Departments

The Center for Thoracic Cancers at Smilow Cancer Hospital consists of a multidisciplinary team of experts dedicated to providing evaluation of and treatment for patients with a thoracic malignancy, including lung cancer, esophageal cancer, thymoma, or chest wall tumors. Patients in Connecticut and beyond have access to nationally recognized expert clinicians, who provide an organized, collaborative approach to cancer care, as well as the latest technologies and treatments. Our team consists of a collaboration of specialty physicians, including medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, digestive diseases, pathology, diagnostic imaging, and nursing. In addition to our expert clinicians, patients also receive comprehensive care to help with the physical, emotional, and psychological issues that are part of confronting cancer. Patients also benefit from the attention of the team's care coordinators, who make management of even the most detailed multidisciplinary treatment plan less complicated. Our team is active in clinical research, and focuses on developing advances to care in areas of thoracic oncology where the standard treatment needs improvement and where the optimal treatment approach remains unclear. To provide the best care, most of our patients are enrolled in a clinical trial where they can receive innovative therapy for their advanced disease, including immunotherapy, which was first used in clinical trials at Smilow Cancer Hospital. The Center for Thoracic Cancers offers second opinions that are easy, convenient, and all done remotely. Call (203) 200-LUNG for more information and learn how to schedule a second opinion appointment with one of our providers. Medical Oncology Our medical oncologists are nationally recognized for their leadership and expertise in lung cancer treatment and research, and are dedicated to offering personalized treatment options. Biomarker testing is often performed on the tumor to look for specific mutations that can be targeted by medication. There are currently FDA-approved lung cancer treatments for tumors showing abnormalities in EGFR, KRAS, ALK, ROS1, BRAF V600E, MET, RET , and NTRK genes. Recent studies conducted at Yale have led to FDA approval of drugs for the treatment of lung cancer, such as the immunotherapy drug Tecentriq (atezolizumab), which has been proven to improve patient survival for newly diagnosed NSCLC. This drug is designed to block PD-L1, a protein that was discovered by scientists at Yale and that has been instrumental in improving survival for lung cancer patients. Another FDA-approved drug, osimertinib, which stemmed from Yale Cancer Center and Smilow Cancer Hospital researchers, was approved for the treatment of adults with early-stage NSCLC with EGFR gene mutations. Surgery Many patients in need of surgery are referred for a minimally invasive surgery known as a video-assisted thoracoscopi

We employ a multidisciplinary approach to care for children’s asthma, which is the most common chronic respiratory illness in children, affecting 5 to 10% of all children in the United States, and accounting for the majority of missed school days. One-third of all emergency department visits are related to asthma, and it is the common reason children are admitted to hospitals.The goals of asthma therapy are to have children lead normal, active lives, and prevent the occurrence of frequent troublesome symptoms or the need for emergency visits and hospitalization. Asthma rates have been on the rise over the past 15 to 20 years. Although asthma cannot be cured, and may be a life-threatening illness, it can be well controlled with proper medication and education. All of our physicians and medical staff who participate in any aspect of children's asthma care work together as a team. This team, the Pediatric Asthma Care Team (PACT), includes pediatricians and pediatric pulmonologists, allergists, emergency department physicians, intensivists, a nurse practitioner, and certified asthma educators.

The Yale Medicine Department of Anesthesiology is a national leader in its field, and is dedicated to providing the highest quality anesthesia care to both children and adults. We provide pain management care to patients before, during, and after surgery, and work in a variety of clinical and specialty areas. We care for patients undergoing a wide range of procedures, whether they are healthy or gravely ill. We are committed to providing cutting-edge, safe, and short-acting anesthetic medications to patients. Our expert care teams include certified registered nurse anesthetists (CRNAs), APRNs, PAs, RNs and technicians, and specialist physicians. In our clinical research, we focus on developing technologies to improve patient safety and reduce perioperative care costs. Our translational research efforts are particularly strong in areas of regenerative medicine and vascular engineering. Our comprehensive care includes: Consulting with surgeons, providing pain control, and monitoring life functions during surgery Ambulatory care anesthesia Anesthesia for procedures outside the operating room (catheterization, CT scan, MRI, interventional radiology, neuroradiology) Cardiac anesthesia (including assist devices) Presurgical evaluation Supervising care after surgery Comprehensive inpatient and outpatient pain management Pediatric anesthesia and pain management Regional (local) anesthesia Adult pre-admission testing facilities Pediatric pre-admission testing service 24/7 in-house obstetrics coverage, and outpatient high-risk consultations

