Department of Otolaryngology - Head and Neck Surgery

General Information

The Department of Otolaryngology—Head and Neck Surgery offers consultation, medical management, and surgery for patients with problems associated with the ear, nose, throat, and neck, including:

• dizziness of vestibular origin
• facial plastic and reconstructive surgery
• head and neck cancer
• hearing loss
• problems of the larynx
• swallowing
• sinuses
• tumors of the auditory nerve
• voice production

Medical Services include:

• Cleft Palate Clinic
• Head and Neck Cancer
• Voice and Swallowing Disorders
• Nose and Sinus Disorders
• Otolaryngology-neurotology/Skull Base Surgery
• Pediatric Otolaryngology
• Plastic and Reconstructive Surgery
• Head and Neck Endocrine Oncology
• Audiology
• Hearing Aid Center
• Cochlear Implant Center
• Speech and Language
• Voice Clinic

For consultation or referral, or to obtain information on patients, please call UI Consult toll-free at 1-800-322-8442.

Consultations are facilitated by mailing out or faxing pertinent clinical information in advance, if possible.

Department and division addressed correspondence can be directed to:

Department of Otolaryngology
University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City, IA 52242-1009

Phone: 319-356-2201
Fax: 319-356-4547 (monitored weekdays)

Department head

Medical Services

Director: John W. Canady, MD

The craniofacial anomalies clinic treats patients with all problems associated with congenital birth abnormalities of the head and neck with cleft lip and/or palate being one of the major problems addressed. The team of specialists includes plastic surgeons, audiologists, pediatric otolaryngologists, speech pathologists, orthodontists, pediatricians, geneticists, pediatric dentists, prosthodontists, ophthalmologists, pediatric neurologists, psychologists, and social workers. Specialized surgical procedures include:

• primary cleft lip repair (cheiloplasty)
• cleft lip repair (palatoplasty)
• z-plasty or pharyngeal flap
• fistula repair
• alveolar bone graft
• maxillary distraction osteogenesis
• lip and/or nasal revision (cleft rhinoplasty)

Head and Neck Cancer

Director: Henry T. Hoffman, MD

This service manages patients with a wide spectrum of disorders of the head and neck within the anatomic limits determined by the structures between the dura and the pleura. Specialized care is directed to specific regions including:

• oral cavity
• larynx and pharynx
• nose and sinuses
• thyroid and parathyroid glands
• lymphatics
• muscle and bone of the head and neck

A weekly Multidisciplinary Tumor Board directs management of patients with head and neck malignancies with all cases comprehensively reviewed. An emphasis is placed on offering the patient and referring physician a recommended management plan. A full spectrum of treatments is available and includes: 

• endoscopic laser surgery for laryngeal cancer
• organ preservation protocols
• advanced reconstructive techniques including microvascular free tissue transfer, and osseointegrated implants

Speech and swallowing disorders are managed through a weekly Voice Clinic and monthly dysphagia conference. A multidisciplinary approach is offered through participation of physicians, speech pathologists, and speech scientists including those jointly appointed with the National Center for Voice and Speech.

Skull base procedures for patients with more advanced benign and malignant skull base diseases involve a multidisciplinary approach in combination with neurotology and neurosurgery. Surgical approaches to the skull base are performed through techniques that include:

• lefort osteotomies
• subfrontal craniotomies
• infratemporal fossa approaches that permit effective tumor removal with minimal morbidity

Defects caused by cancer treatment, as well as by trauma, are dealt with through a combination of techniques including free tissue transfer.

Director: Scott Graham, MD

The rhinology and paranasal sinus section provides comprehensive team-oriented care for patients with all nasal and sinus complaints, including:

• nasal obstruction
• allergies
• cosmetic concerns
• problems with sense of smell
• troublesome sinusitis

Patients with tumors of the nose or sinuses receive multidisciplinary care in conjunction with radiotherapists, medical oncologists, and reconstructive surgeons.

Otolaryngologists work closely with colleagues in Allergy and Immunology to establish individualized treatment plans for each patient. Every attempt is made to isolate and treat medical factors which predispose patients to sinusitis. Same-day, on-site X-ray studies allow for a prompt, thorough evaluation of patients' conditions.

Otology-Neurotology/Skull Base Surgery

Director: Bruce Gantz, MD

This subspecialty service manages patients with diseases and disorders of hearing, balance, cranial nerves, and the skull base. The physician team specializes in the management of:

• neurosensory or inner ear hearing loss
• chronic ear disease
• conductive hearing loss
• balance disorders
• facial nerve disorders
• tumors of the cranial nerves

The center has extensive experience with hearing preservation procedures for patients with acoustic tumors.

A skull base team consisting of neurotologists, neurosurgeons, neuro-ophthalmologists, and neuroradiologists manage patients with large skull base disorders including:

• neuromas
• clivus chordomas
• petroclival meningiomas
• canvernous sinus tumors

The Iowa Cochlear Implant Clinical Research Center evaluates the latest cochlear implant technology and is developing new strategies to improve speech processing and speech perception. The hearing aid center has experience with digital hearing aids as well as other programmable and conventional hearing aid models. Two new surgically implanted hearing aids are undergoing evaluation which includes a new bone anchored hearing aid for conductive hearing loss, and the placement of an electromagnet on the incus for inner ear hearing loss.

