation has been helpful by improving the structure and quality of the didactic program, increasing accountability and standardization of the curriculum and by improving the national recognition of the program. The remaining accredited programs are either indifferent to ACGME accreditation or consider the administrative burden, cost of program administration and excessive regulation as harmful to their program. The programs that are not currently accredited site the lack of a relationship with a core res idency program and the f inanc ia l and administrative burdens as the most common reason for not seeking ACGME accreditation. 3 of the nine programs who are not currently accredited are in the process of becoming accredited. 40% of program directors (both ACGME accredited and not) are provided with protected, compensated time to administer the fellowship program. This ranges from 0.1 to 0.2 FTE. 75% of programs receive financial support for the training program from a sponsoring hospital with a small percentage receiving financial support from the university or the department of otolaryngology.

It was clear from the survey that all programs would like more help from ASPO when it comes to administration and development of their pediatric otolaryngology fellowship programs. Assistance was most commonly reques ted for cur r icu lum development, milestone evaluation methodology, didactic session and reading syllabus creation. Most programs have 1 or 2 fellows per year of training. 25% of the current fellowship programs plan to increase their complement in the near future.

We are still collecting data and the final analysis is not complete. However, the survey provides useful information to the ASPO leadership and may help to guide future initiatives with respect to how we train the future leaders in our field.

DEVELOPMENT COMMITTEESanjay Parikh, MD, Chair The ASPO Development Committee is a standing ASPO Committee which has the goal of increasing and sustaining the ASPO Endowment. This endowment, funded mostly by ASPO Members and some corporate support, has developed over 15 years as an extraordinary mechanism by which ASPO research, education, & special projects may be funded.

I am fortunate to have been asked by Marci Lesperance, our current ASPO President, to chair this committee with the goal of increasing our endowment while sharing thanks with ASPO Members who have contributed to the “Sustain the Future” campaign now starting its fourth of a five year cycle. Over the last 3 years, committee has raised >$250,000 in donations from membership of approximately 450 members.

Our committee is particularly grateful to recent ASPO Presidents Joe Kerschner, Richard Rosenfeld, and Bob Ward who have made the ASPO Endowment a priority. Our donations reflect the understanding of ASPO members and ASPO leadership that our endowment is critical to the

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success of our society and to the future of pediatric otolaryngology as a field.

I am very grateful to my committee members who will work with me this year on the development committee: Marci Bothwell, Newton Duncan, Lindhe Guarisco, Blake Papsin, Lawrence Simon, and Brian Wiatrak.

We will be calling on you this upcoming year to help us “Sustain the Future” and to share our thanks for your support!

PATIENT SAFETY AND QUALITY

Rahul Shah MD, ChairEmily Boss, MD

Otolaryngology in NSQIP Pediatric: Accomplishments and future directions

The American College of Surgeon’s National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric option is a nationwide risk-adjusted, clinical, outcomes-based platform aimed at measuring and improving quality and safety of pediatric surgical care. There are currently over 60 participating centers inclusive of all types of children’s surgical care settings. The program follows a close case sampling algorithm and evaluates a host of comorbidities and 30-day postoperative adverse events. Cases with extremely high volume such as tonsillectomy and tympanostomy tube insertion, or hernia repair in the general surgery population, are not included in NSQIP-P so as not to dilute collection of outcomes for higher morbidity procedures.

Many ASPO members have been actively participant in NSQIP-P on the institutional and national levels. As a subset of the ASPO Safety and Quality Committee, an ASPO taskforce has been developed to address pediatric otolaryngology-specific issues within

the NSQIP data platform. A call for increased national participation in this taskforce will follow soon, as energy surrounding quality improvement projects is vast ly increasing. Recent otolaryngology accomplishments have included an analysis of cases and events in the first 2 years of NSQIP-P data collection, dramatic revision of collected CPT codes with expansion to represent a more complete tertiary pediatric otolaryngology practice and elimination of codes with high volume and low morbidity, and preliminary development of a pediatric otolaryngology NSQIP-P pilot addressing procedure-specific outcomes related to tracheostomy and airway reconstruction.

