1938

Introduction

The leadership of the Children'sHospital at Dartmouth is com-mitted to fulfilling its mission ofp roviding outstanding emer-gent, maintenance, and preven-tive health care, education, andre s e a rch to the children andfamilies of the region. TheSection of Pe d i a t ric Surgi c a lSpecialties is the result of amulti-year effort to create an

environment that can attract and retain high quality surgical specialists to fulfill this mission. By workingtogether on common interests and concerns, a ‘voice’ isgiven to the surgical needs of infants, children, and ado-lescents within the greater institution.

Patient Care

The Section of Pediatric Surgical Specialists presentlyconsists of Laurie Latchaw, MD, General Pediatric andThoracic Surgeon, Dr. Ann-Christine Duhaime, MD,Pediatric Neurosurgeon, and Sharon Haire, PNP. TheSection also successfully recruited Paul Merguerian, MD,Pediatric Urologist, who will be joining the staff in thesummer of 2004.

Dr. Latchaw, who joined thestaff in late 1999, specializes inthe general and thoracic surgi-cal care of infants and toddlers.Other interests include pedi-a t ric surgical oncolog y, g a s-t rointestinal surgery, t h o r a c i csurgery in older children aswell as care of the pediatrictrauma patient. This past yearshe has also been followingand operating on some of the

Pediatric Urology patients awaiting Dr. Merguerian’sarrival. Total OR cases, including those done at Pain FreeCHAD and the Manchester Surgicenter, were up nearly14% over 2002. This increase in volume would not havebeen possible without the help of Ms. Haire, who c o n t i nually liasons with prov i d e rs and parents for Dr. Latchaw. She is always available for consultations,inpatient evaluations, and telephone triage and advice.

Dr. Duhaime, who joined thestaff in 2001, has seen an expo-nential growth in her practiceover the last year, especially inthe area of pediatric braintumors. In addition, she hasbeen working to establish sever-al new perioperative protocolsand nursing protocols for thepediatric neurosurgical patients.Dr. Duhaime has been instru-mental in establishing intraoper-ative neurophysiological moni-

toring at DHMC, as well as a Pediatric MovementD i s o rd e rs Clinic. She is working with the ChildAdvocacy and Protection Team and helped recruit its newleader, Dr. Robert Reece, a nationally recognized childabuse and neglect expert. Most recently, Dr. Duhaime hasbeen working with a unique deep brain stimulator pro-gram for the treatment of epilepsy.

Along with the other members of the multidisciplinaryPediatric Trauma Group, Dr. Latchaw, Dr. Duhaime, andMs. Haire have established new quality assurance proto-cols for the Pediatric Trauma Patients. Their combinedefforts, along with the Adult Trauma Service, also resultedin redesignation by the American College of Surgeons asa Level I Trauma Center with expertise in PediatricTrauma. Continued work in the area of PediatricRehabilitation and Physiatry has also benefited our trau-ma patient care.

Education

Educational activities for the Section of Pediatric SurgicalSpecialists included didactic and informal sessions withthe General Surgery, N e u ro s u r g e ry, Pe d i a t r i c, a n dOrthopedic Residents. Dr. Duhaime is the ResidentResearch Coodinator for the Section of Neurosurgery.Dr. Latchaw gave a combined Pediatric Grand Roundswith Drs. Gosselin and Stokes on the pediatric airway.D r. Duhaime continued the Pe d i a t ric Neuro s c i e n c eSeminar Series that began last year during Pediatric GrandRounds. She was also the invited guest speaker at over 15national and international meetings or seminars. Ms.Haire gave several teaching sessions with the ward andICN nurses on the care of the surgical patient.

