Newsletter-Spring-05 by mforbush


									                                                               Heads Up!
                                                               Otolaryngology — Head and Neck Surgery Newsletter

                   Volume 2, Issue 1 / Spring 2005                     University of California, San Francisco / Department of Otolaryngology — Head and Neck Surgery

                                                               Exciting Developments                                                         You Oto Know
                                                               Chairman’s Address                                                            News and Events
                                                               Welcome to the Spring 2005 edi-      Gibson, our department develop-          Andrew H. Murr, MD has been
                                                               tion of Heads Up!, the UCSF De-      ment officer, has initiated an am-       promoted to Professor of Clinical
                                                               partment of Otolaryngology –         bitious fundraising campaign in an       Otolaryngology, UCSF Department
                                                               Head and Neck Surgery Newslet-       effort to further advance the R. A.      of Otolaryngology — Head and
                                                               ter. Since our last edition, our     Schindler Temporal Bone Labora-          Neck Surgery.
                                                               Department has expanded fur-         tory. We gratefully acknowledge
                                                               ther, resulting in enrichment of     all of the generous donations that       Steven W. Cheung, MD has been
                                                               both our patient care services and   have made this effort possible.          awarded the Edmund Prince Fowler
                                                               educational offerings. This edi-                                              Award, given for excellence in Basic
                                                               tion of our newsletter presents      Endowed lectureships are an              Research by The Triological Society.
                                                               some of the exciting new develop-    important way to bring our faculty,
      David W. Eisele, MD                                      ments.                               residents, alumni, and community         2004 AAO-HNSF Annual
      Professor and Chairman                                                                        surgeons together for enlighten-         Meeting Awards and Honors:
                                Grand Rounds                   In this issue, we highlight three of ing discourse on the advances in
                                Mondays 4:30-6:30pm            our enhanced clinical programs:      our specialty. The Lewis Francis             David W. Kim, MD
                                N225, Parnassus                Head and Neck Endocrine Sur-         Morrison, MD Lectureship in                  AAFPRS Leslie Bernstein
                                                               gery, the UCSF Voice Center,         Head and Neck Surgery and the                Investigator Development Grant
                                Skull Base Conference          and Facial Plastic and Recon-        Robert A. Schindler, MD Lecture-             Eric J. Kezirian, MD
                                3rd Wednesday of every Month   structive Surgery. These services    ship in Otology, are two newly-              Earleen Elkins Research
                                7-8am A723, Parnassus          are directed by three of our tal-    established endowed lectureships             Training Award
                                                               ented faculty, Lisa Orloff, MD,      in the department. We encourage              David W. Eisele, MD
                                Head & Neck Tumor Board        Mark Courey, MD, and David           all of you to join us at these an-           Distinguished Service Award
                                Wednesdays 7:30-9am            Kim, MD, respectively. These         nual educational events.
                                H3805, Mt. Zion                specialists provide contemporary,                                             UCSF Association of Clinical
                                                               state-of-the-art clinical expertise I hope you find this edition of our       Faculty - department promotions:
Upcoming Lectures and Courses

                                Challenges in Facial           and educational leadership in newsletter interesting, and I wel-
                                Plastic Surgery Conference     these subspecialties.                come your comments at Eisele’s               Sheldon S. Kabaker, MD
                                2nd Friday of every Month                                           Corner on our Department web-                Clinical Professor
                                8-9am, 2330 Post Street        Resident education is a top prior- site at                 David J. Quenelle, MD
                                5th Floor Conference Room      ity for our department. With the                                                  Clinical Professor
                                                               building of our new Robert A. Sincerely,                                          Brian E. Schindler, MD
                                OHNS Resident                  Schindler, MD Temporal Bone                                                       Clinical Professor
                                Research Symposium             Laboratory this year under the                                                    Carol Dimeling, MD
                                Friday, June 17, 1pm           direction of Dr. Lawrence Lustig,                                                 Associate Clinical Professor
                                N225, Parnassus                Director of the Division of Otol-                                                 Jacob Johnson, MD
                                                               ogy, Neurotology and Skull Base                                                   Assistant Clinical Professor
                                Francis Sooy Lectureship       Surgery, resident training in Otol- David W. Eisele, MD
                                Saturday, June 18, 7:30am      ogy and Skull Base Surgery will Professor and Chairman                        The Head and Neck Surgery prac-
                                N225, Parnassus                be greatly enhanced. Candler                                                  tice scored an impressive 96.9% on
                                                                                                                                             the January 2005 Press Ganey
                                Otolaryngology Update
                                November 10-12
                                                               A Lifetime of Service                                                         Patient Satisfaction Survey question.

