Otolaryngology – Ear, Nose and Throat Surgery
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The department evaluates approximately 13,000 patients per year in the otolaryngology outpatient clinics and performs nearly 1,700 hospital-based surgical procedures annually. The Department of Otolaryngology - Head and Neck Surgery provides care for patients with problems involving the ears, sinuses, oral cavity, nose, throat, neck (ENT) including sinus conditions, allergy, sleep disorders, and snoring.
"Dr. Grillone is such a class act! Very accommodating and helpful! Saw him 8 years prior and he remembered me. I am happy he's right around the corner from my office. And he brings in fellow docs he can trust and will help make your case top priority."
The department also specializes in swallowing disorders, voice problems, dizziness and balance disorders, and hearing loss, cancers of the head and neck and the division of Facial Plastic and Reconstructive Surgery offers cosmetic surgery and management of facial deformities and facial fractures.
Our physicians are making headlines in local news.
1st Floor, Suite 1400
Moakley Building 617.638.8124
Scheduling a Virtual Visit
Telehealth visits are also available. In addition to regular telehealth visits, we offer short notice urgent telehealth appointments, which are available within one to two business days. You can book these appointments online using ZocDoc.
The Head and Neck Cancer Center is a major provider in the Northeast for patients with early-stage, recurrent, or aggressive head and neck cancers. The nationally recognized team of multidisciplinary specialists who care for these patients collaborate to manage patient care from the first consultation through treatment and follow-up.
Conditions We Treat
Similarly to chronic sinusitis, allergic rhinitis is a common medical condition. It affects about 30% people.
Autoimmune inner ear disease (AIED) is an inflammatory condition of the inner ear. It occurs when the body's immune system attacks cells in the inner ear that are mistaken for a virus or bacteria. AIED is a rare disease occurring in less than one percent of the 28 million Americans with a hearing loss.
A cholesteatoma is a skin growth that occurs in the middle ear behind the eardrum. This condition usually results from poor Eustachian tube function concurrent with middle ear infection (otitis media), but can also be present at birth. The condition is treatable, but can only be diagnosed by medical examination. Over time, untreated cholesteatoma can lead to bone erosion and spread of the ear infection to localized areas such as the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and death can occur.
The most common causes of hoarseness and vocal difficulties are Acute Laryngitis, Chronic Laryngitis, Laryngopharyngeal Reflux Disease (LPRD), Voice Misuse and Overuse, Benign Vocal Cord Lesions, Vocal Cord Hemorrhage, Vocal Cord Paralysis and Paresis, Laryngeal Cancer.
A deviated septum occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases, the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
Otitis media refers to inflammation of the middle ear. When an abrupt infection occurs, the condition is called "acute otitis media." Acute otitis media occurs when a cold, allergy, and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube. This can cause earache and fever.
Researchers continue to look for help for children and parents of children who suffer from the most common type of ear infection, called middle ear infection or otitis media (OM). About 62 percent of children in developed countries will have their first episode of OM by the age of one, more than 80 percent by their third birthday, and nearly 100 percent will have at least one episode by age five.
Earwax (also known as cerumen) is produced by special glands in the outer part of the ear canal and is designed to trap dust and dirt particles keeping them from reaching the eardrum. Usually the wax accumulates, dries, and then falls out of the ear on its own or is wiped away. One of the most common and easily treatable causes of hearing loss is accumulated earwax. Using cotton swabs or other small objects to remove earwax is not recommended as it pushes the earwax deeper into the ear, increasing buildup and affecting hearing. Excessive earwax can be a chronic condition best treated by a physician.
When the body's immune system is suppressed, fungi find an opportunity to invade the body and a number of side effects occur. Because these organisms do not require light for food production, they can live in a damp and dark environment. The sinuses, consisting of moist, dark cavities, are a natural home to the invading fungi. When this occurs, fungal sinusitis results.
Gastroesophageal reflux disease, or GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from “refluxing” or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up the esophagus.
