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Resident Training Program

Message from the Institute

We welcome your interest in the Cleveland Clinic Resident Training Program in the Head & Neck Institute. This program includes one year of general and specialty surgical rotations and four years of head and neck surgery. Each member of the institute is strongly committed to providing the best possible graduate otolaryngology training.

Because of our large staff, we are able to offer an abundance of clinical experience in areas including auditory, balance, speech and swallowing disorders. We are equally committed to basic research and provide exceptional opportunities through both the institute’s laboratory and in conjunction with Cleveland Clinic’s Lerner Research Institute. Our collegial atmosphere enables residents to receive broad clinical training and develop investigative skills, yet still have time for family and personal interests outside the hospital.

Otolaryngology is a dynamic specialty, and Cleveland Clinic’s Head & Neck Institute is a leader with strong programs in all subspecialty areas. We believe our residency program is at the forefront of the field and will provide you with the necessary skills to become one of the otolaryngology leaders of tomorrow.

Michael S. Benninger, MD
Chairman
Head & Neck Institute

Resident Training Program Contact

Anne Monreal
Cleveland Clinic
9500 Euclid Avenue A/71
Cleveland, Ohio 44195
216.444.4949
800.223.2273, ex. 4949
monreala@ccf.org

Mission

Produce superbly trained academic otolaryngology-head and neck surgeons.

General Information

Three applicants are accepted into the residency program each academic year. The residency is fully accredited.

Program Structure

The program consists of five years total training.

Graduate Level I

During three months of their first postgraduate year, residents begin their otolaryngology rotations. Each of the rotations is for a period of one month, with the audiology/speech rotation split into two weeks each. The head and neck preliminary rotation gives the resident early exposure to the head and neck service. The rotation with our satellite facilities gives the resident exposure to the community practice. Our audiology/speech rotation allows intense time to learn and become familiar with these subspecialties. This rotation provides a clear understanding on how these subspecialties fit into the patient care team.

Graduate Level II

The resident will learn how to perform a complete head and neck examination, including nasopharyngoscopy, indirect laryngoscopy, microscopic examination of the ear, flexible fiberoptic laryngoscopy, rigid endoscopy of the nose and paranasal sinuses, myringotomy with and without placement of PE tube, tonsillectomy, adenoidectomy, excision head and neck cysts, simple wound closure, tracheotomy, and panendoscopy.

Graduate Level III

The resident will learn external ethmoidectomy, simple surgery of the osteomeatal complex via transnasal telescopy, laser surgery of the upper aerodigestive tract, excision simple branchial cleft remnants, lymph node biopsy, excision thyroglossal duct cyst, simple flap rotation, submandibular gland excision, true vocal cord injection, foreign body removal from aerodigestive tract, flap tracheostomy, incision and drainage of deep neck abscesses, uvulopalatopharyngoplasty, septoplasty, placement eyelid spring, maxillary antrostomy, myringoplasty, tympanoplasty, mastoidectomy, meatoplasty, endolymphatic sac decompression, labyrinthectomy, and all aspects of facial aesthetic surgery.

Graduate Level IV

The resident will learn to perform endoscopic and traditional sinus surgery, revision septoplasty, transsphenoidal approach to pituitary gland, lateral rhinoplasty/medial maxillectomy, rhinoplasty, superficial parotidectomy, radical neck dissection, total laryngectomy, pectoralis major flap, excision oral cavity neoplasm, thyroidectomy and parathyroidectomy, frontal osteoplasty, dacryocystorhinostomy, excision of meningoencephaloceles, transpalatal approach to choanal atresia, excision juvenile nasopharyngeal angiofibroma, repair laryngotracheal stenosis, foreign body endoscopy, and reduction of mandibular and maxillofacial fractures.

Graduate Level V

Chief resident learns to perform tympanoplasty with mastoidectomy, modified radical mastoidectomy, ossicular reconstruction/middle ear surgery, stapedectomy, placement endolymphatic shunt, subtotal temporal bone resection, peripheral facial nerve decompression and grafting, revision sinus surgery, transantral ethmoidectomy, revision rhinoplasty, laryngeal framework surgery and reinnervation, partial laryngectomy, composite resection and plate reconstruction, laryngotracheal reconstruction, total maxillectomy, facial reanimation, blepharoplasty, and major head and neck flaps.