Pediatric Otolaryngology initiated the first subspecialty pilot in July 2012 in an effort to study perioperative factors more relevant to our patients. The pilot was conducted in addition to standard case collection. In this pilot, participating centers collected information on 6 custom variables related to 4 procedural categories (tracheostomy, airway reconstruction, otologic procedures, neck abscesses). Data collection for this pilot ended July 31, 2014, and the taskforce will aim to summarize data across centers over coming months. The aim of the next pilot is to include more outcome variables specific to only a small number of CPT codes, as the outcomes chosen for this initial pilot may have been too specific and rare. Still, our subspecialty is congratulated for being the torchbearers of the pilot initiatives in NSQIP-P which will now be the foundation for adding procedure-specific variables permanently to the platform. General surgery followed suit with an appendectomy pilot (now closed), and orthopedic surgery has just launched their spinal fusion pilot.

Future challenges to ASPO are for our members to determine how NSQIP-P can truly drive quality improvement across institutions for our patients and not simply act as a data registry for high acuity surgical cases. Development and addition of meaningful outcomes in otolaryngology are critical steps which must ensue for this platform to be most effective.

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RESEARCH COMMITTEEAlan Cheng, MD, ChairThe research committee is pleased to congratulate the four grant awardees this year, Simon Best, MD, Emily Boss, MD, Robert Morrison, MD, and Graham Strub, MD, PhD. A total of four grants from three funding mechanisms were offered this year. Out of the 18 ASPO-related grants reviewed at the CORE study section in March 2014, these four grants were recommended for funding. Here is a brief synopsis on these outstanding projects and investigators. Simon Best, MD is an Assistant Professor at John Hopkins University School of Medicine. As a member of the Johns Hopkins Voice Center, he specializes in voice and airway disorders, while focusing his research on developing targeted immunologic strategies against the HPV infection that causes recurrent respiratory papillomatosis (RRP). Supported by the ASPO Dustin Micah Harper RRP grant, he will be evaluating the regulatory signals (PD1 and PD-L1 pathway) underlying RRP.

Also an Assistant Professor at Johns Hopkins University School of Medicine is Emily Boss, MD, who is a pediatric otolaryngology with a research interest in surgical outcomes and utilization, patient experience of care, and healthcare equity and quality. At Hopkins, she is a member of the Armstrong Institute for Patient Safety and Quality and the Center for Health Services and Outcomes Research. At the national level, she is a leader in surgical quality and outcomes evaluation for ASPO, the AAO-HNSF, and the ACS. In her ASPO Research Career Development Award, entitled “Shared Decision-Making and Outcomes in Pediatric SDB”, she will further evaluate these topics commonly encountered in our practice.

One of two ASPO Research grants has been awarded to Graham Strub, MD PhD, who is a third year otolaryngology resident at the University of Washington. Under the mentorship of Jonathan Perkins, DO, he aims to characterize the mechanisms by which

propanol induces regression of hemangioma by studying microRNAs.

The other ASPO Research grant has been awarded to Robert Morrison, MD from University of Michigan who will be studying “Computer-Aided Designed 3D-Printed Bioscaffold for Auricular Reconstruction” under guidance of Glenn Green, MD.

These awardees will be recognized for their achievements in the Research Awards Ceremony to take place during the upcoming AAO-HNSF Annual Conference in Orlando (Tuesday, September 23, 10:30-11:50 AM). Please join me to congratulate them!

The review and approval process of these grant applications required much efforts and time devoted by the CORE study section and the ASPO research committee members. I would like to acknowledge John Germiller, MD PhD, Nira Goldstein, MD, Steven Goudy, MD John Greinwald, MD, Judith Lieu, MD, Renee Park, MD MPH, Debra Weinberger, MD, Stephen Maturo, MD, Henry Ou, MD, Robert Reilly, MD, Emily Boss, MD, Albert Park, MD and the CORE staff members Stephanie Jones and Sarah O’Connor for their tremendous contribution. Special thanks to Albert Park, as the outgoing research committee chair, for his tireless work on this regard and also leadership on this committee.