The Head and Neck Cancers Program at Smilow Cancer Hospital provides total care, as well as innovative and organ-sparing treatment options to patients with cancers of the head and neck. Our team sets the tone nationally and internationally for clinical trials and state-of-the-art cancer care. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures. Our multidisciplinary team includes head and neck surgeons, radiation oncologists, medical oncologists, pathologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. Functional outcome is an important element in deciding which treatment approach is recommended. Our program offers a promising new surgical technique, transoral robotic surgery (TORS), that can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries. Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments. In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, without sacrificing cure rates. Additionally, in recent years, the field of reconstructive surgery has achieved many breakthroughs, yielding previously unattainable cosmetic and functional outcomes. Medical Oncology Our medical oncologists have unique expertise in head and neck cancers and dedicate their practice entirely to cancers of the head and neck. The integration of chemotherapy with radiation has become very important for patients with head and neck cancers that involve the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also being studied. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available. A study led by Yale Cancer Center revealed that the checkpoint inhibitor pembroli

We offer comprehensive state-of-the-art care for adults and children with disproportions of the upper and lower jaws and related facial structures. Yale has one of the most respected maxillofacial and orthognathic surgery programs in the nation. Our team helps patients maximize the ability to speak, eat, and chew; alleviate breathing problems; and minimize temporomandibular joint (TMJ) pain and the potential for sleep apnea. We also focus on improving facial symmetry by balancing jaw-to-face ratio. In caring for our patients, we harness the latest in medical care and technologies, as well as the most effective reconstructive surgical procedures. During the planning stage, we use the most sophisticated 3-D imaging tools available. With 3-D photo imaging, 3-D CT scan imaging and special software programs, we can simulate proposed outcomes so that patients can see the results before surgery. Our team includes leading surgeons, nurse practitioners, and care coordinators who work together to address our patients’ needs in managing disproportions of the upper and lower jaws.

Obesity is a common problem that can cause fatigue, diabetes, fatty liver disease, and sleep problems, and raise the risk of many cancers. It reduces energy, and can take the pleasure out of many aspects of life. Extra weight also places stress on vital organs, including the heart, liver, and kidneys, as well as joints and the reproductive system. Although organs can work under this extra stress for a number of years, eventually they are likely to fail. Most organs lose about 80% of their capacity before symptoms are evident, and by that time, it is often too late to return them to normal function. The conditions associated with obesity are: Cancer Cardiovascular disease Diabetes Liver disease Obstructive sleep apnea Losing weight can help improve and sometimes cure many of these conditions, as well as fertility issues. Losing weight can also lead to a life with fewer medications, lower health expenses, and overall greater enjoyment. At the Yale Metabolic Health and Weight Loss Program, we offer all nonsurgical weight-loss interventions in one location. Our philosophy is to focus on health, rather than specific disease, and to tailor our care to each patient’s specific needs and goals. The first step in our care is to determine weight-loss goals. Patients may need to lose 5 to 10% of their body weight to help in the treatment of a disease. We will help patients choose from interventions that include intensive meal-replacement programs, a range of medications, or endoscopic (nonsurgical procedure) options. Sometimes, there are additional medical necessities, such as an upcoming surgery, that require a specific weight-loss goal. We will explain the advantages and disadvantages of the various options, but the choice will depend primarily on what feels right to the patient. We provide therapies under the medical supervision of obesity experts. Patients can choose from the full range of tested interventions: Lifestyle changes: Nutrition counseling goes hand-in-hand with medical management of metabolic health. Care will include a personal visit with a registered dietitian with advanced training in weight management. OPTIFAST® program: OPTIFAST® is a medically monitored weight management program that allows patients, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education. The OPTIFAST program provides full meal replacement for 12 weeks and transitions to self-prepared “everyday” meals in conjunction with comprehensive patient education and support, to help patients achieve long-term weight loss. Medications: All medications are used as part of a comprehensive program that includes proper nutrition and a healthy lifestyle. Contrave® is a single pill that contains two medications (naltrexone and bupropion) and is taken twice a day. It will reduce appetite and can produce weight loss in the 5 to 10% range. Phentermine is taken once in the morning, and is prescribed for a few weeks.