With aging, the physiology and function of the nose changes. The nose lengthens, and the nasal tip begins to droop due to weakening of the supporting cartilage. This in turn causes a restriction of nasal airflow, particularly at the nasal valve region (where the upper and lower lateral cartilages meet). Narrowing in this area results in the complaint of nasal obstruction, often referred to as geriatric rhinitis.
There are many types of head and neck cancers, including cancers that occur in the mouth, those that affect the nasal passages and other area cancers, including thyroid and parathyroid cancers. Treatment depends on the type, location and size of the cancer.
Conductive hearing loss is a form of hearing impairment where the transmission of sound from the environment to the inner ear is impaired, usually from an abnormality of the external auditory canal or middle ear.
Hyperacusis is a condition that arises from a problem in the way the brain’s central auditory processing center perceives noise. It can often lead to pain and discomfort.
Laryngeal cancer is a type of throat cancer that develops in the voice box (larynx), which contains the vocal cords that vibrate to make sound when air is directed at them. Using tobacco products and drinking alcohol can raise the risk of laryngeal cancer.
During gastroesophageal reflux, the contents of the stomach and upper digestive tract may reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), and into the back of the throat and possibly the back of the nasal airway. This is known as laryngopharyngeal reflux (LPR).
Vocal cord lesions (physicians call them vocal fold lesions) are a group of noncancerous (benign), abnormal growths within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems and are generally seen in three forms; nodules, polyps, and cysts.
The term otosclerosis is derived from the Greek words for "hard" (scler-o) and "ear" (oto). It describes a condition of abnormal bone growth around the stapes bone, one of the tiny bones of the middle ear. This leads to a fixation of the stapes bone. The stapes bone must move freely for the ear to work properly and hear well.
Paradoxical vocal fold movement (PVFM), happens when the vocal folds close instead of open. For example, when taking a deep breath, the vocal folds should open to let air through to the lungs. With PVFM, the vocal folds will close, making it hard to breathe. Often misdiagnosed as asthma, PVFM most often causes wheezing, stridor, and breathing problems.
Pediatric feeding disorders consist of problems related to feeding and swallowing, specifically addressing concerns around an infant, a toddler, or a child's ability to chew, swallow, and complete a feeding/meal safely and efficiently.
Thyroid cancer is the third most common solid tumor malignancy and the most common endocrine malignancy in children. It occurs four times more often in females than males and has similar characteristics as adult thyroid cancer.
A perforated eardrum is a hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear. A perforated eardrum is often accompanied by decreased hearing and occasional discharge with possible pain. The amount of hearing loss experienced depends on the degree and location of perforation. Sometimes a perforated eardrum will heal spontaneously, other times surgery to repair the hole is necessary. Serious problems can occur if water or bacteria enter the middle ear through the hole. A physician can advise you on protection of the ear from water and bacteria until the hole is repaired.
The glands are found in and around your mouth and throat. The major salivary glands are called the parotid, submandibular, and sublingual glands. They all secrete saliva into the mouth, the parotid through tubes that drain saliva, called salivary ducts, near the upper teeth, submandibular under the tongue, and the sublingual through many ducts in the floor of the mouth.
Sinus and nasal passages can become inflamed leading to a headache. Headache is one of the key symptoms of patients diagnosed with acute or chronic sinusitis. In addition to a headache, sinusitis patients often complain of pain and pressure around the eyes, across the cheeks and the forehead, achy feeling in the upper teeth, fever and chills, facial swelling, nasal stuffiness and yellow or green discharge.
The body's nasal and sinus membranes have similar responses to viruses, allergic insults, and common bacterial infections. Membranes become swollen and congested. This congestion causes pain and pressure; mucus production increases during inflammation, resulting in a drippy, runny nose. These secretions may thicken over time, may slow in their drainage, and may predispose to future bacterial infection of the sinuses.
Symptoms of Sinusitis include facial pressure or pain, nasal discharge that is yellow or green, post-nasal drip, and cough. For the most part, sinusitis symptoms, diagnosis, and treatment are the same for the elderly as other adult age groups. However, there are special considerations for older Americans.