For the next funding cycle in 2015, ASPO will again be offering 4 grants. The Dustin Micah Harper RRP Research Grant (one grant, up to $10,000 for 1 year), ASPO Career Development Research Grant (one grant, up to $40,000 for up to 2 years), and ASPO Research Grant (two grants, up to $20,000 for 1 year). The primary goal for these funding mechanisms is to promote research in pediatric otolaryngology. As the new chair of the research committee, I hope to help ASPO members (and their collaborators) to make this application process as seamless as possible. First, I would like to make you aware of a mentoring program the research committee has arranged. Past applicants who were paired up with ASPO members experienced in grant writing have found program highly beneficial.

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For applicants and ASPO members interested to serve as mentors, please feel free to contact me. For more information, please use the following link (http://www.entnet.org/CORE), which contains the most updated information pertaining eligibility, deadlines for letters of intent and applications, etc. If you have any other questions or suggestions, please let me know and I look forward to working with you!

Grant awardees 2014Simon Best, MD Emily Boss, MD Robert Morrison, MD Graham Strub, MD, PhD

INTERNATIONAL VISITING SCHOLAR AWARD

The international scholar award was presented to Dr.Manoj Nair at ASPO meeting in Las Vegas on May 18th, 2014. Dr. Nair is an Otolaryngologist with thirteen years of clinical experience from Kerala, India. After completing his Masters degree from Armed Forces Medical College, Pune, India in 2001, he joined the Kerala State Govt. Health Services as an Otolaryngologist.

He is currently the State Nodal Officer of National Program for Prevention and Control of Deafness(NPPCD) of the state of Kerala. His job is to provide technical guidance and expertise to the State Health Department for the implementation of the program which aims at prevention of avoidable hearing loss, early identification, diagnosis and treatment of health problems responsible for hearing loss, rehabilitation of persons with deafness, and development of institutional capacity by providing equipment support and personnel training.

Dr. Dana Thompson presenting the International Visiting Scholar Award to Dr.Manoj Nair

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PERSPECTIVES

Scott Manning MDRetirement (Boomers Going Down)

I was in clinic last week with our visiting medical student Suraj (my residents were off doing index cases presumably) when a patient’s mother remarked that their pediatrician Dr J, an old colleague, was retiring. Wow, I thought, I am hearing this story a lot lately. I turned to Suraj and said: “Boomers going down baby. You have no fear of job security. After a lot of talk, but not much retirement action, I think the pig in the python is finally moving to Palm Desert.” Suraj looked at me funny and replied: “I think there’s an effusion on the left.” But I was feeling the loss. As members of the same generation often do, Dr J and I would tease each other when we met occasionally at meetings. “Dr J, still working? I thought they replaced you with a computer algorithm a few years ago.” “Dr M, what are you’re plans for the weekend? A nap? “No, as a matter of fact, I’m thinking of climbing Mt Rainier. Again. But really I’m thinking: “Nap? Why would I not?” I will miss Dr J.

I am becoming obsessed. The thought of the uncertainty of the next phase brings on a strange mixture of fear and excitement. The first thing my old otolaryngology friends ask me about at meetings is my retirement plans. The second thing we talk about is who is out of the game voluntarily or due to illness or injury – or – yikes – death. Hey, weren’t we the young studs and studesses that invented pediatric otolaryngology just yesterday? And many of my non-MD friends and family have retired already or never had a job that seemed like work to begin with. Increasingly I don’t relate: it’s like talking to Martians. I do relate to my 20 year old car that my daughter derides because it does not have Blue Tooth. I’m leaking fluids a little but I pay attention to regular replacement. My check engine light comes on but I tighten my gas cap and it goes off again after a few days. There is plenty of space in the trunk. And I don’t need collision insurance.

Retirement. Yes, there are things that I would not miss. Getting up extra early to attend government mandated lectures on the importance of sleeping. Required talks from Byron, Dean of Empathy, on relating to Generation X with 65 affirmations per day per resident (“Erin, that tonsillectomy was good, good, good, good…”). The Dilbertization of my hospital administration (“At the end of the day, we’ll meet in the parking lot, to pick the low hanging fruit”). But who would I tell my stories to if I retired? My wife won’t let me finish 2 words of any potential diatribe. The curse and the joy of this job is that I get a new batch of trainees every few months. What would I do? Blog?