We care for children with a variety of allergic and immunologic disorders, and chronic respiratory diseases. Our highly specialized, board-certified clinicians diagnose and treat everything from the most common to the very rare conditions. Nasal and eye allergies Asthma Hives Medication allergy Chronic sinusitis Angioedema Hereditary angioneurotic edema Common variable immunodeficiency Secondary immune deficiencies Cystic fibrosis Sleep disorders Chronic lung disease in infants and older children Acute respiratory failure Treatments we offer include: Allergen vaccine immunotherapy (allergy shots) Asthma environmental controls and pharmacological controller therapy Intensive antihistamine regimens Biological therapy for hereditary angioneurotic edema Intravenous and subcutaneous immunoglobulin replenishment Aspirin desensitization Desensitization to antibiotics and other medications Our services include: Pediatric pulmonary function testing:We evaluate and follow lung disease in children with a full spectrum of tests, including diffusion analysis, challenge tests, and exercise. Physicians may order a pulmonary function test by calling 203-688-4667. Bronchoscopy:Bronchoscopy is the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body. Bronchoscopies are performed in the pediatric operating room, and in the Pediatric Intensive Care Unit. Our pulmonologists who perform this procedure have extensive experience with flexible bronchoscopy, including its use in newborns. In many cases, flexible bronchoscopy, which can be safely and comfortably performed under conscious sedation, eliminates the need for an exam under general anesthesia.

The Pituitary Program is a destination center for the clinical management of pituitary, parasellar, and anterior skull base disease delivering state-of-the-art, multidisciplinary care. It is the referral center for the state of Connecticut for treatment of complex pituitary and sellar-parasellar pathology using the expertise of minimally invasive endoscopic skull base surgery jointly performed by neurosurgery and ENT. Patient cases are reviewed by a multidisciplinary pituitary tumor board, with intraoperative hormone monitoring, intraoperative MRI, and whole exome sequencing of tumors for potential genomic-based diagnosis and treatment. The Yale endocrinology team and other supporting subspecialties follow each patient during the hospitalization for uninterrupted endocrine care. We aim to maximize the quality of care and the ultimate outcome of each patient. To ensure the best care possible, we co-manage the pituitary disorder with each patient’s primary care physician, and actively seek second opinions, exploring dynamic testing and pituitary hormone replacement therapy options. Yale New Haven Hospital is a regional center for pituitary surgery, and our physicians have specific expertise in treating a variety of neuroendocrine diseases, including Cushing's disease and adult growth hormone deficiency syndrome. We also evaluate and treat reproductive disorders in collaboration with the sections of Reproductive Endocrinology and Infertility. Additionally, we work closely with colleagues in neurosurgery, surgical endocrinology, therapeutic radiology, and other departments to make sure patients benefit from our patient-centered, team-based approach. Combined with first-rate technology at Yale New Haven Hospital, the Yale Cancer Center and the Department of Neurosurgery’s Gamma Knife Center, the Pituitary Program is uniquely positioned to offer every diagnostic and treatment option available, including: Dynamic pituitary magnetic resonance imaging (MRI), an enhanced diagnostic imaging technique Inferior petrosal sinus sampling to sample hormones from the veins that drain the pituitary gland 3-D conformal radiotherapy to better target tumors Intensity-modulated radiation therapy, an advanced high-precision technique Transphenoidal surgery performed through the nose and sphenoid sinus Gamma Knife surgery (stereotactic radiosurgery) performed at the Gamma Knife Center, the only dedicated Gamma Knife facility in Connecticut. At Yale New Haven Children's Hospital, our longstanding pediatric endocrinology clinic provides the same services and excellence of care that adults receive.