PEDIATRIC SURGICAL SPECIALTIES

Laurie Lat c h aw, MDSection Chief

Ann-Christine Duhaime, MD

General SurgeryJohn Sutton, MD

Laparoscopic-Assisted ColectomyThadeus Trus, MD

SAGES

Plastic SurgeryDale Collins, MD

BRAVO Cost StudyContour Profile Gel Mammary Prosthesis

Mitchell Stotland, MDThe Psychological and Social Effectsof Glabellar Botox

UrologyAjay Nangia, MBBS

BPH Registry - Protocol #L8890Ann Gormley, MD

Mixed Urinary Incontinence - Protocol FLJ-MC-SBBOTofterodine Liquid and Capsules for ChildrenTrospium Chloride - Protocol # IP631-005

John Heaney, MB, BChDutasteride 0.5mg - G1198745/AR140 006Casodex Study -- Early - 70541UO023Dihydrotestosterone (DHT) Levels - ProtocolLamm Study

Vascular SurgeryDaniel Walsh, MD

HEAL-IT Protocol No. 21-01-334Jack Cronenwett, MD

ENACT (EVT) StudyMark Fillinger, MD

Zenfth - Protocol TX2Tm ThoracicTAAVanguard 1/11Edwards Lifepath AAA 2001-2002Cordis Endovascular Quantum LP - Protocol No P01 -4601Gore EXCLUDER - 98-03AneuRxVALOR Study - ProtocolEdwards Lffepath AAA

Richard Powell, MDPrevent IIIAnGesValentis Study - Protocol VLTS-589-121

Sponsored Research: Clinical Trials

Sponsored Research: Clinical Trials

General

Plastics

Urology

Vascular

Sponsored Research: Clinical Trials

3918

hopes to learn how the device can best be used in theevaluation of inner ear disease and intracranial hyperten-sion.

Other Activities/Physician Highlights

The Section of Otolaryngology continues to work withother disciplines at DHMC in the ongoing developmentof several multidisciplinary clinical programs. We contin-ue to participate in multidisciplinary programs in skullbase surgery, surgery for acoustic neuromas, and a pro-gram in collaboration with Norris Cotton Cancer Centerfor the management of patients with head and neck can-cer. This program includes a multidisciplinary outpatientclinic, Head and Neck Tumor Conference and TumorBoard. We also participate in the Cosmetic SurgeryCenter for facial cosmetic and reconstructive surgery.Lastly, we continue our close collaboration with CHaD(Children’s Hospital at Dartmouth) in the management ofchildren with ENT problems including congenital airwayanomalies, tumors and otologic disease.

AUDIOLOGY

Introduction

Audiology has a staff of six full-time audiologists, one perdiem audiologist, and two audiometric assistants and weenjoy a close collaborative relationship with our parentsection, Otolaryngology. Audiology has seen tremendousgrowth in our clinical services and patient base. In thepast year, we saw more than 6,900 patients in the audiol-ogy clinic and performed over 7,700 clinical procedures.Our practice covers diagnostic evaluations of all ages,including infants, children, adults, elderly, and individualswith special needs. We also see patients for electrophysi-o l ogic eva l u a t i o n s , including electro ny s t a g m ogr a p hy( E N G ) , a u d i t o ry brainstem evo ked response testing(ABR), and otoacoustic emissions (OAE). We also dis-pense hearing aids and assistive listening devices, includ-ing FM/auditory trainer units utilized in educational set-tings. One exciting area of growth has been our involve-ment with both pediatric and adult patients who havereceived cochlear implants.

Pediatric Audiology

In our Pediatric Audiology program, we are developing amultidisciplinary program for evaluation of pediatricpatients with hearing loss, including infants andpreschoolers who have received cochlear implants. This

c o l l a b o r a t ive ve n t u re will invo l ve A u d i o l og y,Otolaryngology, Developmental Psychology, Social Work,Speech-Language Pathology, and the Family ResourceCenter, among other disciplines.

We also serve as a referral site for infants who fail thenewborn hearing screening either at the CHaD nurseryor at other newborn hearing screening programs acrossthe region. We are quite pleased to see this clinical serv-ice area grow as early identification of hearing loss cou-pled with early intervention are critical for a child’s life-long success in all facets, including education, socializa-tion, and language and speech development.

Audiology programs for adult patients

In our audiologic program for adults, we have beenpleased to see our hearing aid dispensing program grow.In 2003, we fit 245 patients with hearing aids through avery active program that offers a full range of the latestamplification technolog y, including advanced digi t a ldevices, and a hearing aid repair lab for minor in-houserepairs. We are also actively developing our assistive lis-tening and alerting devices program to complement hear-ing aid use.

