Global Health, Virtue-Based Professional Development and Leadership, Device Development for Cancer Detection
Associate Professor of Head and Neck Surgery and Communication Sciences
Head and Neck Surgery & Communication Sciences
School of Medicine
Associate Professor in Radiation Oncology
School of Medicine
Affiliate, Duke Global Health Institute
Duke Global Health Institute
Institutes and Provost's Academic Units
Member of the Duke Cancer Institute
Duke Cancer Institute
School of Medicine
The George Washington University
Clinical Evaluation of the OncAlert® RAPID in Subjects Presenting for Evaluation and/or Initial Biopsy
A Quantitative Optical Sensor to Monitor Tumor Vascular Physiology
Zenalux Biomedical, Inc.
TERT promoter mutation frequency in subsets of oral tongue cancer patients
American Medical Association Foundation
CHECKPOINT Head & Neck Nerve Stimulator/Locator Product Validation Study (9394-CSP-000-B)
A Virtue Based on-line Leadership Curriculum: A Nationwide Resource for Professional Development
Society of University Otolaryngologists
Development of a Surgical Video Atlas for Resident Education: 3-Year Experience.
Objective: To create a high-quality annotated online surgical video atlas of key indicator otolaryngology cases and assess its use and overall journal trends over time. Methods: Videos are recorded from multiple viewpoints within the operating room and compiled into a single stream. Postediting includes chaptering videos and overlaying relevant text annotations. Videos are published online and viewership trends analyzed. Results: Over 3 years, 29 otolaryngology videos were published out of 161 journal publications (18%). Eight of the 14 key indicator procedures are included (57%). From the beginning of 2017 to the end of 2019, viewership of otolaryngology pages increased from 548 to 11,139 views per month, totaling >150,000 views. These now represent 10% of the total journal monthly views and 10% of the overall views. Users originate from the United States and from >10 other countries. Discussion: Residents and faculty face challenges of providing the highest standard of clinical care, teaching, and learning in and out of the operating room. Inherent difficulties of surgical training, high-fidelity surgical simulation, and imposed work hour restrictions necessitate additional, more efficient and effective means of teaching and learning. Surgical videos demonstrating key anatomy, procedural steps, and surgical dexterity with hand positioning are increasing in their popularity among learners. Implications for Practice: Surgical video atlases provide a unique adjunct for resident education. They are enduring and easily accessible. In a climate of work hour restrictions or elective case reduction, they may supplement how residents learn to operate outside the operating theater.
Brown, CS; Cunningham, CD; Lee, WT; Puscas, L
Brown, C. Scott, et al. “Development of a Surgical Video Atlas for Resident Education: 3-Year Experience.” Oto Open, vol. 4, no. 3, July 2020, p. 2473974X20939067. Pubmed, doi:10.1177/2473974X20939067.
The effect of lateral neck dissection on complication rate for total thyroidectomy.
PURPOSE: To determine the complication profile for total thyroidectomy with and without concomitant lateral neck dissection using a large administrative database. MATERIALS AND METHODS: The IBM MarketScan® Commercial Database (2010-2014) analytic cohort was queried for patients ≥18 years or older undergoing total thyroidectomy (or equivalent procedures) from January 1, 2010 to June 30, 2014. Subgroup analysis was performed for patients undergoing concomitant unilateral and bilateral lateral neck dissection. The complication profiles were described. RESULTS: 55,204 patients underwent total thyroidectomy or equivalent procedures. Hypoparathyroidism or hypocalcemia was coded in 20.3% overall, with 4.7% having permanent hypoparathyroidism. Vocal cord paralysis was coded in 3.3% overall with permanent rate of 0.7%. Tracheotomy was performed in 0.3% of patients. 2743 underwent total thyroidectomy with concomitant unilateral lateral neck dissection, and 560 of these patients underwent bilateral lateral neck dissection. In patients undergoing unilateral lateral neck dissection, 30.5% of patients have hypoparathyroidism/hypocalcemia coded, with a permanent rate of 8.8%. Vocal cord paralysis was coded in 8.3% of patients, with a permanent rate of 1.9%. Tracheotomy was performed in 1.2% of patients. In patients undergoing bilateral lateral neck dissection, 39.6% had hypoparathyroidism/hypocalcemia coded, with a permanent rate of 10.9%. These patients had vocal cord paralysis coded in 10.2% of cases, with a permanent rate of 2.1%. Tracheotomy was performed in 2.5% of patients. CONCLUSION: The addition of unilateral and especially bilateral lateral neck dissection increases both overall and permanent complication rates for total thyroidectomy. These data may help to inform preoperative discussions with patients.
Rocke, Daniel J., et al. “The effect of lateral neck dissection on complication rate for total thyroidectomy.” Am J Otolaryngol, vol. 41, no. 3, May 2020, p. 102421. Pubmed, doi:10.1016/j.amjoto.2020.102421.
Am J Otolaryngol
Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.
Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery in 5 patients ≥60 years of age who developed postoperative cognitive dysfunction and 5 matched controls who did not. We detected 12,654 ± 4895 cells/10 mL of CSF sample (mean ± SD). Patients who developed postoperative cognitive dysfunction showed an increased CSF monocyte/lymphocyte ratio and monocyte chemoattractant protein 1 receptor downregulation on CSF monocytes 24 hours after surgery. These pilot data demonstrate that CSF flow cytometry can be used to study mechanisms of postoperative neurocognitive dysfunction.