The GL-V chief resident participates in all aspects of patient care, including the most sophisticated surgical techniques, and supervises junior residents.

The resident assigned to otology–neurotology is the Chief Administrating Resident for that four-month rotation. With appropriate input from the Program Director, other faculty, and other residents, the Chief Administrating Resident coordinates the night call, vacation and conference schedules, and acts as a liaison between staff and residents.

Scope of Otolaryngology Services

In addition to providing general adult and pediatric otolaryngology services, the Institute provides several highly specialized tertiary care services through its various sections.

Communicative Disorders

The Sections of Audiology and Speech-Language Pathology address speech, language and hearing disorders in a patient population ranging from neonatal to geriatric. Residents rotate through the section and observe all facets of Speech-Language Pathology and Audiology in an integrated, allied health/medical team approach. Residents are exposed to state-of-the-art instrumental techniques, including acoustic and aerodynamic assessment of the vocal tract, videostroboscopy, basic audiometry, tympanometry, otoacoustic emissions, evoked potentials, cochlear implants, real ear measurements, hearing aids and assistive listening devices.

Head and Neck Surgery

Specialists in the Section of Head and Neck Surgery evaluate and treat a large volume of patients with a variety of head and neck malignancies. All patients are seen jointly by the surgeons, radiation therapists and oncologists. Weekly Tumor Board ensures communication among team members. Research protocols are in constant use and development. Residents are part of the decision-making team and are actively involved in all facets of patient care.

Laryngotracheal Reconstruction

The Section of Laryngotracheal Reconstruction is dedicated to the management of laryngeal airway obstruction, upper and lower respiratory foreign bodies, esophageal reflux, tracheal aspiration, and voice preservation and rehabilitation. The section has achieved international status in pioneering new techniques for managing tracheal and laryngeal stenosis, and long-term/permanent tracheostomy. Ongoing research should provide better control of intractable aspiration and more effective rehabilitation of laryngeal stenosis.

The section sponsors a yearly resident endoscopy course for rigid and fiberoptic removal of foreign bodies of the airway, tracheostomy and cricothyroidotomy.

Nasal and Sinus Disorders

Nasal and sinus disorders are very common in Northeast Ohio, creating a large patient volume for this section. Patients are evaluated by appropriate clinical and radiographic workup, including endoscopy, CT scanning and allergy assessment, then offered medical and/or surgical therapy. Residents learn functional endoscopic sinus surgery as well as other, more traditional techniques in managing these patients.

The section also is committed to managing snoring and sleeping disorders associated with obstruction of the upper airway. Treatment options include out-patient laser-assisted surgery.

Otology-Neurotology

The Section of Otology-Neurotology provides comprehensive care of all forms of otologic disorders, including middle and posterior cranial fossa surgery for cerebellopontine and skull base tumors. Nearly 500 surgical cases per year provide the in-depth experience that enables resident graduates to treat otologic disorders with confidence. Research interests in the section include molecular biology of deafness (immune-mediated inner ear disease), Meniere’s disease and cochlear implantation in adults and children. Staff otologists assist residents in clinical and basic science research in auditory, vestibular and temporal bone disorders.

Pediatric Otolaryngology

The section offers total medical and surgical management of pediatric otolaryngologic disorders, from infancy through adolescence, with more than 400 surgical procedures each year.

Designated outpatient clinics, including a Cleft Palate Clinic, provide comprehensive pre- and postoperative care.

Cleveland Clinic includes a Children’s Hospital, a Pediatric Intensive Care Unit, and numerous pediatric tertiary care specialists to help manage the most complex otolaryngologic problems of infancy and childhood.

Vestibular and Balance Disorders

The Section of Vestibular and Balance Disorders provides laboratory diagnosis, medical neurotology and vestibular rehabilitation of patients with dizziness, disequilibrium and imbalance. An outpatient clinic manages self-referred patients and those referred from Otolaryngology, Neurology, Internal Medicine and other departments. Residents rotate through the Section of Vestibular and Balance Disorders to learn about test administration and interpretation.

The section has state-of-the-art, computer-based electronystagmography and rotational chair and posturography, with the world’s largest database of laboratory test results. As Northeast Ohio’s only comprehensive laboratory, the section offers regional referral laboratory services for physicians outside Cleveland Clinic.