In addition, we are developing a transition program forteenagers and young adults with hearing loss who areready to transition from our pediatric program to our pro-gram for adult patients but yet have diagnostic and inter-vention needs uniquely different from the young child orolder adult patient.

Research

The Audiology faculty has made presentations at thenational level during the past year. We have also beeninvolved in two funded research projects: Dr. MichaelNorris has collaborated with Dr. Dudley Weider inOtolaryngology on a research study on implantable hear-ing aids and Mrs. Stella McHugh has collaborated withDr. Jack Baird in Clinical Psychology on a research studyon a software program designed to evaluate patient satis-faction with hearing aids. Also, our former director, Dr.Frank Musiek, a world-renowned researcher on centralauditory processing (CAP) and now with the Universityof Connecticut, continues to see patients on a per diembasis for CAP evaluations and continues to publish andpresent extensively in this area.

OTOLARYNGOLOGY & AUDIOLOGY (CONT.)

General SurgeryRichard J. Barth, Jr., MD

ACOSOG Studies Z10 and Z11( DUKE)Mechanisms Underlying CD40L's Role in Tumor Immunity (NCI)COBRE

John D. Birkmeyer, MDVertobroplasty (NIH)Surgical Volume Matters: Helping PatientsPick Hospitals (HRQ)

Burton L. Eisenberg,MDRTOG Committee Chair Agreement (ACR)

Samuel R.G. Finlayson, MDUtilization and Outcomes of Laparoscopic Surgery:A Population-based Assessment (SAGES)Medical and Surgical Treatment of Esophageal Reflux (NIH)

OphthlamologyMichael E. Zegans, MD

Biofilm Formation Associated with P.aeruginosa Infection of the Eye (NEI)

Pediatric SurgeryAnn-Christine Duhaime, MD

Trauma to the Developing Brain:Response and Treatment (NIH)Biomechanics of Pediatric Head Trauma (UPenn)Trauma to the Immature Brain: Response,Repair, & Treatment (NIH)

Surgical Research LabJeffrey Bergeron, DVM

Teaching and Development of Endoscopic Therapeutic Techniques (Bard)Evaluation of Prototype Electrosurgical Instruments (Tissuelink)

Nancy J.O. Birkmeyer, PhDPublic Reporting on Hospital Volumes (HCFA)Assessing and Improving the Quality of Care for Low Back Pain (HRQ)

P. Jack Hoopes, DVM, PhDCommercialization of Microwave Thermo Keratoplasty Safety Study

(Thermal Vision Incorporated)Basivertebral Nerve (DuPuy, Inc)Heat Sensitive Liposome for Treatment of Prostate Cancer (Celsion Corp.)FiberOptic Fluorescence Detector for Photosensitizer Quantitation (Aurora)Hernia Survival in a Porcine Model (Onux)The Effect of Maturation, Hypoxia and Afferent Feedback (NHLBI)Impedance Spectroscopy Monitoring of Irradiated Tissue (NCI)

Kathleen Martin, PhDInduction of Vascular Smooth Muscle Cell Differentiation by Rapamycin (AHA)

Mary Jo Mulligan-Kehoe, PhDMechanisms of PAI-1 Induced Anti-Angiogenesis (NHLBI)Angiogenesis and Myocardial Ischemia (NHLBI)

Sujatha Sundaram, PhDPromotion of Apoptosis by Vitamin D Analog EB 1089 in Irradiated Breast Tumor Cells (VCU)

UrologyJohn A. Heaney, MB, BCh

The Prostate Cancer Prevention Trial (SWOG)Selenium and Vitamin E Cancer Prevention Trial (SELECT)

VascularJack L. Cronenwett, MD

Northern New England Vascular SurgeryQuality Improvement Initiative (NIH)

Mark F. Fillinger, MDAortic Aneurysm Wall Stress and RuptureRisk (NHLBI)

Richard J. Powell, MDEndothelial Cell Control of Smooth Muscle Cell Matrix (NHLBI)

Marc Schermerhorn, MDUltrasound Screening for Abdominal Aortic Aneurysm (CMMS)

Sponsored Research: Federal & Corporate

Sponsored Research: Federal & Corporate

Urology

Vascular

Surg Res Lab

Ophthal

General

Peds Surg

Sponsored Research: Federal & Corporate