Berger, Miles, et al. “Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.” Anesth Analg, vol. 129, no. 5, Nov. 2019, pp. e150–54. Pubmed, doi:10.1213/ANE.0000000000004179.
Establishing a Healthcare Research Network in Vietnam: A Platform for Collaborative Quality Improvement
© 2020, Springer Nature Singapore Pte Ltd. There is both a demand and need for delivering patient centered care in health systems. This is especially challenging in developing countries in which resources are limited, population health burdens are extensive, and coordination between facilities is fractured. The development of a low cost, centralized, real time data collection platform would be a powerful tool in understanding patient centered healthcare needs and issues. We report a pilot project that seeks to establish such a healthcare research network in Vietnam. This pilot used a web-based database collection tool called REDCap (Research Electronic Data Capture). We programmed a validated general health quality of life questionnaire in both English and Vietnamese that was used to collect patient responses. A total of four hospitals located in Hanoi, Vietnam participated in the pilot project of patients presenting with otolaryngology-head and neck complaints and concerns between January 23 and January 26, 2018. We report outpatient responses and their associated quality of life in ten specific domains. This pilot demonstrates the successful international collaboration among academic, non-profit, clinical entities in establishing this low-cost research network. This will be a platform that could easily be expanded to include other healthcare facilities in conducting quality improvement and research projects. We envision this approach as an important tool in improving health care quality in developing countries throughout the world.
Bui, AT; Trung, DD; Le Minh, K; Nguyen, T; Le Dinh, H; Tran, L; Nguyen, N; Vohra, P; Ji, KSY; Lee, E; Campbell, J; Lee, WT
Bui, A. T., et al. “Establishing a Healthcare Research Network in Vietnam: A Platform for Collaborative Quality Improvement.” Ifmbe Proceedings, vol. 69, 2020, pp. 567–70. Scopus, doi:10.1007/978-981-13-5859-3_97.
Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model.
There remain gaps in knowledge concerning how vascular morphology evolves during carcinogenesis. In this study, we imaged neovascularization by label-free dark-field microscopy of a 7,12-Dimethylbenz[a]anthracene (DMBA)-induced hamster cheek pouch model of oral squamous cell carcinoma (SCC). Wavelength-dependent imaging revealed distinct vascular features at different imaging depths and vessel sizes. Vascular tortuosity increased significantly in high-risk lesions, whereas diameter decreased significantly in hyperplastic and SCC lesions. Large vessels preserved the same trends seen in the original images, whereas small vessels displayed different trends, with length and diameter increasing during carcinogenesis. On the basis of these data, we developed and validated a classification algorithm incorporating vascular features from different vessel masks. Receiver operator curves generated from the classification results demonstrated high accuracies in discriminating normal and hyperplasia from high-grade lesions (AUC > 0.94). Overall, these results provided automated imaging of vasculature in the earliest stages of carcinogenesis from which one can extract robust endpoints. The optical toolbox described here is simple, low-cost and portable, and can be used in a variety of health care and research settings for cancer prevention and pharmacology research. Cancer Res; 77(24); 7109-19. ©2017 AACR.
Hu, Fangyao, et al. “Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model.” Cancer Res, vol. 77, no. 24, Dec. 2017, pp. 7109–19. Pubmed, doi:10.1158/0008-5472.CAN-17-1058.
Academic Medical Centers
Aged, 80 and over
Attitude of Health Personnel
Attitude to Health
Carcinoma, Squamous Cell
Cation Transport Proteins
Clinical Trials as Topic
Combined Modality Therapy
Conflict of Interest
Cranial Nerve Neoplasms
Data Interpretation, Statistical
Disease Models, Animal
Dose-Response Relationship, Drug
Drug Evaluation, Preclinical
Drug Therapy, Combination
Early Detection of Cancer
Education, Medical, Graduate
Enzyme-Linked Immunosorbent Assay
False Negative Reactions
Genes, Tumor Suppressor
Head and Neck Neoplasms
Health Care Surveys
Heart Defects, Congenital
Human papillomavirus 16
Internship and Residency
Mice, Inbred BALB C
Mice, Inbred C57BL
Monte Carlo Method
Neoplasm Recurrence, Local
Neoplastic Stem Cells
Nerve Tissue Proteins
Organ Sparing Treatments
Promoter Regions, Genetic
Randomized Controlled Trials as Topic
Recombinant Fusion Proteins
Reconstructive Surgical Procedures
Recovery of Function
Respiratory Tract Neoplasms
Sensitivity and Specificity
Sentinel Lymph Node Biopsy
Specific Pathogen-Free Organisms
Surgical Procedures, Operative
Surveys and Questionnaires
Tumor Cells, Cultured
Tumor Markers, Biological
Vestibulocochlear Nerve Diseases
Vocal Cord Paralysis
Associate Professor of Head and Neck Surgery and Communication Sciences
3561B Dhs, Box 3805 DUMC, Durham, NC 27710