                                Ritz Carlton Hotel, SF         Dr. Robert A. Schindler’s Retirement
                                For More Information, please   Dr. Robert A. Schindler’s world-     Wersall and Åke Flock at one of         other areas of investigation. Due
                                contact Rachelle Venegas:      renowned research career at          the world’s foremost inner ear          to his initiative and fundraising
                                (415) 476-4952                 UCSF was highlighted at the re-      biology research laboratories at        efforts, the UC Board of Regents
                                                               cent research symposium and          the King Gustav V Karolinksa Insti-     established the Epstein Laboratory
                                                               retirement dinner held at the        tute in Stockholm, Sweden. After        in 1976.
                                                               Westin St. Francis Hotel.            his tenure in the Karolinska’s
                                                                                                    world-class facilities, Dr. Schindler   The mid-1970’s to the early 1980’s
                                                               Dr. Schindler’s research in co-      developed his vision of a state-of-     saw important developments in
                                                               chlear implants began with animal    the-art morphology and electron         cochlear implant research. A clini-
                                                               studies conducted in the Coleman     microscopy laboratory to comple-        cal trial of the first true multichan-
                                                               Laboratory in the early 1970’s in    ment the electrophysiological labo-     nel device - a 4-channel implant
                                                               collaboration with Michael Merzen-   ratories in the Coleman Laboratory      fabricated in the Coleman Lab -
                                                               ich, Robin Michelson and others.     and to provide facilities for multi-    was initiated with Dr. Schindler as
                                                               In 1973 he received a Fogarty        disciplinary approaches to re-          the surgeon.
                                                               Fellowship to work with Drs. Jan     search on cochlear implants and                   Continued on back page
   Alfred E. Mann and Dr. Schindler
The Lewis Francis Morrison
Endowed Lectureship in
                                                      Head and Neck Endocrine Surgery
Head and Neck Surgery                                 The Department is pleased to welcome its          microscopic head and neck surgery. A
                                                      newest faculty member, Lisa A. Orloff, MD,        graduate of Stanford University and UCLA
The Inaugural Lewis Francis Morrison, M.D. En-        a specialist in the surgical care of patients     School of Medicine, Dr. Orloff completed
dowed Lectureship in Head and Neck Surgery was        with thyroid and parathyroid diseases. Dr.        her residency training at the University of
held on March 24, 2005.                               Orloff has joined the Division of Head and        Washington, and a visiting fellowship in
                                                      Neck Surgery at UCSF Medical Center and           microvascular and reconstructive surgery at
                  Dr. Lewis Francis Morrison at-      the UCSF Comprehensive Cancer Center              Mount Sinai Medical Center in New York.
                  tended UC Berkeley, receiving       as Professor of Clinical Otolaryngology –         She has enhanced her ultrasonography
                  his BA in May 1920, his MS in       Head and Neck Surgery.                            experience through a recent Fulbright
                  bacteriology in December 1920                                                         scholarship and visiting professorship at
                  and his MD in 1926. He then         In addition to her expertise in head and          the Universities of Mainz and Regensburg
                  entered into private practice in    neck endocrine surgery, Dr. Orloff brings a       in Germany. Prior to joining the faculty at
                  otorhinolaryngology with Wallace    new dimension to the clinical practice in the     UCSF, Dr. Orloff was a member of the fac-
                  B. Smith, MD, and was ap-           form of real-time, office-based ultrasono-        ulty and Co-Director of the Multidisciplinary
                  pointed Instructor in the depart-   graphy. Not only is this non-invasive and         Thyroid/Parathyroid Clinic at the University
                  ment of Otorhinolaryngology at      painless imaging modality dynamic, sensi-         of California, San Diego.
