Updated Publications & Presentations List

Updated Publications & Presentations List

We are working hard on making arrangements for our mid-October trip to Malindi, Kenya!

Here are some of the academic papers in peer-reviewed journals, and presentations at academic conferences, that have been made possible by the information and data we gather on our trips:

  • Jayawardena A, Kahue C, Netterville JL. Evaluation of a pre-surgical otologic screening tool: a pilot study in rural Kenya. Presented at the ENT World Congress, International Federation of Otorhinolaryngological Societies (IFOS), Paris, France, June 26, 2017. Associated video, Kenya Hear Me, awarded Best Video.
  • Fagan JJ, Zafereo M, Aswani J, Netterville JL, Koch W. Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries. Head Neck. 2017 Mar;39(3):605-611. Epub 2016 Nov 23. PMID: 27880008.
  • Dwojak S, Sharbel D, Espahbodi M, Fernando S, Ghiam M, Netterville J. "Outcomes of a 2-Week Head and Neck Teaching Course in East Africa." 2016 American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting. San Diego, CA. 18-21 September 2016.
  • Fagan JJ, Aswani J, Otiti J, Mushamba V, Liyombo E, Woodson G, Weed D, Zender C, Mannion K, Netterville JL, Wagner R, Zafereo M. Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries. Springerplus. 2016 Sep 23;5(1):1652. eCollection 2016. PMID: 27722069.
  • Chambers KJ, Aswani J, Patel A, Fundakowski C, Mannion K, Lin DT, Netterville JL. The Value of a Collaborative Course for Advanced Head and Neck Surgery in East AfricaLaryngoscope. 2015 Apr; 125(4):883-7. Epub 2014 Nov 21.PMID: 25417971.
  • Netterville JL, Invited Lecturer, "Surgery for Goiter in Africa," Harvard Surgery of the Thyroid and Parathyroid Glands Continuing Medical Education Course 2014, Boston, MA, December 8, 2014.
  • Chambers KJ, Aswani J, Patel A, Fundakowski C, Mannion K, Lin DT, Netterville JL. "The Value of a Collaborative Course for Advanced Head and Neck Surgery in East Africa." Poster presented at the Combined Otolaryngology Spring Meetings, Orlando, FL, May 14 – 17, 2014.
  • Mainthia R, Reppart L, Reppart J, Pearce EC, Cohen JJ, Netterville JL. A Model for Improving the Health and Quality of Life of Single Mothers in the Developing WorldAfrican Journal of Reproductive Health. 2013 Dec; 17(4):14-25. PMID: 24558778.
  • Pearce EC, Mainthia R, Freeman KL, Mueller JL, Rohde SL, Netterville JL. The usefulness of a yearly head and neck surgery trip to rural KenyaOtolaryngol Head Neck Surg. 2013 Nov;149(5):727-32. Epub 2013 Sep 17. PMID: 24046273.
  • Pearce EC, Mainthia R, Netterville JL, Rohde SL. "Impact of a Yearly Head and Neck Surgery Trip to Rural Kenya." Poster presented at the AAO-HNS/F Annual Meeting & Oto Expo, Washington, DC, 9 - 12 September 2012.
  • Netterville JL, Keynote Speaker, "Head & Neck Surgery in Third-World Africa," Head & Neck Oncology Summit, University of Utah, Salt Lake City, UT, August 2010.
  • Netterville JL, Invited Lecturer: "More than Medicine: Lessons learned from Medical Missions to Nigeria" Middle East Otolaryngology Meeting, Abu Dhabi, UAE, April 2009.
  • Mueller JS, Schultenover S, Simpson J, Ely K, Netterville J. Value of rapid assessment cytology in the surgical management of head and neck tumors in a Nigerian mission hospitalHead Neck. 2008 Aug; 30(8):1083-5. PMID: 18528905.
  • Netterville JL. "Surgical Treatment of Thyroid and Other Head and Neck Tumors in a Third World Country – Nigeria," 2003 Spring Seminar Series & 17th Annual Pediatric ORL Nurses Spring Meeting, Society of Otorhinolaryngology and Head-Neck Nurses, Inc., Nashville, TN, May 4, 2003.