An individual with sleep apnea experiences breathing that stops and starts during the sleep cycle. The two main types of sleep apnea are central sleep apnea, when the brain isn’t sending the right signals to the muscles that control breathing, and obstructive sleep apnea, when the throat muscles relax.
An infection of the outer ear structures caused when water gets trapped in the ear canal leading to a collection of trapped bacteria is known as swimmer’s ear or otitis externa. In this warm, moist environment, bacteria multiply causing irritation and infection of the ear canal. Although it typically occurs in swimmers, bathing or showering can also contribute to this common infection. In severe cases, the ear canal may swell shut leading to temporary hearing loss and making administration of medications difficult.
Tinnitus is commonly defined as hearing a sound in the absence of external sounds. Tinnitus is not a disease in itself but a common symptom, and because it involves the perception of sound or sounds, it is commonly associated with the hearing system. In fact, various parts of the hearing system, including the inner ear, are often responsible for this symptom.
Tonsillitis refers to inflammation of the pharyngeal tonsils (glands at the back of the throat, visible through the mouth). The inflammation may involve other areas of the back of the throat, including the adenoids and the lingual tonsils (tonsil tissue at the back of the tongue). There are several variations of tonsillitis: acute, recurrent, and chronic tonsillitis, and peritonsillar abscess.
Tonsils and adenoids are the body’s first line of defense as part of the immune system. They “sample” bacteria and viruses that enter the body through the mouth or nose, but they sometimes become infected. At times, they become more of a liability than an asset and may even cause airway obstruction or repeated bacterial infections. Your ear, nose, and throat (ENT) specialist can suggest the best treatment options.
Vocal cord paralysis happens when the nerve impulses to the vocal box (larynx) are interrupted, causing paralysis. Because the vocal cord muscles not only help produce sound but help to keep saliva, food and fluid from entering the windpipe (trachea), vocal cord paralysis requires medical help. The condition can be caused by number of things including nerve damage during surgery, from cancer, or a viral infection.
Zenker's diverticulum (ZD) is a condition characterized by a pouch that develops in the upper esophagus in the neck.
Treatments & Services
Ear Plastic Surgery
Ear deformities occur in a number of conditions. Some patients are born with absent (microtia), protruding or drooping ears, due to weak or poorly formed cartilage. Traumatic deformities of the ear also occur due to trauma (e.g. car wreck or dog bite) or torn earlobes. Deformity of the ears may cause social anxiety and may make children vulnerable to teasing. Regardless of the origin of the ear deformity, these ear conditions can be surgically corrected. These procedures do not alter the patient's hearing, but they may improve appearance and self-confidence.
Cochlear Implant Surgery
There are several types of cochlear implants. Working with the doctor, adults and children choose the cochlear implant to best fit their needs. The team provides explanations of the different options available for internal/external components, speech processors, etc.
Buteyko is a clinically-proven, natural, safe breathing retraining program which utilizes the body’s self-healing capacities. It is based on the standard medical principles of respiration and the Bohr effect.
Continuous Positive Airway Pressure (CPAP)
The most common and effective nonsurgical treatment for sleep apnea is Continuous Positive Airway Pressure or CPAP which is applied through a nasal or facial mask while you sleep. The CPAP device does not breathe for you. Instead, it creates a flow of air pressure when you inhale that is strong enough to keep your airway passages open. Once your otolaryngologist determines that CPAP is the right treatment, you will need to wear the CPAP mask every night.
Each year thousands of people undergo surgery of the nose. Nasal surgery may be performed for cosmetic purposes, or a combination procedure to improve both form and function. It also may alleviate or cure nasal breathing problems, correct deformities from birth or injury, or support an aging, drooping nose. Patients who are considering nasal surgery for any reason should seek a doctor who is a specialist in nasal airway function, as well as plastic surgery. This will ensure that efficient breathing is as high a priority as appearance.
The ear, nose, and throat specialist will prescribe many medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) and procedures (flushing) for treating acute sinusitis. There are occasions when physician and patient find that the infections are recurrent and/or non-responsive to the medication. When this occurs, surgery to enlarge the openings that drain the sinuses is an option.