UCSF, beginning a 30-year association with the        tive, interactive, and convenient for pa-
university. He rose in the department from Instruc-   tients, but also it has proven to be an ex-
tor in 1928 to Clinical Professor and Chairman of     tremely useful tool for operative planning
the Division in 1944. He became a Director of the     and anatomic teaching. State-of-the-art
American Board of Otolaryngology in 1952. As a        management of patients with thyroid cancer
testament to his success at teaching, Dr. Morrison    involves ultrasonographic surveillance for
was presented with a silver laryngoscope at a tes-    thyroid bed and lymph node metastases,
timonial dinner in 1952 by the doctors he had         which Dr. Orloff incorporates into her
trained.                                              perioperative care. Additionally, ultrasound
                                                      is valuable in the staging and monitoring of
At the time of his death in 1958, he was president-   primary tumors and lymph node metasta-
elect of the Triological Society. Dr. Morrison is     ses in patients with benign and malignant
best known for his monumental contributions in        head and neck and salivary gland tumors.
laryngology. He clarified our understanding of                                                      Dr. Lisa Orloff performing a neck
anatomy of the recurrent laryngeal nerves, the        Dr. Orloff has additional expertise in laryn- examination in the Head and Neck
paralyzed larynx and cancer therapy. He origi-        gology, microvascular surgery, and head Surgery Clinic using a high-resolution
nated the reverse King operation, and pioneered       and neck surgical oncology. She performs ultrasound unit
the use of radioactive cobalt in otolaryngology and   endoscopic, minimally invasive, open and
the application of Papanicolau smear technique for
malignancies of the nasopharynx.

The Morrison Endowed Lectureship was estab-           UCSF Voice Center
lished by a generous gift from Dr. Morrison's         In April 2004, Mark Courey, MD joined the         related to tremor, Parkinson’s disease and
daughter Helen M. Elkus and her husband, Rich-        Department as Director, Division of Laryn-        ALS. Patients with voice disorders such as
ard J. Elkus, Jr.                                     gology. Previously he was an Associate            hoarseness, early laryngeal cancer, recur-
                                                      Professor at Vanderbilt University and Medi-      rent respiratory papilloma and vocal fold
The first Morrison Lecturer was Herbert H. Dedo,      cal Director of the Vanderbilt Voice Cen-         paralysis are evaluated by the team of pro-
MD, Professor, Department of Otolaryngology -         ter. Dr. Courey’s practice focuses on pa-         fessionals daily.
Head and Neck Surgery, University of California,      tients with hoarseness, breathing difficulties,
San Francisco. Dr. Dedo has been associated           swallowing disorders, and early laryngeal         Miriam van Mersbergen, PhD is the Director
with UCSF since 1951. He earned his BA at UC          cancers. He works extensively with profes-        of Singing Arts and Sciences for the Center.
Berkeley in 1954 and his MD from UCSF in 1958.        sional voice users including teachers, attor-     Dr. van Mersbergen has experience in both
He joined the Department of Otolaryngology,           neys, commercial and classically trained          commercial and classical singing tech-
UCSF, as an Assistant Professor in 1966. He           singers and broadcasters. Through his             niques. With her expertise in the behavioral
served as Vice Chair in Otolaryngology from 1974      research on benign laryngeal diseases,            aspects of treatment of professional voice
to 1991, becoming a Professor in 1982. He has         effects of laryngeal injection on vocal fold      problems, the center will clinically manage
received, for his research on laryngeal paralysis,    physiology and electrical stimulation of the      patients with all types of dysphonia. This
the prestigious Harris P. Mosher Award of the         paralyzed vocal fold, Dr. Courey gained           exciting, technologically-advanced program
Triological Society in 1970.                          experience in the management of laryngeal         is the first multidisciplinary center for pa-
                                                      diseases.                                         tients with voice and swallowing disorders in
Dr. Dedo is renowned for inventing the Dedo-                                                            the Northern California/Bay area.
Pilling Laryngoscope and for developing recurrent     At UCSF, Dr. Courey’s goal has been to
laryngeal nerve resection for treatment of spas-      establish a multidisciplinary center for pa-
modic dysphonia. Dr. Dedo is a world-famous           tients’ with voice and swallowing disorders.
laryngologist who trained in Otolaryngology during    Building on work begun by Mark Singer, MD
the time when Dr. Morrison was Chairman of the        and Susan Langmore, PhD, Dr. Courey
Division of Otolaryngology at UCSF.                   designed a comprehensive Voice and Swal-
                                                      lowing Center which offers patients com-
                                 Dr. Morrison's
                                                      plete diagnostic testing for voice disorders,
                                 daughter Helen
                                                      including laryngeal stroboscopy, laryngeal
                                 M. Elkus
                                                      electromyography and acoustic analysis;
                                 (center) with her
                                                      Dr. Langmore provides fluoroscopic and
                                 husband, Rich-
                                                      fiberoptic evaluations of swallowing.