Kenya Hear Me

Kenya Hear Me

BEST VIDEO AWARD

We just won the ENT World Congress documentary video contest in Paris, France! We took 1st place out of 43 documentary short films. Watch the video below, which highlights the physician-extender program developed in Malindi, Kenya to allow non-otolaryngologists to screen children for correctable hearing loss. Since Kenya has only about 60 ENT doctors for the whole country, extending screening capability to non-otolaryngologists will make an enormous difference to obtaining diagnoses.

The program’s initial findings were also featured in an oral presentation at the World Congress of ENT in Paris.

Restoring communication to the voiceless

Restoring communication to the voiceless

INHEALTH AND GLOBAL OUTREACH

Our very own Jennifer Craig Starkweather has a brief article in InHealth Technologies' newsletter about her work with us in Kenya this past October.

InHealth very generously donated supplies to our surgical camp, and Jenn did pre-operative counseling with many patients and their families and trained several more in the use of an electrolarynx, as well as helping in the outpatient clinic and providing guidance to the surgeons, who did two laryngectomies, two stomal revisions, four tracheoesophageal punctures, and two prosthesis changes.

Help Us Help Hassan

Help Us Help Hassan

A LIFE CHANGED

In October 2015, a 14-year-old boy named Hassan came into our clinic in Malindi, Kenya with severe injuries to his face and jaw.

In the area where he lives, several quarries use dynamite with a fuse cable made of copper and explosive charges. His younger brothers found some of this cable while herding their sheep, and brought it home assuming that it was copper wire, which is commonly attached to batteries to create home-made lamps. That night, Hassan attached the cable to a battery so he could do his homework, and it exploded upwards into his face. 

His upper and lower jaw were shattered, his lips torn away, and his mouth distorted. He could not eat or talk. Uncomfortable with his appearance, he kept his face hidden.

Hassan after his first surgery.

Hassan after his first surgery.

We reconstructed his lower jaw using a piece of bone from his leg in a surgery called fibula osteocutaneous free flap in 2015, and in October 2016 did further repairs to his face. He is now at Kenyatta Hospital in Nairobi, and (unusually) his father has been allowed to stay with him there. We have committed to helping the Caris Foundation and Kenya Ear Nose and Throat Society to pay for his care. Our surgeries and care have been provided free of cost, but Kenyatta Hospital must be paid for his ongoing treatment: drugs, nursing services, operating room charges, meals, and bed charges. His poor, rural farming family does not having any funds.

If you'd like to help us to support Hassan's care and recovery, click the Donate Now button at the bottom of our website, and share his story on Facebook.

Saving Face

Saving Face

See how Mary kept her smile

Last year we treated Mary, a (then) three-year-old who had a cyst from birth. Her father, a waiter in a hotel, and her mother, a student, could not afford an operation elsewhere. Mary traveled an hour by a public bus with her aunt and grandmother to get surgery. 

The way this surgery would normally be done here would have left her with lifelong issues, but our team, in cooperation with the Kenyan doctor-trainees, were able to completely retain her facial expressions by carefully tracing and saving her facial nerves. We prevented the nerves that make her mouth water from invading her sweat glands, and kept her face symmetrical. We were excited to see Mary again this year for a follow-up visit.

Dr. Netterville said, "It's so wonderful to watch the joy in her eyes and the remarkable quality of her life with her loving mother. This is what these trips are all about." 

Instant Diagnosis

Instant Diagnosis

ON-SITE PATHOLOGY CRITICAL TO OUR SUCCESS

This beautiful photo is more sinister than you'd imagine: it's a slide of a multinucleated giant cell containing fungal elements. A 16-year-old young woman came to us on Tuesday with a nodule affecting her left nose. Radiographic imaging from a local hospital suggested a large, deep lesion involving the maxillary sinus that might have been a solid tumor; however, a fine needle aspiration biopsy revealed the mass was a benign fungal infection and not a malignancy. Post-surgically, we'll give her anti-fungal medicine, which should prevent any recurrence. 