The Yale Hearing & Balance Program provides comprehensive care for adult patients with a variety of audiologic and vestibular diagnoses, disorders, and symptoms. We employ a patient-centered health care approach, working as a team of neurotologists, audiologists, and associated healthcare providers to implement evidence-based practice and innovative care. Our multidisciplinary team provides services ranging from diagnostic hearing and/or vestibular evaluations to audiologic rehabilitation, including treatment with hearing aids, osseointegrated devices, and cochlear implants. We know how hearing and balance disorders can isolate and limit our patients, so our team of highly skilled practitioners uses the latest research and technology to not only improve our patient’s daily functionality, but also their overall well-being. Just as every patient is unique, every hearing loss is different and requires specific treatment and rehabilitation options. At our program, we specialize in a variety of treatment options for hearing loss and tinnitus. We perform audiometric evaluations to determine specific hearing sensitivity. Based on the results, we may recommend treatment with hearing aids, osseointegrated devices, or cochlear implants. We also provide in-depth counseling on strategies for effective communication skills. When indicated, we also provide treatment for tinnitus through information counseling and sound therapy. Read about Medicare and Medicaid coverage updates for cochlear implants . Read answers to frequently asked questions about over-the-counter hearing aids Research has shown that patients benefit significantly from a multidisciplinary team approach. Our team includes highly skilled surgeons, audiologists, hearing aid technicians, and support staff. We collaborate weekly to discuss new cases, technology updates, and pertinent topics in our ever-changing field.

The Yale Pediatric Neuromuscular Program is Connecticut’s only pediatric multidisciplinary program and one of the only five in New England supported by the Muscular Dystrophy Association (MDA). Families of children with muscular dystrophy or other childhood neuromuscular disorders see a multidisciplinary team that includes a neurologist, pediatric cardiologist, pediatric pulmonologist, pediatric orthopedic surgeon, neuromuscular geneticist, pediatric physical and occupational therapist, pediatric psychologist, pharmacist, social worker, dietitian, and care coordinator. There is easy access to other relevant subspecialties such as endocrinology, gastroenterology, and general surgery. Here is a short list of various neuromuscular disorders seen in our clinic: Duchenne and Becker Muscular Dystrophy Spinal Muscular Atrophy Myotonic Dystrophy Limb Girdle Muscular Dystrophies Congenital Myopathies Congenital Muscular Dystrophy Metabolic Myopathies Mitochondrial Myopathies Dermatomyositis Myasthenia Gravis Congenital Myasthenic Syndromes Charcot Marie Tooth Disease CIDP and related disorders Other motor neuron disorders Spastic Paraplegia Arthrogryposis The program offers comprehensive diagnostic evaluations by a fellowship-trained and board-certified pediatric neuromuscular specialist and a neuromuscular geneticist, both with experience in pediatric neuromuscular diseases. State-of-the-art, comprehensive genetic testing, muscle biopsy, pediatric EMG (with or without sedation), and other diagnostic tools are available. We are the only center in the state that offers sedated pediatric EMG. Basic diagnostic imaging, pulmonary function tests, and echocardiography occur on-site. Cardiac MRI is available for our patients on the main campus. The state-of-the-art sleep laboratory is run by our pediatric pulmonologist. The program believes in a holistic and customized approach to caring for patients with various neuromuscular disorders. The program is located at Yale New Haven Children’s Hospital’s Pediatric Specialty Center at One Long Wharf Drive, which is a short drive from Yale New Haven Hospital and has ample free parking and easy access for impaired individuals. The program is recognized as an SMA (Spinal Muscular Atrophy) Care Center by CureSMA and offers all three FDA-approved treatments for SMA (Spinraza®, Zolgensma®, and Evrysdi®). A well-established Spinraza program runs in collaboration with Dr. Michele Johnson of Yale Interventional Radiology and is coordinated by Louise Lanouette, RN. We are the only center in Connecticut that provides access to Spinraza to patients of all ages. The program is also recognized as a Certified Duchenne Care Center by Parent Project Muscular Dystrophy (PPMD). We provide access to all FDA-approved treatments for Duchenne Muscular Dystrophy and other neuromuscular disorders, including gene therapy. The program participates in several clinical trials for Duchenne Muscular Dystrophy and Spinal Mus