Director: Richard J.H. Smith, MD

This Division offers internationally recognized expertise in the diagnosis, treatment, and long-term management of a variety of diseases and developmental abnormalities that affect children of all ages.

In the area of hearing impairment, diagnostic services are available, as well as treatment and long-term care for many forms of hereditary hearing impairment. The same types of services are provided for the many types of acquired hearing impairment.

In the area of congenital or late-onset airway abnormalities, expertise is provided in the diagnosis and treatment of patients with a number of problems unique to children, including:

• laryngomalacia
• subglottic hemangiomas
• subglottic stenosis
• vocal fold paralysis
• laryngeal webs
• recurrent respiratory papillomatosis
• laryngeal cysts

The Division offers several advanced treatment options for children with head and neck tumors, including:

• hemangiomas
• lymphangiomas with sclerosing agents
• recurrent respiratory papillomatosis with CO2 laser vaporization, microdebrider, Indole-3-carbinol, DIM, Acyclovir, and mitomycin

Expertise is also offered in:

• Treatment of rare pediatric tumors, including both benign and malignant tumors of the head and neck
• Medical therapy for sinusitis in children, including endoscopic sinus surgery
• Coordinated services with multiple pediatric subspecialty divisions
• Treatments for common pediatric problems such as recurrent otitits media and chronic tonsilitis

Plastic and Reconstructive Surgery

Director: John Canady, MD

Plastic surgeons at UI Hospitals and Clinics are board certified by the American Board of Plastic Surgery. Procedures performed include:

• face/head
• blepharoplasty
• botox injections
• brow lift
• chemical peel
• cleft lip and palate
• collagen injections
• dermabrasion
• eyes
• facelift
• facial implants
• hair transplant
• laser resurfacing
• liposuction
• mid-face lift
• otoplasty (protruding ears)
• rhinoplasty
• scar revision

Head and Neck Endocrine Oncology Program

Director: Russell Smith, MD

This program provides multidisciplinary treatment of patients with thyroid cancer and other diseases of the thyroid and parathyroid glands. Therapy frequently requires the participation of a head and neck surgeon, an endocrinologist, and a nuclear medicine physician. The program also extends to the evaluation of other thyroid conditions such as:

• goiter
• solitary thyroid nodule
• Grave’s disease
• parathyroid diseases such as adenomas, hyperplasias, and carcinomas.

The multidisciplinary approach allows patients the benefit of being seen by all involved specialties in one visit. Patients are able to have discussions on the same day with each physician regarding the role of surgery, medical management, and the use of nuclear medicine in the care of their condition.

A panel of specialists from otolaryngology, medical oncology, radiation oncology, pathology, and radiology meet weekly at a Tumor Board conference to discuss each patient’s diagnostic and therapeutic options. This conference assures that every patient receives a comprehensive review of all the information related to his or her disease.

Other Clinical Services

Director: R.S. Tyler, PhD

Complete diagnostic and rehabilitation audiological services are offered. Electrophysiological evoked audiology nerve, brain stem, and brain potentials are recorded, as well as otoacoustic emission. Additional services include the provision of all hearing aids and assistive listening devices. Services are also available for the management of patients with tinnitus. These include counseling, cognitive behavior modification, masking, and habituation therapy. Referrals are made to a masking and habituation therapy. Referrals are made to a psychologist and a biofeedback specialist when appropriate.

Director: Julie Wieland, AuD

The Center provides comprehensive hearing aid services for infants, children, and adults who have a hearing loss. Specialists fit and adjust a variety of the latest digital, programmable, and analog hearing aids. In addition, depending on the type and degree of hearing loss, an individual may be a candidate for an implantable hearing aid.

The Center also provides consultations and assistance in purchasing a variety of assistive listening devices, most of which substitute a vibration or light signal for the acoustic signal. Information about the voice-carry-over relay system for individuals who cannot understand conversations over the telephone are available.

Director: Bruce Gantz, MD

The cochlear implant project at The University of Iowa began in 1981 with the availability of single channel implants. The center evaluates the latest cochlear implant technology and is developing new strategies to improve speech processing and speech perception. The program is a clinical research project and has included FDA clinical trial studies for each implant device and upgrade seeking approval for use in the U.S.

Director: Michael Karnell, PhD

Chemotherapy and head/neck radiation for head and neck cancer may result in several potential side-effects affecting swallowing function and voice quality. The speech and swallowing team provides advice and support to manage the oral complications arising from chemotherapy and radiation treatment. Advice on diet, swallowing techniques, pain management, and oral hygiene, as well as careful monitoring of the patient’s overall oral and general health, is provided.

Director: Henry T. Hoffman, MD

This multidisciplinary clinic promotes and preserves vocal health. Individuals who have experienced a recent change in voice quality or who have become concerned about a long-standing problem with hoarseness may benefit from the clinic’s voice assessment services.

An otolaryngologist and a team of speech pathologists discuss and study the findings of each evaluation in order to develop a consensus customized treatment plan for each patient.