Stanford Sleep Surgery is a division under the Department of Otolaryngology-Head & Neck Surgery that takes two surgical fellows a year. Sleep orthodontic fellows will be provided with an immersive experience early on to learn how to implement proper head and neck exams, with an emphasis on nasal and pharyngeal examinations focused on the upper airway. A series of lectures will be held in conjunction with Stanford’s sleep surgery fellows on treatment algorithms, endoscopic interpretation (awake and sleep endoscopy), and the understanding of surgical procedures. The sleep orthodontic fellows will contribute to the didactic experience by teaching dental and facial/airway growth and development to the surgical team.
While the surgical fellows are primarily otolaryngologists, they can also be oral and maxillofacial surgeons. Dr. Stanley Liu is the Sleep Surgery Fellowship director, who will also be overseeing the activities of the Dugoni School’s sleep orthodontic fellows at Stanford Sleep Surgery.
The regularly held Sleep Surgery Treatment Planning Conference (STPC) will be led by both the sleep orthodontic and sleep surgery fellows. Comprehensive patient workup and assessment will utilize dental, orthodontic, airway, psychological, and medical findings and data to develop recommended treatment plans. The STPC will comprise the academic faculty of oral surgery, otolaryngology, and orthodontics.
We expect the sleep orthodontic fellows to be involved with at least 5 complete workups of skeletal sleep patients, along with 5 observations in the operating room. The skeletal procedures for sleep surgery include distraction osteogenesis maxillary expansion (DOME), maxillomandibular advancement (MMA), and genioglossus-genioplasty advancement (GGA).
Stanford sleep surgery is the most comprehensive program of its type, and the sleep orthodontic fellow should take full advantage of the experience.
The sleep surgery volume at Stanford is approximately 80 skeletal cases for MMA and GGA, and 30 for DOME. Meeting the requirement is not expected to be a barrier to fellowship training. Additionally, it is recommended that fellows observe 30 drug-induced sleep endoscopies and an equivalent number of awake endoscopies with Muller maneuver. Finally, a total of 30 cases including septoplasty, rhinoplasty, nasal valve surgery, tonsillectomy, uvulopalatopharyngoplasty (UPPP), and hypoglossal nerve stimulation is strongly recommended.