The Smilow Cancer Hospital Lung Cancer Screening Program is a multidisciplinary program that provides lung cancer screening to patients at risk for lung cancer. Our program has a coordinated approach that offers a complete and seamless screening process. Our team includes world-recognized pulmonologists (doctors who treat diseases of the respiratory system), specialized chest radiologists (doctors with advanced skills in reading CT scan images of the lung), thoracic surgeons and thoracic oncologists (doctors who treat lung cancer), tobacco/smoking cessation counselling specialists, and specialized nurse practitioners. Our goal is to provide lung cancer screening in the context of a care process that takes patients from risk assessment to screening to resulting and referral, if needed. Should an abnormal finding be identified, our team will guide and support our patients through next steps. Our program is comprehensive and coordinated, and provides the patient with access to a specialized, expert team of caregivers. Our processes are efficient and seamless. Additionally, our team has the knowledge, experience, and compassion to provide patients with the best lung cancer screening experience. Because of this, our team is available to guide patients throughout the screening process and beyond, if needed. Whether it’s an annual follow-up scan or further evaluation, we have the people and resources to care for each patient. Our team uses nationally established guidelines to care for our patients. Our tobacco treatment services are available in person or via telehealth visits. Read our list of frequently asked questions regarding lung cancer screening . National Cancer Institute: Lung Cancer Screening Lung Cancer Prevention National Lung Screening Trial National Lung Screening Trial - Questions and Answers Lung Cancer Screening (PDQ)- Patient Version Centers for Medicare and Medicaid Services (CMS.gov): NCA - Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) American Cancer Society: American Cancer Society Guidelines on Lung Cancer Screening Early Detection, Diagnosis, and Staging Causes, Risk Factors, and Prevention United States Preventive Services Task Force (USPSTF) A & B Recommendations

Pediatric Otolaryngology is dedicated to ensuring the highest quality of care to children with ear, nose, and throat disorders. Our care team comprises board-certified pediatric otolaryngologists, nurses, audiologists, and speech/swallow pathologists, all specially trained to care for the development and special needs of children. We treat children from birth to 21 years of age with a wide range of ear, nose, and throat conditions. Working with the child and family, our physicians collaborate with other pediatric specialists such as pulmonologists, gastroenterologists, plastic surgeons, general surgeons, oncologists, and oral surgeons to develop an individualized care plan to offer the most effective treatment options. We understand that children need to feel safe during any testing procedure, including those of a routine nature. Our team is highly experienced in working with children. We take extra measures to ensure that the child’s needs are met. We make each child feel safe and comfortable and offer toys for younger children with shorter attention spans. Parents are allowed and encouraged to accompany their child during all testing procedures. Our team includes nationally recognized, board-certified pediatric ear, nose, and throat surgeons. They work with licensed audiologists and nurse practitioners to address each child’s needs as they treat and manage their ear, nose, and throat condition, hearing impairment, or hearing loss. Nurse Coordinators Our ENT Nurse Coordinators are available to support our coordination of all care needs from initial contact with first appointment and throughout the continuum of care. As the main point of contact, the nurse coordinators are the liaison between patient and physician, and coordinates multiple care needs from answering questions and concerns, to planning for diagnostic tests and procedures. Multidisciplinary programs We collaborate with primary care providers and other specialists to optimize each child’s health and provide a comprehensive network for his or her care. By working with multiple multidisciplinary programs, we can ensure that children are receiving the care they need per their specific treatment plan. The programs that we work closely with include: Pediatric Audiology : Our audiologists are pediatric-trained and dedicated to improving the lives of children with hearing difficulties. Highly experienced, they collaborate with otolaryngologists to provide appropriate options and interventions for hearing loss using the latest technology. These options include hearing aids, bone-anchored hearing aids, and cochlear implants. Aerodigestive Program : Pediatric specialists provide comprehensive care for airway breathing, feeding, and swallowing disorders caused by problems of the aerodigestive tract. The team comprises otolaryngologists, gastroenterologists, pulmonologists, nurses, nutritionists and speech language pathologists. Speech & Swallow Program : The Speech and Swallow Progr