                                 ard J. Elkus, Jr.
                                 (left) and Dr.
                                                      Specialized clinics are held weekly for pa-
                                 Herbert H. Dedo
                                                      tients with spasmodic dysphonia and other Dr. Mark Courey performing a video-
                                                      neurolaryngeal disorders including those stroboscopic examination in the Voice Center
Facial Plastic and Reconstructive Surgery                                                             The Francis A. Sooy, MD
                                                                                                      End of the Year Lectureship and Program
Dr. David W. Kim joined us in July 2003 as         challenging problems are examined and
Director of the Division of Facial Plastic and     discussed by a panel of UCSF experts in                         The Francis A. Sooy Lectureship will
Reconstructive Surgery. His areas of spe-          facial plastic surgery, dermatologic surgery,                   be held on June 18, 2005.
cial interest are rhinoplasty, functional na-      oculoplastic surgery, and otolaryngology.
sal airway surgery, facial reconstruction,                                                                           The 2005 Sooy Lecturer will be Ellen
and rejuvenation surgery of the aging face.        Dr. Kim received the prestigious Leslie Bern-
                                                                                                                     M. Friedman, MD, FAAP, FACS,
                                                   stein Young Investigator Grant in 2003 for his
                                                                                                                     Chief of Service, Department of Oto-
Dr. Kim has developed a state-of-the-art           study, “Functional Rhinoplasty: A Multicenter
                                                                                                                     laryngology, Texas Children's Hospi-
UCSF Facial Plastic and Reconstructive             Prospective Outcomes Study.” He is the
                                                                                                      tal, Houston, TX, and Professor, Baylor College of
Surgery Center. With aesthetic nurse spe-          principal investigator of this 3-year project in
                                                                                                      Medicine. Dr. Friedman is also a Director of the
cialist Janet Tanaka, Dr. Kim receives pa-         which national leaders of rhinoplasty study
                                                                                                      American Board of Otolaryngology. Her primary
tient referrals with difficult or revision nasal   patients undergoing nasal valve surgery            clinical interests are pediatric otolaryngology, air-
deformities, deformities related to facial         within a protocol aimed toward determining         way problems, and congenital malformations of the
paralysis, and facial stigmata of the aging        the effectiveness of the various techniques        head and neck.
process.                                           used. Practitioners wishing to enroll patients
                                                   into this protocol or who would like to refer a
                                                                                                      Dr. Francis A. Sooy was associated with the Uni-
Equipped with the latest technology in pho-        patient may do so by calling (415) 885-7700
                                                                                                      versity of California for 50 years, beginning with his
tographic and video imaging, computer              or through the center’s web site:
                                                                                                      undergraduate years at Berkeley in 1933 to his
imaging manipulation, and low-impact facial
                                                                                                      graduation from medical school at UCSF in 1941.
rejuvenation (intense pulse light therapy),
                                                                                                      Dr. Sooy joined the Division of Otolaryngology and
Dr. Kim provides his patients with a thor-
                                                                                                      transformed the enterprise to a department, serv-
ough and individualized consultation. Pa-                                                             ing as Chairman from 1967 to 1972. He then went
tients may receive surgical treatment and/                                                            on to serve as Chancellor of UCSF from 1972 -
or an assortment of minimally invasive in-                                                            1982. During his tenure as Chancellor, UCSF
office procedures such as botulinum toxin,                                                            gained recognition as a premier health sciences
intense pulse light therapy, or injectable
                                                                                                      campus, and Dr. Sooy oversaw the completion of
fillers; his treatment plans reflect a conser-
                                                                                                      the new School of Dentistry building, the new mod-
vative approach to surgery that minimizes
                                                                                                      ernized Moffitt-Long Hospital. Dr. Sooy recruited
risks and complications and emphasizes
                                                                                                      many outstanding physicians and scientists, in-
creating natural-appearing improvements.
                                                                                                      cluding three new deans.
Dr. Kim has established a monthly multidis-
                                                                                                      The Sooy Lectureship was established in his mem-
ciplinary Challenges in Facial Surgery con-                                                           ory by gifts from his family, colleagues, friends and
                                            Dr. David Kim uses the Mirror System to
ference in which patients with especially                                                             former patients.