We're fortunate to have Jeffrey Mueller, a pathologist from the University of Chicago, and his pathology resident Jefree Schultehere to perform on-site fine-needle aspirations, assessing cell specimens to diagnose tumors. Medical equipment is also in short supply, so Mueller brings his own. 

"With no pathologists in Malindi, and the nearest specialist two hours away in Mombasa, our pathologists' diagnoses are critical to our work here," says Jamie Wiggleton, ANP-BC, who runs our clinic here. Having instant diagnostic results is nearly unique to our mission trip: only a handful of others are also doing this. We don't receive pathology reports this quickly in the United States!

 

A New Voice

A New Voice

Johnson is a coffee farmer who lives about an hour away from Nairobi with his wife and son. In January 2015, he noticed his voice getting softer. One day that summer, he began having difficulty breathing. He had an emergency tracheotomy and biopsy showing that he had laryngeal cancer. Two weeks later, in October 2015, he traveled to Malindi to visit our annual surgical camp. He underwent a surgical procedure called a laryngectomy, which is a removal of the voice box. That means he has to relearn how to talk.

Last year, he met with our speech therapist, Jenn Starkweather from InHealth Technologies, to learn what to expect after surgery. This year, he met with Jenn again. Jenn introduced him to Abdullah, who had a laryngectomy three years ago with another team, and was able to demonstrate speaking with an electrolarynx for Johnson. An electrolarynx is a device that creates vibrations to turn into speech. It was fantastic to witness these two patients helping each other with Jenn's oversight.

Johnson's progress with the electrolarynx is already impressive! With practice, he will have little difficulty making himself understood.

We've arrived!

We've arrived!

Our 2016 Malindi team has arrived for our surgical educational camp, bringing 1 1/2 tons of medical supplies from the US in over 50 oversized bags to Tawfiq Hospital in Malindi, Kenya. See us setting up below. We're excited to start surgeries tomorrow!

A model for collaboration

A model for collaboration

We have had another paper published about our work, which is freely available to be read by the public:

Fagan JJ, Aswani J, Otiti J, Mushamba V, Liyombo E, Woodson G, Weed D, Zender C, Mannion K, Netterville JL, Wagner R, Zafereo M. Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries. Springerplus. 2016 Sep 23;5(1):1652. eCollection 2016. PMID: 27722069.

The article outlines how our targeted 1–2 week surgical camps supplement African training in head and neck surgery, and provide rewarding international collaboration while seeking to avoid some of the common pitfalls of short-term humanitarian medical trips. 

We leave tomorrow for Malindi, Kenya!

Helping children in Kenya to hear again.

Helping children in Kenya to hear again.

Vast numbers of children in East Africa who are thought to be deaf actually have fixable hearing losses, if only they could get a diagnosis and treatment. We are working closely with the Caris Foundation to screen children and some adults for repairable hearing losses, to make a radical difference in their lives.

Children with hearing loss often fall behind in their speech and language development, with a lifelong loss of productivity due to the limited resources available to children in the developing world. Currently, not much is known about the kinds of hearing loss that affect children in rural Kenya, which means adequate treatment plans have yet to be developed.

During our two-week surgical camp starting next week, we will screen schoolchildren and some of the adults in their communities in rural Kenya, using a portable iPad audiometer capable of conducting hearing screening equivalent to what is done in the United States. We'll couple this portable technology with endoscopic imaging of the eardrum so we can better understand what is causing these children to have hearing loss. To our knowledge, this is the first screening program to combine both endoscopic imaging and audiometry. The information we gather will help us to plan future mission trips, obtain funding for hearing aids, and ultimately help these children to hear again.

Our Kenyan outcomes research at the annual Academy meeting!

As we write this, the American Academy of Otolaryngology - Head and Neck Surgery is having their big annual meeting in San Diego! We're giving this presentation there, about our work in Kenya:

  • Dwojak S, Sharbel D, Espahbodi M, Fernando S, Ghiam M, Netterville J. "Outcomes of a 2-Week Head and Neck Teaching Course in East Africa." 2016 American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting. San Diego, CA. 18-21 September 2016.

Sharing our work with other medical providers

Sharing our work with other medical providers

Here are some of the academic papers in peer-reviewed journals that have been made possible by the information and data we gather on our trips: