UT ORL Update Newsletter
  December 8, 2010


Martin J. Citardi, MD, FACS

Welcome to the new issue of UT ORL Update.

In this issue, we present 4 commentaries:

  • Rondal Alexander, MD discusses Botox's new FDA indication of headache.  Unfortunately, a FDA indication is not an assurance of appropriate reimbursement.
  • Sancak Yuksel, MD reviews the role of propanolol in the treatment of airway hemangioma in children.  Recent reports have suggested dramatic results from this relatively simple medical treatment and thus offer a signficant nonsurgical option for theses difficult cases. 
  • Ron Karni, MD advocates surgeon-performed ultrasound, specifically in the evaluation of primary hyperparathroidism.  The introduction of ultrasound into the clinical setting gradually shifts the paradigm to a more integrated care model, in which the surgeon directs preoperative evaluation during a routine office visit.
  • Amber Luong, MD, PhD confirms that 2010 was a difficult year for patients who suffer from inhalent allergies.  Allergy is ubiquitous, but that observation should not detract from careful diagnosis and evaluation of patients with suspected allergy. 

As always, we welcome your feedback and comments. Please feel free to contact us at any time—and to forward this newsletter to friends and colleagues.
Happy Holidays!

Martin J. Citardi, MD, FACS      e-mail


A New Dawn for Migraine…Botox

Ronda Alexander, MD

It’s not unusual for a treatment that clinicians anecdotally ‘know’ works to remain unpaid by insurers who classify it as experimental.  This is due, in part, to the wait for research that proves the safety and efficacy of novel treatments.  Such was the case for the use of botulinum toxin (toxin) for pain management in

No More Surgery for Airway Hemangioma?

Sancak Yuksel, MD

Two years ago a group of French physicians, Leaute-Labreze et al. reported their spectacular results in treating infantile hemangiomas with oral propranolol, an antihypertensive drug.  This very recent and serendipitous discovery seems to change the direction of the treatment of this most common tumor of infancy dramatically. Infantile hemangioma is a benign vascular tumor with

A Role for Surgeon-Performed Ultrasound in the Management of Primary Hyperparathyroidism

Ron J. Karni, MD

In patients who are referred for surgical management of primary hyperparathyroidism, a successful outcome may be defined as identification and removal of the adenoma with a commensurate drop in post-operative PTH and serum calcium levels. The traditional operation for primary parathyroid disease is a four-gland exploration via a bilateral neck exploration (BNE).  This operation is

Allergy Update

Amber Luong, MD, PhD

This past spring represented one of the worst allergy seasons in Houston. The unusually long cold season delayed some trees from blooming and consequently led to an usually high peak in the number of trees blooming at one time. Oak is one of those trees whose pollen is highly allergenic. For the last 4 years,