Later Suraj is telling me about a new patient work up which I empowered him to do while I search for any unbilled encounters on the computer. He is coming off a little flat and clinical. “Suraj, buddy, make it interesting. Tell me a story of this patient with this problem and what we are going to do to help. And please remember, this is a privilege not an obligation.” Suraj smiles. I feel affirmed for the moment. Retirement can wait a bit.

Lawrence M. Simon, MD, FAAPThe Importance of Advocacy

Dr. Gavin Setzen of New York may have put it best when he said, “Advocate or Abdicate.” These words have rarely rung so true as they do today, and rarely have they carried more significance for young physicians. For the reasons discussed below, it is incumbent upon young physicians to find the time to become involved in the political process, and not just for themselves, but for their patients as well. Advocacy is the process by which we with our lawmakers to help draft policy. It can be done as both an individual and as a group, and it can be accomplished through many different avenues such as advertisements, direct communication with a candidate, and contributions—either to a candidate directly or to a

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PERSPECTIVES CONTINUED.

Political Action Committee (PAC). The influence that a single, committed advocate can have on any particular issue is immeasurable, and as young doctors we should be among the most vocal and most involved physicians. We have much to gain and much to lose because, as we are just now beginning our careers, any change that occurs will affect us much longer than it will our more senior colleagues. Therefore, our involvement in the process is vital to ensure that decisions are made with the input of both those with the most experience and those whom the decisions will affect the longest. Another reason for young physicians to learn to become strong advocates is that, for better or worse, government involvement in health care is a reality that is not likely to change. Throughout the history of our country, the United States government has played a pivotal role in shaping the direction of the American health care system. For example, our current employer sponsored insurance system is primarily the result of two specific government regulations: the War Stabilization Act of 1942 and the tax credits codified in 1954. The government also directly provides healthcare for a large portion of the population through Medicare, Medicaid, and the Veterans Affairs system. Lastly, the Patient Protection and Affordable Care Act of 2010 has forever changed the way consumers and physicians interact with private health insurance agencies. As we are the people who best understand what is truly needed to practice our craft in a high quality, cost-efficient manner, we must be the drivers of health care reform. Without our input, the laws and regulations that will impact our daily lives for decades to come will be made in a vacuum, and the only avenue to successfully effect the needed changes is through advocacy. The final reason for young (and indeed all) physicians to be involved in advocacy is that doing so has now essentially become part of our fiduciary obligation to our patients. The laws and regulations promulgated by our governing institutions do not only

impact our lives. They also have an even more profound effect on the lives of our patients, and as we are all acutely aware, far too many of our patients do not understand the system well enough to advocate for themselves. Therefore, the time has come for physicians to recognize that understanding the health care system and engaging in advocacy has become as important a part of our care for our patients as maintaining our skill set through CME courses and reading journals. We have all taken a sacred oath to help our patients in ways that they cannot help themselves, and providing this help often goes beyond medical knowledge and surgical expertise. We are the ones who see the real, every day impacts of health care reform—both good and bad. We are the ones who know what is involved in actually delivering care—the rising costs, the logistical burdens, the increasing demands being placed on our time. If we do not speak up, if we do not advocate, if we do not directly communicate with our lawmakers every step of the way, then they will not have the information that they need to legislate effectively. And if that happens, we will have failed not only ourselves, but more importantly, we may have also failed our patients.

Lawrence M. Simon, MD, FAAP with Congressman Charles Boustany, MD, in Lafayette, Louisiana, at an AAO/HNS In-District Grassroots Outreach Meeting.

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FELLOW HIGHLIGHTSVision for our future...Fellow: Elton Lambert, MDNominated by: Richard Smith, MD The Division of Pediatric Otolaryngology in the Department of Otolaryngology/Head & Neck Surgery at the University of Iowa is proud to nominate Elton Lambert as an outstanding fellow in Pediatric Otolaryngology. Elton grew up on the island of Antigua and completed his residency at UT-Houston where he was awarded an AAOA grant for his work in Optical Rhinometry in Non-Allergic Rhinitis. The project gained recognition by the Houston Society of Otolaryngology and the Texas Association of Otolaryngology. Elton recently co-authored book chapters in Pediatric Otolaryngology-Head and Neck Surgery: Clinical Reference Guide and Pediatric Otolaryngology - the August 2013 issue of the Pediatric Clinics of North America. Elton has developed a strong interest in pediatric airway, vascular malformations and congenital anomalies of the head and neck, including velopharyngeal anomalies. The faculty at the University of Iowa is very proud to have matched Elton and excited at his potential to be a future leader in our specialty.

