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Ear, Nose & Throat — Baylor St. Luke's Medical Center
Innovative health care in Houston, Texas
Baylor St. Luke’s Medical Center is an internationally recognized leader in innovation, research and clinical excellence that has given rise to breakthroughs in cardiovascular care, neuroscience, oncology, transplantation, and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere else in the world.
Our strong alliance with Baylor College of Medicine allows us to bring our patients a powerful network of care unlike any other. Our collaboration is focused on increasing access to care through a growing network of leading specialists and revolutionizing healthcare to save lives and improve the health of the communities we serve.
Baylor St. Luke’s Medical Center is also the first hospital in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award six consecutive times.
The only comprehensive surgical center for obstructive sleep apnea in Houston
The Sleep Surgery Center and Positive Airway Pressure (PAP) Alternatives Clinic at Baylor College of Medicine is leading Houston in the care of patients with obstructive sleep apnea (OSA).
OSA is estimated to affect approximately 40 million Americans. As many as 18 million have moderate-to-severe forms of the condition, which is directly associated with serious health complications such as atrial fibrillation, heart attack, and stroke.
Directed by Dr. Andrew T. Huang, MD FACS, the Baylor College of Medicine team offers the full range of interventions for people suffering with OSA who are not able to tolerate PAP therapy. These interventions range from in-office soft tissue surgery to facial skeletal surgery (maxillomandibular advancement) to hypoglossal nerve stimulation/upper airway stimulation therapy (Inspire).
Inspire, a form of neuromodulation, is the only FDA-approved therapy that works inside the body to treat the root cause of the problem for patients whose tongue is causing OSA. While there are less invasive ways of treating OSA, like with oral appliances such as CPAP and BiPap machines, many patients cannot tolerate these interventions.
Inspire, which is implanted in the chest with a wire that runs to the person’s throat, works by preventing the tongue from being able to collapse and obstruct a person’s breathing.
Currently, the Sleep Surgery service at Baylor St. Luke's Medical Center is the busiest Inspire implantation center in Houston and has helped hundreds of patients. In fact, Baylor College of Medicine was one of the first to offer Inspire through clinical trials.
Today, more than 50,000 people have undergone the procedure. Studies show most patients show significant sleep improvement with the device with minimal side effects. Batteries have to be changed through a simple procedure every 10 to 12 years and most insurance companies cover the cost.
TEJAS Study: HPV-related oropharyngeal cancer screening and monitoring through remote self-sampling
TEJAS is a groundbreaking cancer early detection/cancer screening study, led by Dr. Erich Sturgis, that aims to evaluate non-invasive and self-sampling techniques for the early detection of human papillomavirus (HPV)-related oropharyngeal (throat) cancer. The study is for men and women aged 45 to 69 years and focuses on blood, saliva, and urine markers that can detect the presence of cancer or assess the risk of developing it before cancer signs/symptoms develop.
HPV-related oropharyngeal cancer is the most common HPV-associated cancer in the United States, surpassing cervical cancer. Despite its prevalence, most cases are diagnosed at advanced stages, requiring aggressive treatment.
"Developing an effective early detection tool for HPV-related throat cancer could significantly reduce cancer death rates and lessen the side effects of treatment," said Dr. Sturgis.
This study represents a critical step in the pursuit of personalized cancer prevention, aiming to identify individuals at high risk and detect cancer at its earliest, most treatable stage.
For more information, please visit the TEJAS Study page.
Reconstructive surgery program helps patients with advanced-stage head and neck cancer
A team of surgeons from Baylor College of Medicine is leading a free flap reconstructive surgery program at Baylor St. Luke’s Medical Center for patients with advanced-stage head and neck cancer.
Free flap, or microvascular reconstructive surgery, is often required for patients with oral cavity, oropharynx, larynx, skin, and thyroid cancers. The surgery can be extensive and often life-altering, especially for individuals with advanced cancers and those whose cancer returns after being successfully treated with chemotherapy and radiation.
While chemo and radiation are effective, the treatment itself is grueling, intensive, and can leave burns on both the skin and neck as well as the inside of the patient’s throat. Should the patient’s cancer return, repeating radiation in the head and neck region is too risky, leaving surgery as the only option.
