Tammara Watts

Positions:

Instructor in the Department of Head and Neck Surgery and Commu Sciences

Surgery, Head and Neck Surgery and Communication Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 1995

University of Virginia

M.D. 2004

University of Maryland - Baltimore

Ph.D. 2005

University of Maryland - Baltimore

Otolaryngology Resident, Otolaryngology

Medical College of Georgia School of Medicine

Facial Plastics & Microvascular Reconstruction Fellow, Otolaryngology

Oregon Health and Science University School of Medicine

Publications:

The pectoralis major myocutaneous flap

© 2019 The pectoralis major myocutaneous flap has enjoyed a long history of over 40 years utilization to reconstruct a variety of head and neck defects. Despite the attractiveness, feasibility and success rates of free tissue transfer, the role of the pectoralis major myocutaneous flap is irreplaceable in the setting of high-risk patients, the vessel-depleted neck, and in overall poor free tissue transfer surgical candidates. This chapter reviews the pertinent surgical anatomy, flap design and harvest with emphasis on mitigation of donor site morbidity when mobilizing the pectoralis major myocutaneous flap.
Authors
MLA Citation
Watts, T. L. “The pectoralis major myocutaneous flap.” Operative Techniques in Otolaryngology  Head and Neck Surgery, vol. 30, no. 2, June 2019, pp. 134–37. Scopus, doi:10.1016/j.otot.2019.04.008.
URI
https://scholars.duke.edu/individual/pub1426655
Source
scopus
Published In
Operative Techniques in Otolaryngology Head and Neck Surgery
Volume
30
Published Date
Start Page
134
End Page
137
DOI
10.1016/j.otot.2019.04.008

Correlation of intraoperative parathyroid hormone levels with parathyroid gland size.

OBJECTIVES: To study the relationship of intraoperative intact parathyroid hormone levels (iPTH) with parathyroid adenoma weight and volume in patients with primary hyperparathyroidism. METHODS: Retrospective evaluation of consecutive patients undergoing minimally invasive parathyroidectomy with iPTH measurement. Data collected include preoperative serum calcium, ionized calcium, and serum parathyroid hormone (PTH) levels, iPTH levels at baseline, 5 minutes, and 10 minutes, and parathyroid adenoma weight. Adenoma volume was calculated using an equation for the volume of a spheroid object. RESULTS: Thirty patients underwent minimally invasive parathyroidectomy with iPTH measurement for a single parathyroid adenoma between March 2004 and January 2006. There were 8 men and 22 women, with a mean age of 59.3 (range 26-92) years. A significant correlation between preoperative serum calcium and ionized calcium levels and parathyroid adenoma weight was identified (P = .0008 and P = .03, respectively). A significant correlation was also shown between baseline iPTH measurements and parathyroid adenoma volume (P = .03). There was no correlation between baseline iPTH levels and parathyroid adenoma weight. There was a significant correlation between parathyroid adenoma weight and percentage decrease of iPTH levels at 10 minutes compared to baseline (P = .04). CONCLUSION: Preoperative serum calcium and baseline iPTH levels may be useful in predicting parathyroid adenoma weight and volume, respectively. Adenoma weight may relate to the percentage decrease of iPTH levels at the 10-minute postparathyroidectomy interval.
Authors
Moretz, WH; Watts, TL; Virgin, FW; Chin, E; Gourin, CG; Terris, DJ
MLA Citation
Moretz, William H., et al. “Correlation of intraoperative parathyroid hormone levels with parathyroid gland size..” Laryngoscope, vol. 117, no. 11, Nov. 2007, pp. 1957–60. Pubmed, doi:10.1097/MLG.0b013e31813c14fc.
URI
https://scholars.duke.edu/individual/pub1426666
PMID
17891053
Source
pubmed
Published In
Laryngoscope
Volume
117
Published Date
Start Page
1957
End Page
1960
DOI
10.1097/MLG.0b013e31813c14fc

Role of Google Glass in improving patient satisfaction for otolaryngology residents: a pilot study.

OBJECTIVES: To demonstrate the feasibility and efficacy of the Google Glass as a tool to improve patient satisfaction and patient-physician communication for otolaryngology residents in the outpatient clinic setting. The primary outcome of the study was to improve patient satisfaction scores based on physician communication-related questions from Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. STUDY DESIGN: Prospective randomised trial. SETTING: Tertiary care hospital. SUBJECT AND METHODS: To evaluate the effect on patient satisfaction, five residents were recorded using the Google Glass in an outpatient clinic setting by 50 randomised patients. Modified surveys based on the CG-CAHPS survey were completed by patients at the conclusion of each clinic encounter. The recorded videos were evaluated by two independent faculties. Summarised data and video were distributed to each resident for review as the intervention. The residents were recorded again by 45 additional patients with evaluation by patients and faculties. RESULTS: After intervention, the scores from faculty surveys regarding patient satisfaction including the subject of better explanations (P > 0.001), listening carefully (P > 0.001), addressing patient questions (P > 0.001), displaying respect (P > 0.001) and spending adequate time (P = 0.0005) all significantly improved, as well as overall performance (P = 0.014). The scores from patient surveys did significantly improve. CONCLUSION: This study demonstrates the improvements in patient satisfaction and patient-physician communication can be achieved with the use of Google Glass as a first-person recording device in the outpatient otolaryngology clinic setting.
Authors
Son, E; Halbert, A; Abreu, S; Hester, R; Jefferson, G; Jennings, K; Pine, H; Watts, T
MLA Citation
Son, E., et al. “Role of Google Glass in improving patient satisfaction for otolaryngology residents: a pilot study..” Clin Otolaryngol, vol. 42, no. 2, Apr. 2017, pp. 433–38. Pubmed, doi:10.1111/coa.12810.
URI
https://scholars.duke.edu/individual/pub1426656
PMID
27992944
Source
pubmed
Published In
Clin Otolaryngol
Volume
42
Published Date
Start Page
433
End Page
438
DOI
10.1111/coa.12810

Role of the intestinal tight junction modulator zonulin in the pathogenesis of type I diabetes in BB diabetic-prone rats.