Clinical and basic science research is ongoing, particularly in the areas of vestibular evoked potentials, outcome of home-based vestibular rehabilitation, and genetics of motion sickness.

The program’s mission is to produce superbly trained academic head and neck surgeons. Those graduates who wish to pursue fellowship training will be highly competitive. Three applicants are accepted into residency training each academic year.

Resident Rotations

The program consists of five years of training. Individual supervision and teaching are provided at all levels of training by physicians in the Institute. Participation in the clinic and operating room is commensurate with the resident’s level of competence and ability. Each resident will develop skill and knowledge in all aspects of modern Otolaryngology-Head and Neck Surgery, i.e., head and neck surgery, microsurgery of the ear, neurotology, facial plastic and reconstructive surgery, audiology, speech pathology, maxillofacial trauma, endoscopy (including laser), pediatric otolaryngology, laryngoscopy, sleep medicine, and allergy. Rotations at the main campus hospital, regional hospitals and county hospital are blended to provide a quality learning experience.

Educational Purpose of each rotation is:

  • Gain experience and achieve basic competence in the comprehensive care of the adult and/or pediatric patient
  • Treatment of acute and chronic otolaryngologic illnesses that are commonly seen in pediatric practice
  • Assumption of some of the roles and responsibilities of an otolaryngologist in the outpatient and operative setting when appropriate
  • Gain familiarity with surgical anatomy
  • Gain an understanding of the longitudinal care of the otolaryngologic patient

Download the 2010/2011 Residency Rotation Schedule

Didactic Program

Monday, Wednesday, and Friday mornings 7 a.m. – 8 a.m.

  • Faculty Lectures
  • Tumor Board
  • Pathology
  • Head and Neck Radiology
  • Oral Boards Preparation
  • Audiology
  • Speech pathology
  • In-service Review Sessions

8 Week Anatomy Course: fresh cadaveric dissection of common surgical procedures

Monthly

  • Journal Club
  • Temporal Bone Lab
  • Grand Rounds
  • QA (Quality Assurance)

Instructional Courses – Annual

  • Facial Fracture Plating Course
  • Multidisciplinary Care of the Head and Neck Cancer Patient
  • Rhinology Course
  • Laser Course
  • Airway Course

Sample Schedule:

Cleveland Clinic Head And Neck Institute
Otolaryngology Residency Program
Didactic Conference Schedule For
2011-12 Academic Year

July, 2011

Monday Tuesday Wednesday Thursday Friday
1
6:45 a.m. Tumor Board L2-150
4 5 6 7 8
Clinic Closed; Independence Day Observance. No conferences 7 a.m. Lecture/Dissection Lab Regional Flaps (Plastics) 6:45 a.m. Tumor Board L2-150
11 12 13 14 15
7 a.m. New Year Meet and Greet with Program Director, Associate Program Director, and Coordinator – Overview of Basics 7 a.m. QA 6:45 a.m. Tumor Board L2-150
18 19 20 21 22
7 a.m. Salivary Glands and Non-Neoplastic Disease Reading Assignment: Bailey’s 37,38,39 A7-148 7 a.m.: Lecture/Dissection Lab Thyroidectomy (General/Head&Neck) 6:45 a.m. H&N Strategic Planning L2-150

6:30 a.m. Patient of the Month A7-148
25 26 27 28 29
7 a.m. Snoring, OSA Reading Assignment: Bailey’s 46 A7-148 7 a.m.: Temporal Bone Lab 6:45 a.m. Tumor Board L2-150

Over the past 10 years of graduating residents (2002-2011), 22 have continued their studies in fellowships. These include fellowships in

  • Head and Neck Surgery
  • Rhinology
  • Mohs surgery
  • Laryngology
  • Pediatrics
  • Skull Base Surgery
  • Facial Plastic and Reconstructive Surgery

The locations of these fellowships are diverse, and have included:

  • Vanderbilt
  • Ohio State
  • University of Michigan
  • Johns Hopkins
  • UCLA
  • Children's Hospital of Pennsylvania
  • Harvard
  • University of Pittsburgh
  • University of Iowa
  • University of Minnesota

Nine graduates have gone into private practice upon graduation.

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To find a head and neck specialist for your needs, contact the Head & Neck Institute at 216.444.8500 (or toll-free 1.800.223.2273, ext. 48500)

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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