Surgeons can perform free flap reconstructive surgery in cases where the cancer has spread into the jaw. The surgery entails replacing bone in the jaw with healthy fibular bone, muscle, and skin from the patient’s leg. Once the cancer is removed, surgeons use computer modeling to fashion an identical match from fibular bone and connect it to the blood supply in the neck which is able to restore both form and function.
Free flap reconstructive surgery is also significant because some patients may be able to receive radiation a second time in case the cancer returns since healthy tissue has now replaced the previously radiated tissue—a possibility that was unheard of in previous decades.
The Baylor College of Medicine team has a lower than 1% complication rate and reduced time of stay in the hospital for patients (three to five days, as opposed to the standard average of 11 to 12 days). The team has built one of the busiest head and neck reconstructive practices in the country and recently has started a Head and Neck Surgical Oncology and Reconstruction fellowship, accredited by the American Head and Neck Society, to train future leaders in the field.
Multidisciplinary approach to caring for patients with cervical spine disease produces better outcomes for preserving voice and swallow function following surgery
The Baylor Medicine Spine Center at Baylor St. Luke’s Medical Center has adopted a multidisciplinary approach to patients with cervical spine disease who need surgery that has proven to better preserve two vital functions that are often taken for granted: speech and swallowing.
Spine surgeons typically work with physical medicine/rehabilitation specialists, neurologists, reconstructive surgeons, and pain management specialists. At Baylor Medicine, they also routinely collaborate with head and neck surgeon, Eddie Liou, M.D., F.A.C.S., to provide comprehensive care for patients undergoing anterior cervical discectomy, which can greatly affect a person’s ability to speak and to swallow.
Lying immediately anterior to the spine, the throat—consisting of the larynx, pharynx, and esophagus—is potentially at risk for temporary or permanent issues after spine surgery. Given that Dr. Liou’s surgical expertise as a head and neck surgeon is focused on preserving these anatomical structures, he has been able to improve voice and swallow outcomes for this patient group while decreasing operative times for these surgeries.
Additionally, through this collaboration between spine surgery and head and neck surgery, patients who might have once been regarded as poor candidates for an anterior cervical surgery due to complex medical histories (such as previous head and neck irradiation, previous thyroid/parathyroid surgery, or neck dissection, and patients with extended levels of disease) may now benefit from this direct approach.
Non-invasive NAVDx blood test eliminates unnecessary biopsies for monitoring treatment outcomes for oropharyngeal cancer
Head and neck surgeons as well as radiation oncologists and medical oncologists at Baylor College of Medicine are using a highly sensitive blood test that measures circulating tumor DNA and is superior to surgical methods in diagnosing and monitoring patients with throat cancers caused by human papillomavirus (HPV).
Baylor is one of the only institutions in Southeast Texas to offer the NavDx blood test (developed by biotechnology company Naveris) to help evaluate oropharyngeal cancers of the throat, especially those of the tonsils and base of the tongue (known medically as the oropharynx) and pinpoint the origin of cancers initially showing up in lymph nodes of the neck.
The NAVDx blood test circumvents unnecessary trips to the operating room for biopsies of the throat. After the cancer is treated with either surgery or radiation or in combination with chemotherapy, it is sometimes difficult to determine if the cancer is fully eradicated. The NavDx blood test is used to monitor patients post-treatment as it allows a highly sensitive method to show that there are no cancer cells remaining by demonstrating no tumor-specific DNA is found in the blood.
Head and neck cancer surgeons build free flap reconstruction program to restore quality of life
Baylor St. Luke’s Medical Center reconstructive surgeons Dr. Andrew Huang, Dr. David Hernandez, and Dr. Angela Haskins are leading a microvascular (free flap) reconstructive surgery program focused on patients with advanced stage of head and neck cancer—matching or exceeding the science at academic centers in the United States.
Free flap reconstructive surgery is a complex procedure where skin, muscle, or even bone are transplanted to the head and neck (tongue, jaw, skin, voicebox) in order to repair deformities caused by the removal of a patient’s cancer. This surgery is important in ensuring patients optimize their cosmetic and functional outcomes. These reconstructive procedures also allow some patients to be able to receive another round of radiation if their cancer returns since the healthy tissue has replaced sometimes previously radiated tissue.