Treatment Options for Adults with Snoring
Snoring is a sound produced by vibration of the soft tissues of the upper airway during sleep and is indicative of increased upper airway resistance. Studies estimate that 45% of men and 30% of women snore on a regular basis. It can affect not only the snorer’s sleep but also the sleep of a spouse or other family members nearby. In fact, snoring causes many couples to sleep in separate rooms and often places strain on marriages and relationships. Recent evidence suggests that snoring may even cause thickening of the carotid arteries over time and potentially increase risk of stroke.
For patients who have moderate sleep apnea, or are unable to use a C-PAP device, an oral appliance can be an effective treatment. The oral appliance is a molded device that is placed in the mouth at night to position the lower jaw and bring the tongue forward, elevating the soft palate while keeping the tongue from falling back in the airway and blocking breathing.
Sleep Apnea Surgical Treatments
Inspire® therapy (Upper Airway Stimulation) is an FDA-approved, minimally invasive, implantable device that delivers mild stimulation to the nerves of the tongue muscles, thereby keeping the airway open during sleep.
Tonsillectomy and Adenoids Post-Op
The tonsils are two clusters of tissue located on both sides of the back of the throat. Adenoids sit high in the throat behind the nose and the roof of the mouth. Tonsils and adenoids are often removed when they become enlarged and block the upper airway, leading to breathing difficulty. They are also removed when recurrence of tonsil infections or strep throat cannot be successfully treated by antibiotics. The surgery is most often performed on children. The procedure to remove the tonsils is called a tonsillectomy; excision of the adenoids is an adenoidectomy. Both procedures are often performed at the same time; hence the surgery is known as a tonsillectomy and adenoidectomy, or T&A.
Otolaryngologists - Head and Neck Surgeons
Benign and Malignant Tumors of the Head and Neck, Robotic Surgery and Minimally Invasive Surgery for Head and Neck Tumors, Laryngeal, Voice and Swallowing Disorders, Surgical Treatment of Sleep Apnea, Diseases of the Trachea and Esophagus, Zenker's Diverticulum
Professor of Otolaryngology, Head & Neck Surgery, Boston University School of Medicine
Hoarseness, Parathyroid, Thyroid and Voice Problems, Zenker's Diverticulum
Residency Program Director
Sinusitis, Nasal Polyps, CSF Leak, Sinus Mass, Deviated Septum
Pediatric Otolaryngology, Chronic Sinusitis, Allergy, Salivary Gland Disorders, Snoring and Sleep Surgery
Professor, Department of Neurological Surgery
Endoscopic minimally invasive skull base surgery; Otologic/vestibular disorders; Lateral skull base diseases and tumors; Anterior skull base tumors/paranasal sinus diseases; Head and neck surgery; Head and neck cancer; General otolaryngology
Assistant Professor, Boston University School of Medicine
Minimally invasive approaches, Microvascular reconstruction, Improving functional outcomes after cancer care
Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine
Microvascular surgery; Head and neck reconstructive surgery; Facial trauma; Head and neck cancer; Facial paralysis; Facial plastic surgery; Facial cosmetic surgery
Minimally invasive surgery, Management of HPV related oropharynx cancer
Ear and hearing disorders, Sudden hearing loss, Dizziness, Vertigo, Tinnitus
Associate Professor of Otolaryngology and Pediatrics, Boston University School of Medicine
Assistant Residency Program Director
Pediatric Neck Masses, Pediatric Airway Problems or Noisy Breathing, Pediatric Sleep Disordered Breathing, Pediatric Sinusitis or Nasal Congestion, Pediatric Cysts of the Neck/Face