Fellow: Paul Hong, MDNominated by: Anthony Magit, MD Paul completed his fellowship in 2010 and is on the faculty of Dalhousie University in Halifax, Nova Scotia. Paul has an active research career holding the position of PI or co-PI on more than 14 grants with total funding of more than $800,000. Within the past 2 years, he has been a research mentor for more than 10 medical students, with several having received awards for their research. Paul has a diverse clinical and surgical practice, including craniofacial surgery and cochlear implants. On a personal level, Paul is a delightful individual who in a short period of time, has inspired numerous trainees and colleagues.

Fellow:Josee Paradis, MDNominated by: Anna Messner, MD Josee was the Stanford Children’s Health fellow for 2013-2014. Josee was a key participant in Stanford Ignite, a 4-week course designed to teach innovators how to formulate, develop, and commercialize their ideas. After Josee’s product idea was chosen from several proposals, her Ignite team (physicians/engineers) addressed the disconnect between the American Association of Sleep Medicine recommendation for sleep studies in the evaluation of pediatric OSA, and the current practice, whereby only a small percentage of children actually obtain a sleep study. Market research identified in-lab studies as barriers because they are costly, often inaccessible, inconvenient, and poorly tolerated by children. This inspired their solution - a home sleep apnea device designed specifically for children. The team conceptualized a prototype incorporating novel methods with existing technologies (no wires or straps), developed a business model, established the potential market and strategies, and proposed milestones. Hopefully, home sleep testing will soon play a key role in the evaluation of pediatric OSA

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FELLOW HIGHLIGHTS CONTINUED.

Fellow: Nikhila Raol, MDNominated by: Christopher Hartnick, MDNikhila Raol is currently a 2nd year fellow in pediatric otolaryngology at the Massachusetts Eye and Ear Infirmary. While completing her first year, she received the prestigious Arthur Tracy Cabot Fellowship at the Center for Surgery and Public Health at the Brigham and Women’s Hospital. Through this fellowship over the next two years, she will obtain her Master of Public Health at the Harvard School of Public Health, as well as work on research related to quality metrics in otolaryngology. Her research involves looking at the utility of the current quality metric (obtainment of audiograms prior to all tympanostomy tube placement) used in the state of Massachusetts for physician ranking and copay determination. She is studying the clinical relevance and cost effectiveness of the metric in an effort to develop better quality metrics that are aligned with the otolaryngologist's view of high quality, low cost patient care. She is interested in a career in academics as a pediatric otolaryngologist, while also working to improve quality-related health policy, both related to otolaryngology and more broadly to medicine overall.

ANNOUNCEMENTS

Dr. Ronald W. Deskin is awarded 2014 Ashbel Smith Distinguished Alumni. The award is in recognition for outstanding service to the medical profession and humankind. Dr. Ronald W. Deskin, graduated from UTMB with highest honors, was ranked third in a class of 150 and was the recipient of the Gold-Headed Cane Award. He became the first pediatric otolaryngologist in Texas in private practice in 1982, at a time when there were only two such specialists – both in the academic centers at Baylor and UTMB. After serving as a fellow at the Children’s Hospital of Boston and an instructor at Harvard Medical School, Deskin returned to UTMB in 1993 to serve as Professor of Pediatrics and Otolaryngology, Director of the Pediatric Otolaryngology Division and Vice Chairman of the Department of Otolaryngology. During his career, he has: served on various committees and boards; held many leadership positions in his field; edited numerous textbooks and journals; participated in several medical mission trips; was voted one of the Best Doctors in America multiple times; and has been a Texas Monthly Super Doctor for the past nine years. Deskin currently serves as Professor of Pediatrics and Otolaryngology at UT Southwestern and Children’s Medical Center in Dallas.

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ANNOUNCEMENTS

Robin Cotton was presented with the American College of Surgeons Jacobson Award for Surgical Innovation for his pioneering work in airway reconstruction in children.