                                            provide post operative projections

Robert A. Schindler, MD                                                                               Robert A. Schindler, MD
                                                                                                      Endowed Lectureship in Otology
Temporal Bone Laboratory Established
With the decision to name the department's dation that has supported research in the                               The Inaugural Robert A. Schindler MD
temporal bone and microvascular laboratory department annually for over 16 years.                                  Endowed Lectureship in Otology was
in honor of Dr. Robert Schindler (see article                                                                      held on October 9, 2005 at the Westin
on his retirement, pg. 1), plans are rapidly                                                                       St. Francis Hotel in San Francisco.
emerging for the lab's design and its equip-                                                                       The Inaugural Lecturer was Alfred E.
ment needs. Dr. Lawrence Lustig, Director                                                                          Mann who presented "How Bob
of Otology, Neurotology, and Skull Base                                                                            Schindler Helped the Deaf to Hear."
Surgery, is heading up our effort to design
and equip the Robert Schindler Temporal                                                               Al Mann is one of the world's most influential and
Bone Laboratory.                                                                                      well-respected medical technology entrepreneurs.
                                                                                                      Mr. Mann is Chairman and Co-Chief Executive
Space has been secured in UCSF’s Mission                                                              Officer of Advanced Bionics Corporation, a global
Center Building at 15th and Folsom Streets                                                            leader in implantable neurostimulation devices.
for the department to build the laboratory                                                            The company was founded in 1993 to manufacture
and equip it with 12 surgical instrumentation                                                         and distribute the CLARION ® cochlear implant to
stations and microscopes. The goal of the                                                             treat total deafness.
                                                   Dr. Robert A. Schindler receiving a plaque
lab will be to train residents and visiting        from Chief Resident Dr. Steven Pletcher
surgeons in all aspects of temporal bone                                                              This lectureship is named for Dr. Robert A.
anatomy and surgical technique.                                                                       Schindler, who served as Chairman of the Depart-
                                                                                                      ment of Otolaryngology - Head and Neck Surgery
After directing renovation of the new space,                                                          from 1989-1999, and retired from UCSF in the fall
Dr. Lustig will continue to work with his col-                                                        of 2004. Dr. Schindler performed fundamental
leagues to identify additional funding                                                                research documenting auditory nerve survival in
sources to outfit the lab. They will be looking                                                       chronically implanted experimental animals, which
for both corporate and private cash gifts or                                                          provided early impetus for the development of
gifts-in-kind donations of equipment to use                                                           long-term intracochlear multichannel implants. It
in the laboratory. It is estimated that the                                                           was this groundbreaking research that prompted
total cost of the project will approach                                                               Al Mann to develop the CLARION ® cochlear im-
$400,000. To date, the department has                                                                 plant for commercial use by patients.
raised approximately $150,000 from our
generous alumni as well as timely support Faculty managing the laboratory. Left to                    The endowed lectureship was established by a
from Hearing Research Inc., a private foun- right: Drs. Cheung, Lustig, Wang and Murr                 generous gift from Dr. Robert A. Schindler and
                                                                                                      Mrs. Janet Feinberg Schindler.
                                                                                                                     Head and Neck Surgery, Univer-
Continued from front page             response to ototoxic drugs, fluid/
                                      particle transport, hyaluronan
                                                                             Calling Alumni                          sity of Texas at Houston.