Rhinoplasty - nose job, Facelift, Blepharoplasty, Facial Plastic Surgery, Botox and Juvederm and Fillers, Cosmetic Surgery
Hoarseness and voice disorders, Professional voice, Dysplasia and vocal cord cancer, Office-based laser laryngeal surgery, Airway and swallowing disorders, Diseases of the trachea and esophagus, Zenker's Diverticulum
Professor of Otolaryngology, Boston University School of Medicine
Cochlear implants & other implantable hearing devices, hearing loss disorders, acoustic neuroma, cholesteatoma, otosclerosis, facial nerve disorders, chronic ear infections, tinnitus, vertigo, dizziness, glomus & other skull base tumors
Dysphagia (swallowing problems), Dysphonia (voice problems), Cognitive Deficits and Aphasia (language problems), Reflux-related disorders
Dysphonia (voice disorders), professional voice, globus syndrome, muscle tension dysphagia
Professional voice, dysfunctional breathing, muscle tension dysphonia, irritable larynx and chronic cough
Dysphagia, dysphonia, and neurogenic disorders of language and cognition
Swallowing assessment, FEES, MBS, dysphagia therapy, aphasia, cognitive-communication deficits
Dysphagia (swallowing problems), Dysphonia (voice problems), Reflux-related disorders, Alaryngeal Rehabilitation included Tracheoesophageal (TEP) Voice Restoration/Management
Feeding Difficulty, Selective Eating, Pediatric Dysphagia
Dysphagia (swallowing problems), Alaryngeal rehabilitation including tracheoesophageal (TEP) voice restoration/management, Evaluation and treatment of swallowing problems after head and neck cancer
Samantha Ashinoff, MS, CCC-SLP
Kim Boscodoss, MS, CCC-SLP
Michelle Ganann, CCC-SLP
Anna Lifvergren, CCC-SLP
Keri Miloro, CCC-SLP
Juliet Ochura, MS, CCC-SLP, CLC
Jennifer Perez, MS, CCC-SLP, CLC
Krystal Radnor CCC-SLP-CFY Clinical Fellow
Casey Scott, MS, CCC-SLP-CFY Clinical Fellow
Pediatric Through Geriatric Diagnostic Testing, Auditory Evoked Potentials, Newborn Diagnostic Testing, Vestibular Testing
Pediatric through geriatric diagnostic hearing evaluations, auditory evoked potentials, vestibular evaluation, bone-anchored and cochlear implants, and hearing aid evaluation and dispensing.
Clinical Audiologist Pediatric and Adult audiologic evaluations, hearing aid evaluations and dispensing, bone-anchored hearing aids, newborn diagnostic evaluations, newborn hearing screenings
Pediatric and adult audiologic evaluations, hearing aid evaluation and dispensing, cochlear implants, vestibular evaluations, auditory evoked potentials, and newborn hearing screenings.
Pediatric through adult diagnostic hearing evaluations, cochlear implants and bone-anchored hearing devices, hearing aid evaluation and dispensing, and vestibular testing.
Sarah Frazier, BSN, RN
Susan Griever, NP
Lanisha Harrison, RN
Brandy Kenner Keefe, FNP
Marianna Keegan, NP
Shirley R Koss, NP
Jennifer Lauver, RN
Jessica Lizotte, NP
Ann Poulsen, RN
Rebecca Ryan, RN, BSN
Researchers and Instructors
Gintas Krisciunas, MPH, MA
Zimmern Wang, MD
What to Expect When You Arrive For Your Appointment
Many education and training opportunities exist for both existing medical professionals and medical students through the Department of Otolaryngology – Head and Neck Surgery. Please visit the sections below to learn more.
Students who are considering or intend to pursue a career in Otolaryngology are strongly encouraged to apply for the four week elective clerkship during their fourth year. To apply for this elective, Boston University School of Medicine (BUSM) students should contact the Otolaryngology Education Coordinator, Janine Lipsky 617-638-7066 [email protected] and students from schools other than the BUSM should apply for the month long elective through the AAMC’s Visiting Student Application Service (VSAS®) (https://www.aamc.org/students/medstudents/vsas/).