For the past seven years, our head and neck reconstructive team at Baylor St. Luke's has performed over 700 of these surgeries with a complication rate of less than one percent and is leading the way in defining and improving quality metrics where they have decreased postoperative length of stay by an average of six to nine days compared to national inpatient data.
Baylor St. Luke’s Medical Center surgeons help hearing loss patients to not suffer in silence
Since 2015, our ear and hearing team of surgeons (Dr. Alex Sweeney, Dr. Nathan Lindquist), audiologists, and rehabilitation specialists across different disciplines have worked diligently to address a patient’s hearing issues head-on. Our goal is to find the most appropriate technology to address a specific patient’s hearing loss.
“With so many different types of hearing loss, it is important that we tailor our approach to each individual patient,” says Dr. Alex Sweeney. “Some patients are best treated with a hearing aid, while others are better suited for a surgery that implants a hearing device such as a cochlear implant or bone conduction implant. Our team is committed to finding the best option for each patient.”
Hearing loss is a health condition that can have devastating medical and social consequences. Growing evidence is linking hearing loss to cognitive decline, and patients with hearing loss can often find themselves isolated from friends and family when they are unable to hear well enough to communicate. Given that the United States has a growing number of people who are at risk for hearing loss, finding a solution to this problem is critical.
Our hearing implantation practice at Baylor St. Luke’s Medical Center and Baylor College of Medicine has grown significantly over the past seven years, and we are proud to be one of the only institutions in our region that allows patients to work with all three of the FDA-approved cochlear implant manufacturers: Cochlear Americas, MED-EL GmbH and Advanced Bionics; and a variety of different bone conduction implant manufacturers: Cochlear Americas, MED-EL GmbH and Oticon Medical. We also have a research team that studies hearing loss so that we can help define the best methods to care for patients with this disease.
“Hearing health is incredibly important, and we have the expertise and experience to be a part of the solution for our patients in need,” says Dr. Angela Peng.
A multidisciplinary approach to skull base surgery
From Neurosurgery to ENT/Neurotology and Radiation Oncology, our providers within Baylor St. Luke's and Baylor College of Medicine combine their expertise to work together to care for patients with skull base diseases from Texas and around the world.
Our skulls are filled with a large number of tunnels and spaces that allow blood vessels and nerves to travel to and from the brain. Unfortunately, this area of the body can be injured by infections and tumors, and the consequences can be devastating.
"This is an area of medicine and surgery where teamwork is essential," says Dr. Alex Sweeney, one of the skull base surgeons at Baylor St. Luke's and Baylor College of Medicine. "We are incredibly fortunate to have a robust team and a team of incredibly talented surgeons, clinicians and therapists."
Our skull base team sees various skull base diseases, ranging from infections to tumors (schwannomas, meningiomas, epidermoids, metastases, sarcomas and cholesterol granulomas, among others).
"We look at each person individually, discuss treatment options, that include surgery, radiosurgery, novel chemotherapies or observation, as a team to come up with a customized plan for each patient.” says Dr. Akash Patel, Director of the Baylor College of Medicine Brain Tumor Program. "Our team also has a robust research program that focuses on understanding the best way to care for patients with skull base diseases and the genetics responsible for developing skull base tumors."
HPV-related throat cancer screening study to revolutionize early detection
The TRINTY clinical trial, led by physician Dr. Erich Sturgis, is screening men between the ages of 50-64 with no history of throat cancer to determine early screening methods that will help identify HPV-related throat cancers before requiring treatment.
Human papillomavirus (HPV)-related oropharyngeal (throat cancer) is rising in the United States—it has surpassed cervical cancer as the leading HPV-related cancer in the country.
“A routine early detection test for HPV-related oropharyngeal cancer, or at least a biomarker to identify those at high risk, could revolutionize our specialty and disrupt worrisome trends in cancer incidence and mortality, as well as the devastating effects of cancer treatment on this growing population,” said Dr. Sturgis.
More than 80% of oropharyngeal cancer patients have metastatic cancer by the time they are diagnosed and require advanced treatment. Early detection can potentially reduce treatment toxicity and improve the chances of achieving a cure.
Throat and Other HPV-Related Cancers in Men: Identifying Them Early (TRINITY Study)
Erich M. Sturgis, MD, MPH