Published on December 15, 2016
Pleased to post an interview with Dr. Alexander (Zandy) Hillel, laryngeal surgeon. #fellowshipofthelarynx #laryngology #airwaystenosis #voicescience #voicetherapy #voicerehab #laryngealsurgeon #airwaysurgery
TVF: Where do you currently practice/teach?
AH: The Johns Hopkins Hospital in Baltimore, Maryland.
TVF: Where did you complete your medical training? Laryngology?
AH: I completed my otolaryngology residency at Johns Hopkins Hospital followed by a fellowship in Laryngology at the Emory Voice Center.
TVF: How/why did you come to choose laryngology?
AH: My mentor during early residency, Dr. Paul Flint, is a Laryngologist and he encouraged my interest in airway surgery and associated research. I also enjoy listening to help identify the pathology in a voice disorder.
TVF: What are your research interests?
AH: I run a laboratory that investigates laryngotracheal stenosis, www.hillellab.com. That’s a fancy way of saying scar that forms in the airway, i.e., the larynx and trachea. We study the interrelationship between the immune system, bacteria and scar formation, and how to prevent scar from forming.
Our lab has shown that large breathing (endotracheal) tubes and having breathing tubes in place for a long period of time are both associated with the development of airway scar. I am also part of an international collaborative, www.noacc.net, which pools data and resources from multiple medical centers to study how best to reduce the development of airway scar. Our collective findings have broad implications for best-practice protocol development across hospitals.
TVF: How do you hope your research will be applied in the clinical field?
AH: We are investigating drugs and developing a drug-eluting stent to prevent the development of and treat patients with laryngotracheal stenosis.
TVF: How can one bridge the gap between basic science and clinical application?
AH: We use preclinical models to test drugs and biomaterials that may halt the progression of or reverse scar formation. After a candidate drug or biomaterial is identified, we then launch clinical studies to test these materials in humans.
TVF: In your opinion, what poses the greatest challenge in care of voice disorders?
AH: Not enough patients are seeing voice therapists to improve their voice. A combination of lack of insurance coverage and patients’ own hesitance to undergo voice therapy reduces the number of patients seeing voice therapists, and many patients simply won’t get better without that care.
TVF: In your opinion, what are some of the most important advances made in the field of laryngology in the recent years?
AH: As an airway surgeon, I am excited by recent advances in our understanding of how scar develops in the larynx and trachea, and the development of new surgeries to treat laryngotracheal stenosis, including those developed by Rob Lorenz at the Cleveland Clinic, and Guri Sandhu at the Imperial College, London.
TVF: What is your vocal pet peeve and why?
AH: My vocal pet peeve is the voice patient who is unwilling to participate in voice therapy to help their voice get better.
TVF: Which vocal myth would you like to dispel?
AH: That whispering is the same thing as voice rest. I think it must arise from our belief as kids that quiet (or not so quiet) whispering is like not using our voice.
TVF: Your most memorable case?
AH: I recently had a young woman who couldn’t lead a normal life due to her severe laryngotracheal stenosis. She had a breathing tube in place, which narrowed her airway, and she was unable to walk without being really short of breath. Restoring her airway and her ability to breathe allowed her to return to a normal life, go out with friends, and take trips with her family.
TVF: As a laryngologist/surgeon, what keeps you on your toes?
AH: Airway cases – I always find it challenging to operate and remove or dilate scar in the larynx and trachea. This is because they also need to breathe through the same area during the surgery.
TVF: What do you think the next steps are in growing the field of laryngology and voice rehabilitation?
AH: Increasing awareness amongst patients over 55 and their physicians that age-related voice changes (presbyphonia) can and should be treated. I think many patients, especially the elderly, feel that a weak voice is something they have to live with. Furthermore, the physicians who see them regularly do not appreciate their voice handicap and the need to get them seen by an otolaryngologist or speech language pathologist.
TVF: Who have been your most important/influential mentors?
AH: Lloyd Minor encouraged me to become a clinician scientist, and Susan Thibeault fostered my scientific development. Mike Johns taught me how to run a laryngology practice and reinforced how important it is to enjoy what we do professionally.
TVF: What is your advice in mentoring future laryngologists?
AH: 1) Provide superior patient care. 2) Ask good scientific questions in the field of laryngology and then dedicate your academic efforts to answering them. 3) Align your clinical practice and research niche with your passion(s) in laryngology.
TVF: What advice do you have for aspiring laryngologists?
AH: Actively participate in your career development. Pursue your passion.
TVF: Who are your favorite singers?
AF: Brandi Carlile, Johnny Cash, Adele
TVF: What sparks “joy” for you as a person?
AH: Having ice cream with my kids.