The award was presented at a dinner in his honor in Chicago on June 6th. He was nominated by the ACS-Otolaryngology Advisory Council chaired by Dr.Craig Derkay. The award recognizes an individual whose work represents a truly novel development or technique in the field of surgery. The list of prior recipients of the Jacobson Innovation Award is listed at http://www.facs.org/news/2012/jacobson-list0613.html and includes a remarkable list of world-renowned surgeons. Dr. Dan Choo relays this personal reflection from his acceptance of the award: ‘Perhaps the most poignant (and proper) moments during the banquet came from a few patient testimonies that were part of the ceremonies. Most notably, Alex came up to read his prepared speech before the entire audience but quickly became overwhelmed by the scope of what he was going to do and the weight of the gaze of some 150 adults intently focused on him. In typical fashion, Robin put his arm around his patient and urged him to go on (see photo) standing right next to him for the duration of his speech. With this encouragement and support, he did indeed go on to give a compelling and heartfelt recount of Dr. Cotton’s care over the years and his intense gratitude for helping him overcome his airway problem.’ Congratulations to Dr. Cotton on this honor.

Link to Summer Newsletter for Otolaryngology Advisory Council for the American College of Surgeons The chair of the committee is Dr. Craig Derkay. There is an excellent program upcoming in San Francisco, Oct 26-30, 2014 that includes topics of interest to Pediatric Otolaryngologists.

Link is as follows: http://www.facs.org/about/councils/adv-oto-news.html

ACS LIAISON FOR ASPOWebmaster: Bernadette TrubatiskyAdministrator, Association Management Servicesc/o ASPO Headquarters

American College of Surgeons633 North Saint Clair StChicago, IL 60611-3211

btrubatisky@facs.orgaspo@facs.org Tel. 312.202.5580Fax. 312.268.7267

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2nd Annual RESIDENT/FELLOW EDUCATION CONFERENCE Discovery Garden, NEMOURS CHILDREN’S HOSPITAL

REGISTRATION IS FREE, BUT REQUIRED. RSVP BY 9/13/14 at: https://www.surveymonkey.com/s/APSO-ResEd-2014

SEPTEMBER 20, 201412:30-7:00PM

12:30 pm - Welcome and IntroductionJulie L Wei, MD, Nemours Children’s Hospital, Orlando FL

12:45 pm – “Complex Tonsillitis- Beyond Group A Strep”Joseph Dohar, MD; Pittsburgh Children’s Hospital (UPMC)

1:15 pm- "Excellence in office procedures and BMT/T&A”

Julie L Wei, MD, Nemours Children’s Hospital, Orlando FL (UCF)

1:45- “Vascular Malformations”Gresham Richter, MD, Arkansas Children's Hospital (UAMC)

2:15 pm – “Chronic Rhinosinusitis”Robert Chun, MD, Children’s Hospital of Wisconsin (MCW)

2:45 pm- “Hearing loss in infancy ”Judith Lieu, MD, St. Louis Children’s Hospital (Wash U)

3:15 pm - BREAK

3:45 pm – “Dysphagia”James Schroeder, MD, Ann & Robert H. Lurie Children’s Hospital of Chicago (Northwestern)

4:15 pm – “Acquired hearing loss”Alan Cheng, MD; Stanford Children’s Health

4:45 pm – “Laryngomalacia”David White, MD, M e d i c a l C o l l e g e o f S o u t h C a r o l i n a

5:15 pm- “Voice Disorders”Christopher Hartnick, MD, Massachusetts Eye and Ear Infirmary (Harvard)

6:00 -7:00 pm Reception with ASPO Board of Directors and Fellowship Directors

DIRECTONS: Nemours Children’s Hospital is 7.7 miles from Orlando International Airport.13535 Nemours Parkway Orlando FL, 32827

Take South exit from airport on Jeff Fuqua Blvd; Turn left on FL-417 N; Exit 19 Lake Nona Blvd,Left onto Nemours Parkway. Hospital visible from FL-417 highway

NOTE:Return Transportation will be provided from the conference to the Orlando Convention Center

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UPCOMING MEETINGS

AAO-HNS ANNUAL MEETING & OTO EXPO 2014Orlando, Fl September 21 - September 24, 2014 www.entannualmeeting.org

Fall Board and Committee Meetings in OrlandoThe schedule of the Committee meetings at the upcoming AAO-HNSF meeting in Orlando have been forwarded to all committee chairs. All meetings will be held at the Hyatt Regency Orlando on Saturday, September 20, 2014. If you have not received the email confirming your meeting, please contact Kathy Madryk at kmadryk@facs.org.

