Goals and Clinical Duties of the Fellowship

The Fellow's primary duties and responsibilities will be in the reconstructive and rehabilitative aspects of the Otolaryngology Service. The Fellow will have primary responsibility to the Microvascular Reconstruction Team, which works in close conjunction with the Head and Neck Oncology Ablative Team. It is expected that the Fellow will obtain expertise in, and clinical exposure to, all reconstructive aspects of patients who have undergone major ablative procedures. Secondarily, exposure to a broad spectrum of facial plastic surgery and reconstructive procedures will also be obtained.

While on the Clinical Service, the Fellow will participate in the preoperative assessment, intraoperative management, and postoperative follow-up of all patients who are seen by the Service. The Fellow's clinical and administrative responsibilities will progress as his/her technical and academic excellence improves. Responsibilities can be divided up into three aspects: research, clinical, and operative.

Research

The Fellow will have access to a fully equipped microvascular laboratory with ACUC-approved protocols for rat experimentation. There is also the potential for rabbit tracheal airway research to be performed in the comparative medicine lab facilities. Recently, a collaborative study involving the Department of Plastic Surgery with tissue engineering using gene therapy has been initiated. Grants have been obtained from the AAO and further research is going on in this field. The laboratory will be involved in a number of microvascular projects, which it is expected the Fellow will both initiate and complete. It is the expectation of the program that the Fellow will finish a minimum of two basic science/research projects that will be presentable during the fellowship year or in the year following it. Funding for these projects will be through the department and various other sources.

The Facial Plastic and Microvascular Reconstruction Fellowship Program at OHSU provides research opportunities and facilities for physicians who participate in our fellowship program. Fellows are expected to complete at least two basic science/research projects during the fellowship year. Below is a list of some recent research projects from our fellows.

• Application of fibrin sealant in microvascular reconstructive surgery
  Comparison of radial vs. ulnar artery free flaps in oral cavity reconstruction
• The functional effect of radial forearm flap innervation: a randomized, prospective study
• Incidence of hematomas following microvascular reconstructive surgery: the impact of various postoperative protocols
• The role of COX-2 inhibitors on free flap revascularization
• Functional assessment of anterolateral thigh donor sites
• Functional assessment of the radial osteocutaneous donor site
• Work study project of the Microvascular Committee for the AAO
• Bone morphogenic protein delivered by plasmids in a rhisosomal mixture
• The effects of FGF and VEGF plasmid delivery on the revascularization and survival of fasciocutaneous flaps in an animal model
• Donor site morbidity following fibular free tissue transfer
• Outcomes following intraoperative use of vasopressors in free tissue transfer

Clinical

The Fellow will run a joint clinic with the Preceptor to maintain both preoperative and postoperative evaluations of patients who are evaluated and/or undergo surgical procedures. The Fellow will participate in the clinical decision making, as well as have broad latitude as experience is gained in the management of these patients. It is expected that the Fellow be involved in the ongoing clinical research protocols that have been developed. It would be expected of the Fellow to complete two or three clinical projects and participate in a number more, all of which would be presented and, hopefully, published.

Operative Experience

The Fellow will participate in the operating room with microvascular reconstruction in all cases. Participation will naturally depend upon the Fellow's technical expertise, but it is expected that, by three months after laboratory and clinical exposure, most Fellows will be able to perform the majority of these procedures under direct supervision as a first assistant or as a surgeon. Teaching of residents of Otolaryngology, as well as Plastic Surgery, will be a responsibility as experience is gained.

Incoming Fellow

TBD

Previous Fellows

Skylar Trott, MD

Those physicians who have completed the Microvascular Fellowship have gone on to national and international positions, and are recognized as experts in the field. Previous fellows have gone on to Case Western Reserve University, University of California (Irvine), Northern Ireland, and many other positions. 

List of previous fellows