Increased intestinal permeability has been observed in numerous human autoimmune diseases, including type-1 diabetes (T1D) and its' animal model, the BB-wor diabetic prone rat. We have recently described zonulin, a protein that regulates intercellular tight junctions. The objective of this study was to establish whether zonulin-dependent increased intestinal permeability plays a role in the pathogenesis of T1D. In the BB diabetic-prone rat model of T1D, intestinal intraluminal zonulin levels were elevated 35-fold compared to control BB diabetic-resistant rats. Zonulin up-regulation was coincident with decreased small intestinal transepithelial electrical resistance, and was followed by the production of autoantibodies against pancreatic beta cells, which preceded the onset of clinically evident T1D by approximately 25 days. In those diabetic prone rats that did not progress to diabetes, both intraluminal zonulin and transepithelial electrical resistance were similar to those detected in diabetic-resistant animal controls. Blockade of the zonulin receptor reduced the cumulative incidence of T1D by 70%, despite the persistence of intraluminal zonulin up-regulation. Moreover, treatment responders did not seroconvert to islet cell antibodies. Combined together, these findings suggest that the zonulin-induced loss in small intestinal barrier function is involved in the pathogenesis of T1D in the BB diabetic-prone animal model.
Authors
Watts, T; Berti, I; Sapone, A; Gerarduzzi, T; Not, T; Zielke, R; Fasano, A
MLA Citation
Watts, Tammara, et al. “Role of the intestinal tight junction modulator zonulin in the pathogenesis of type I diabetes in BB diabetic-prone rats..” Proc Natl Acad Sci U S A, vol. 102, no. 8, Feb. 2005, pp. 2916–21. Pubmed, doi:10.1073/pnas.0500178102.
URI
https://scholars.duke.edu/individual/pub1426674
PMID
15710870
Source
pubmed
Published In
Proceedings of the National Academy of Sciences of the United States of America
Volume
102
Published Date
Start Page
2916
End Page
2921
DOI
10.1073/pnas.0500178102

PDGF-AA mediates mesenchymal stromal cell chemotaxis to the head and neck squamous cell carcinoma tumor microenvironment.

BACKGROUND: The robust desmoplasia associated with head and neck squamous cell carcinoma (HNSCC) suggests that the tumor microenvironment may be an important component in the pathophysiology of this cancer. Moreover, the high recurrence rate and poor clinical response to chemotherapy and radiation treatment further underscores that the non-cancerous cells of the microenvironment, such as mesenchymal stromal cells (MSCs), cancer associated fibroblasts (CAFs), and pericytes, may be important in the pathophysiology of HNSCC. METHODS: Confocal microscopy and immunohistomchemistry approaches were used to identify MSCs tumor microenvironment from patients with oral cavity and oral pharyngeal squamous cell carcinoma (SCC). In vitro Boyden chamber assays and multiplex magnetic bead assays were used to measure MSC chemotaxis and to identify the chemokines secreted by JHU-011, -012, -019, three cells lines derived from patients with oral pharyngeal SCC. RESULTS: We show here that MSCs reside in the tumor microenvironment of patients with oral cavity and oral pharyngeal SCC and are recruited via paracrine mediated tumor cell secretion of (platelet derived growth factor) PDGF-AA. The MSC markers CD90+, CD105+, and gremlin-1+ were found to co-localize on cells within the tumor microenvironment in oral cavity SCC specimens distinct from α-smooth muscle actin staining CAFs. The conditioned media from JHU-011, -012, and -019 caused a significant increase in MSC migration (>60%) and invasion (>50%; p < 0.0001) compared to oral keratinocyte (OKT) controls. Tumor cell induced MSC chemotaxis appears to be mediated through paracrine secretion of PDGF-AA as inhibition of the PDGF-AA receptor, PDGFR-α but not PDGFR-β, resulted in near arrest of MSC chemotaxis (p < 0.0001). CONCLUSIONS: Tumor microenvironment expression of PDGFR-α has been shown to correlate with a worse prognosis in patients with prostate, breast, ovarian, non-small cell lung cancer and osteosarcoma. This is the first evidence that a similar signaling paradigm may be present in HNSCC. PDGFR-α inhibitors have not been studied as adjunctive treatment options in the management of HNSCC and may prove to be an important driver of the malignant phenotype in this setting.
Authors
Watts, TL; Cui, R; Szaniszlo, P; Resto, VA; Powell, DW; Pinchuk, IV
MLA Citation
Watts, Tammara L., et al. “PDGF-AA mediates mesenchymal stromal cell chemotaxis to the head and neck squamous cell carcinoma tumor microenvironment..” J Transl Med, vol. 14, no. 1, Dec. 2016. Pubmed, doi:10.1186/s12967-016-1091-6.
URI
https://scholars.duke.edu/individual/pub1426657
PMID
27931212
Source
pubmed
Published In
Journal of Translational Medicine
Volume
14
Published Date
Start Page
337
DOI
10.1186/s12967-016-1091-6