Program Overview

Introduction to the Facial Plastic and Microvascular Reconstruction Fellowship

The Facial Plastic and Microvascular Reconstruction Fellowship at OHSU is a comprehensive program designed to provide fellows with expertise in the reconstructive and rehabilitative aspects of otolaryngology. The program focuses on microvascular reconstruction, facial plastic surgery, and related research.

Goals and Clinical Duties of the Fellowship

The primary duties and responsibilities of the fellow 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. The fellow is expected to obtain expertise in, and clinical exposure to, all reconstructive aspects of patients who have undergone major ablative procedures.

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. The laboratory will be involved in a number of microvascular projects, which it is expected the fellow will both initiate and complete. The fellow is expected to finish a minimum of two basic science/research projects that will be presentable during the fellowship year or in the year following it.

Some recent research projects from our fellows include:

• 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.

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.

Current and Previous Fellows

The current fellow is Jason C. Lee, M.D., who holds an M.D. and Ph.D. from the Medical College of Georgia. His areas of interest include head and neck cancer, microvascular reconstructive surgery, and facial trauma. Previous fellows have included Skylar Trott, MD, and others who have gone on to national and international positions, recognized as experts in the field.

Program Director

The program director is Mark K. Wax, M.D., FACS, FRCS, who serves as the Director of the Residency Program and Co-Director of the Facial Plastic and Microvascular Reconstruction Fellowship Program. He holds an M.D. from the University of Toronto and specializes in cancer, otolaryngology (ENT), head and neck cancer, head and neck surgery, melanoma, microvascular reconstructive surgery, and sleep apnea.