BUSM 4th year students who wish to learn about Otolaryngology, but are not intending to pursue Otolaryngology as a career, can do a two week Surgical Subspecialty Otolaryngology elective clerkship during their fourth year General Surgery sub-i elective clerkship. A new innovative individualized curriculum is being developed to afford students coming to Otolaryngology for two weeks a customized learning experience that attempts to match their exposure to learning experiences with their intended career path. To sign up for the two week elective in Otolaryngology, contact Ms. Lana Ketlere at [email protected].
The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was developed by Dr. Susan Langmore in 1988. Alongside the modified barium swallow (MBS) study, FEES has become a globally recognized gold standard for evaluating oropharyngeal dysphagia and for assessing swallowing function.
Cancer Clinical Trials
Please visit the external Boston University School of Medicine Cancer Clinical Trials website for information on current research studies in head and neck oncology.
Center for Innovative Technology
The Center for Innovative Technology (OCIT) is located in the Gilmore/Vines Building at 801 Albany Street, Suite 102.
Early diagnosis of oral cancer using spectroscopic techniques
Early detection of oral cancer is critical for successful treatment and improvement of the survival rate. However, current detection is usually done by visual screening and biopsies. It presents a major challenge for even experienced clinicians. Since 1995, our group has been working with Dr. Michael Feld and his group at the Massachusetts Institute of Technology (MIT) to develop a real-time, noninvasive approach by using new laser-induced fluorescence and spectroscopic techniques.
Our findings from animal models and patient studies are very encouraging. Now, we are continuing to work on this study to develop new tri-modal spectroscope (a combination of three spectroscopic techniques) and scattering imaging techniques. We expect that our new study will further improve the sensitivity and specificity of diagnosis. We will also explore the feasibility of using these new technologies for intraoperative guidance of tumor surgery and for prediction of the treatment efficacy with cancer chemoprevention.
New chemoprevention strategy for head and neck cancers
Oral cancer is one of the most common neoplasms, and it is estimated that close to 40,000 Americans will be diagnosed with oral or pharyngeal cancer this year and it will cause will cause over 8,000 deaths. Its slow and cumulative process strongly supports the rationale for its prevention. Chemoprevention is a promising strategy, but its widespread use has been hampered by its significant toxic side effects. Anti-angiogenesis has been established as one of the cornerstones of chemoprevention.
Our previous studies have indicated the effectiveness of selective microvascular targeting with a 585 pulsed dye laser (PDL) for tumor inhibition with no damage to neighboring tissue. Importantly, PDL is capable of providing a synergic effect with some routine chemopreventive agents (i.e., retinoic acid) via its ability to selectively destroy existing microvasculature in targeted tissue. In our preliminary studies, a combination of PDL and chemoprevention called laser “photo-chemoprevention,” enabled us to significantly reduce the dose of the chemical agent without sacrificing its efficacy for inhibition of tumor growth. We also are testing a new approach for cancer chemoprevention with less systemic toxicity by topically delivering the agent with polymer “biofilm.” Our long-term goal is to develop new and effective treatment with fewer side effects for chemoprevention or early treatment of cancers.
Novel and less invasive approach for head neck surgery
Our group has been working on testing new laser or other techniques for more than 10 years to develop less invasive surgery or selective targeting therapy for head and neck diseases. Currently, our studies include (1) laser photothermolysis of vocal cord scarring. We are using an antibody-targeted laser photolysis to avoid or reduce hypertrophic scar growth in vocal cords. This method will allow us to apply highly-selective targeting while sparing neighboring tissue from collateral damage with diode laser surgery; and (2) less invasive laser surgery for laryngeal papilloma and vascular lesions. We will use a pulsed dye laser to selectively destroy the lesions while preserving the voice function.
Download the research study on pediatric patients with laryngeal papillomatosis.
Center for Voice and Swallowing Research
The Center for Voice and Swallowing Research is located on the 5th Floor of 800 Harrison Avenue, with a clinic in the 1st Floor of 830 Harrison Avenue at Boston Medical Center. For more information on this research, please visit the Center for Voice and Swallowing website.
Residency and Fellowship Information
We are extraordinarily proud of our residency program and we would be delighted to hear from you if you have any questions or we can provide for you additional information about our program so don't hesitate to get in touch with us.