He developed an instrument for        synthesis and effects of endolym-      News and Updates                        Send us your news:
inserting spiral electrode arrays     phatic duct occlusion. In 1991 the
                                                                                                           , or
into the cochlea and contributed      Coleman Lab became part of the         Congratulations to 1994 Resident        Otolaryngology - Alumni News
extensively to the remarkable         new Keck Center, and the Epstein       Alumnus Dr. C.Y. Joseph Chang           Attn: Vivian Weigel
improvements in devices that          Lab relocated into larger, better-     recently appointed Chairman,            400 Parnassus Ave, Box 0342
occurred over the ensuing years.      equipped facilities that include an    Department of Otolaryngology —          San Francisco, CA 94143-0342
                                      animal surgery and electrophysi-
In 1993, Dr. Schindler convinced      ology suite and new electron and
Mr. Al Mann to undertake the          light microscopy suites. The mul-
commercial development of the
UCSF multichannel cochlear im-
                                      tidisciplinary approach to complex
                                      research issues continues with
                                                                              Residents’ Spotlight
plant through the establishment of    projects focused in areas that          Congratulations to our Graduating Chief Residents:
Advanced Bionics Corporation.         include cochlear implant re-
Contemporary cochlear implants        search, auditory system develop-
have now exceeded the most            ment and plasticity and critical
optimistic early hopes that they      periods. The laboratory has pro-
would restore speech understand-      vided training and collaboration to
ing to profoundly deaf individuals.   dozens of medical and graduate
The latest technology provides        students, postdoctoral fellows,         Dov Bloch, MD          Karsten Munck, MD          Steven Pletcher, MD
more channels, reverse telemetry      visiting scientists and faculty from    Private practice       U.S. Air Force             Fellowship with
for assessing neural responses        around the world, and it will play a    Multi-Specialty        Travis Air Base            Dr. Ralph Metson at the
and high rate/flexible speech         major role in the research mission      Group in Danbury/      Fairfield, CA              Massachusetts Eye and
processors, small enough to be        of the department in the future.        Ridgefield, CT                                    Ear Infirmary, Harvard
worn behind the ear.        Today,    The Epstein Laboratory is Dr.                                                             University, Boston, MA
many of the 85,000 cochlear im-       Schindler’s important legacy to
                                                                              Welcome to our new 2005 / 2006 Program Year 2 Residents:
plant users enjoy 80-90% speech       the department.
recognition and use the tele-
phone. A few even appreciate

Over the past three decades, the
Epstein Lab has continued to
grow. In 1980 Dr. Schindler be-                                               Theresa Kim, MD        Frederick Roediger, MD David Saito, MD
came the first member of the
                                                                              Welcome to our new 2005 / 2006 Program Year 1 Residents:
UCSF faculty to be a recipient of
the Triological Society Fowler
Award for his research on the
human endolymphatic sac. Dur-
ing the next 20 years he collabo-
rated with residents, fellows and
visiting faculty to study and pub- Dr. Robert A. Schindler using an
lish articles on the ultrastructure electron microscope to examine            Harry Hwang, MD        Krista Rodriguez -         Betty Tsai, MD
and pathology of the endolym- the inner ear in 1976                                                  Bruno, MD
phatic sac in Meniere’s disease,

Contact Us                             Heads Up!                             Giving Back: Donors
General Otolaryngology                 Volume 2, Issue                       Philanthropy has provided vi-           dowed Lectureship in Otology,
415-353-2757                                                                 tal support for our educational         which was inaugurated last fall by
                                       Department Chairman,                  mission.         The Robert A.          medical device entrepreneur Al-
Pediatric Otolaryngology               Editor in Chief:                      Schindler, MD Temporal Bone             fred E. Mann. It was at Dr.
415-353-2757                           David W. Eisele, MD                   Laboratory will offer a state-of-       Schindler's retirement event that
                                                                             the-art facility for our residents to   the Elkuses decided to make their
Otology and Neurotology                Executive Editor:                     develop skills in surgery of the        generous commitment.
415-353-2757                           Louisa T. Burgio, MA, MBA             temporal bone and microvascular
                                                                             anatomy. This facility will be the      All of us in the department thank
Cochlear Implant Program               Managing Editor:                      first of its kind at UCSF and al-       our donors for helping us expand
415-353-2464                           Emerald Light                         lows us to enhance our national         our educational opportunities and
                                                                             reputation for outstanding resi-        to support our commitment to
Head & Neck Surgery and                Editors:                              dency training.                         excellence in patient care and
Rehabilitation Center                  Kathy Buchanan                                                                research.
415-885-7528                           Candler Gibson                        Philanthropy has strengthened
                                       Katherine Rollins-McLean              our educational offerings. The          Candler Gibson,
Facial Plastic Surgery                 Vivian Weigel                         Lewis Francis Morrison, MD En-          Development Director
415-885-7700                           Holly Wong, MA                        dowed Lectureship in Head and           Otolaryngology -
                                                                             Neck Surgery has been estab-            Head and Neck Surgery
Voice and Swallowing Center            Artistic Design and Graphics:         lished by a generous gift from          (415) 476-3403
415-885-7700                           Bobby Penn, MBA                       Helen M. and Richard J. Elkus,          UCSF Box 0248
                                                                             Jr. Dr. Robert Schindler and his        44 Montgomery St., Suite 2200
Online                                 Special thanks to photographic        wife Janet generously established       San Francisco, CA 94143-0248                   contributors.                         the Robert A. Schindler, MD En-

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