The following meetings will be open to interested members: IT, Taskforce, Subcertification, Fellowship.

Time Columbia 35 Columbia 347:00am-8:00am8:00am-9:00am Development Ad Hoc Workforce9:00am-10:00am Young Members Education10:00am-11:00am Qual/Safety Program11:00am-12:00n IT Research12:00n-1:00pm RRP Task Force Nominating1:00pm-2:00pm Board2:00pm-3:00pm3:00pm-4:00pm4:00pm-5:00pm Pan Leadership5:00pm-6:00pm Subcertification Open Forum6:00pm-7:00pm

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MEETINGS CONT.ESPO 2014; John Russell ( Chairman ESPO 2014 )

The 12th International Congress of the European Society of Pediatric Otorhinolaryngology (ESPO 2014) recently took place at the National Convention Centre in Dublin Ireland from Saturday 31st May to Tuesday 3rd June . It was well attended with over 1100 Delegates from over 65 countries with an excellent representation and contribution from ASPO members .There were 6 parallel sessions in each of the subspecialities , Airway , Cochlear Implant , General ,Head and Neck , Otology and Rhinology over the 2 1/2 Days .There were also Simulation Skills workshops over 2 days which were extremely popular and very well attended . At the opening ceremony Professor Trevor Mc Gill from The Children's Hospital Boston was awarded the T.G Wilson Medal for his major contribution to Pediatric Otorhinolaryngology in Ireland. After the presentation we were entertained by a Riverdance performance which included a Pediatric component . ESPO bi annual meetings are becoming more popular and we are all very much looking forward to ESPO 2016 in Lisbon , Portugal .

Left to right: John Russell, Mch, FRCSI, President ESPO with Plenary Speakers Anne Schilder, MD, PhD, Past President ESPO & Peter Koltai, MD, FACS.

Image of the Convention Centre Dublin, in the ESPO brand colours taken on the night of ESPO 2014.

From left to right: The TG Wilson medal was awarded to Trevor McGill, MCh, FRCS, FRCSI, Professor of Otology and Laryngology Children’s Hospital Boston, for outstanding contribution to Irish Pediatric Otolaryngology. Pictured left – right Tom Wilson (son of TG Wilson), RosalindWilson (granddaughter of TG Wilson), Trevor McGill & Mrs McGill

Lisbon will host the ESPO2016 MeetingFollowing a very successful Congress of the

European Society of Pediatric Otorhinolaryngology, in Dublin - Ireland, the next meeting will be organized in Lisbon – Portugal, June 19-22, 2016. The theme will be “Current Status and Future Trends in Pediatric Otorhinolaryngology”.

ASPO member Jorge Spratley and Luisa Monteiro will lead the organizing committee and cordially invite ASPO members to actively participate in the event, keeping the tradition of a strong presence of North-American specialists in ESPO meetings.

Lisbon has direct flights from various cities in the US and the typically warm weather at that time of the year will hopefully contribute to a pleasant stay in Portugal.

Further information will be posted periodically at the website www.espo2016.com

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PRESIDENT’S CORNER

PAST PRESIDENTS

Dr. Marci Lesperance and family, Christmas 2012

From left to right:Matthew Karls (age 15), Michelle Karls (age 13), Melanie Karls (age 8), Marci, Maria Karls (age 11), Ed Karls (husband)

From left to right:George H. Zalzal, Scott Manning, Robert F. Ward, Craig S. Derkay, Richard Rosenfeld, Robert J. Ruben, Sugki S. Choi, Jerome Thompson, Michael J. Cunningham, Ralph F. Wetmore, Ellen M. Friedman, Rodney P. Lusk, Charles M. Myer III, and William P. Potsic