Sinus & Nasal Institute of Florida

Institution & address
Sinus & Nasal Institute of Florida, P.A.
550 94th Avenue North
St Petersburg, FL 33702

sf match program id#
2865

fellowship faculty
Donald C. Lanza, MD, MS
Alla Y. Solyar, MD

departmental mission statement
Our mission is to pursue excellence in patient care, education and research. The primary goal of SNI fellowship training is to establish a strong foundation for dedicated otolaryngologists to continually pursue excellence & leadership in Rhinology & minimally invasive management of related orbital and skull base disorders. It is anticipated that Fellows trained at the Sinus & Nasal Institute of Florida will become leaders in their future community regardless if it is in a university or private practice environment.

overview of fellowship
This is a mentorship program dedicated to training one individual at a time. The out-patient experience sets the ground work for developing an enriched understanding of the pathophysiology of severe refractory chronic rhinosinusitis. In the SNI clinic, the Fellow obtains hands-on experience by performing post-operative debridements as well as by performing thousands of nasal endoscopies. This helps the Fellow to hone skills that he/she is exposed to during residency. Fellows become facile in the management of the complex microbiology which can affect patients with CRS. Coding and reimbursement discussions are part of the practice management education while administering care. Allergy management is embraced and immunotherapy administration is new addition to this practice. Drs. Lanza and Solyar strive to maintain cutting edge technology in this practice. Fellows are valued members of the Institute and their input is sought. There are no resident clinics to supervise.

The complexities of the surgical problems encounter at SNI challenge the skills of even the most experienced otolaryngology residents. Nearly all surgery performed for chronic sinus disease is revision work. As might be anticipated, image guided surgery is employed regularly due to the complex nature of the cases. Patients are consented to have surgery with both Dr. Lanza and the Fellow. All patients are informed in advance as to the importance of the Fellow in their complete care. Dr. Lanza or Solyar are available alongside the Fellow for instruction and for participation in surgery. Fellows learn to utilize 70 & 90 degree telescopes to facilitate minimally invasive approaches to complex frontal, maxillary and even sphenoid disease. Surgery is performed in the sitting position to maximize the surgeon’s stability vis-à-vis the delicate skull base and peri-orbital work. This also facilitates the use of all four limbs to achieve the surgical objectives. Four handed work is employed when appropriate, during certain combined neurosurgical procedures.

fellowship description
Clinical Rotations: See above.

Weekly Schedule: Clinic: Monday, Wednesday and Friday. Operating Room: Tuesday and Thursday.

Research Responsibilities: SNI’s research focus is clinically based. A growing number of projects are available now, since this Institute has been in place for 7 years. In 2008, we reported a collective experience from 2 institutions describing minimally invasive treatment of sinus melanoma. In 2009, we are evaluating novel therapies for treatment of biofilms and MRSA. In 2010-11 we reported our experience with Fusarium, atypical mycobacterium, and olfactory loss in pituitary adenoma. Related to the very busy clinical schedule there is a tendency for a significant portion of the research activity to occur after hours. Two research abstracts must be submitted during the fellowship year. Additionally, at least one approved manuscript for peer-review publication must be completed and submitted prior to the end of the fellowship year. SNI supports travel to scientific meetings to present SNI research. Travel support is available regardless if the presentation is given after the fellowship year is completed.

Diversity of Cases:
  • Nasal Obstruction - Deviated septum, Turbinate enlargement, Nasal valve obstruction, Septal perforation, Choanal atresia
  • Nasal & Sinus Inflammation - Recalcitrant sinusitis (all forms inc. fungal), Nasal polyps, antro-choanal polyps, Rhinitis—allergic and non-allergic, Mucoceles, Loss of sense of smell,Post-nasal drip and cough, Discolored nasal discharge, Sinus related facial pain and pressure, Granulomatous Disease—e.g. Wegener’s, Cystic Fibrosis
  • Orbital Disease- Exophthalmos, Compressive optic neuropathy, Selected orbital tumors (eg. hemangioma), Epiphora, Silent sinus syndrome assoc. enophthalmos, Tear duct malignancy
  • Nasal & Sinus Trauma- Nasal fracture, Failed prior sinus surgery with scarring, cerebrospinal fluid fistula (inc. spontaneous), Bleeding (inc. hereditary telangectasia)
  • Benign Nasal & Sinus Tumors-Encephaloceles, Inverted papilloma/Cylindric cell papilloma, Osteoma/ Fibro-osseous lesions, Juvenile nasopharyngeal angiofibroma, Extra-dural meningioma, Hemangiopericytoma, Hemangioma of Pregnancy, Clival Chordoma
  • Malignancy of Sinuses -Squamous cell carcinoma, Adeno -& Adenoid Cystic carcinoma, Esthesioneuroblastoma, Melanoma, Chondrosarcoma, Ameloblastic carcinoma, Plasmacytoma / Lymphoma, Spindle cell carcinoma, Nasopharyngeal carcinoma"
Call Schedule: The “hospital on-call schedule” is for general ENT emergencies and for inpatient consultation. This occurs simultaneously about once in every 6-7 weeks. The Fellow has hospital call for typically 1-2 major holidays per year. The “SNI practice call”, which is separate from the hospital on-call schedule, is split evenly between Dr Lanza, Dr. Solyar and the Fellow.

Additional Information: Available Teaching conferences/resources:
  1. SNI Otolaryngology Journal Club -- 2nd Wednesday of every month
  2. USF Allergy & Immunology teaching conference - Wednesdays at USF St. Petersburg Campus
  3. St Anthony's Hospital Tumor Board
  4. Hands-on cadaver dissection—once annually in Jacksonville, Florida.
  5. Biennial SNI hands-on course in Endoscopic Sinus Surgery in St Petersburg
  6. SNI will support the Fellow to attend Advanced AAOA course (typically offered each December) if the Fellow has taken the Basic AAOA course (typically offered each summer) prior to beginning their Fellowship year. *The basic course is not the same as the resident course.
  7. Well maintained on site medical library including Textbooks, Medical Journals, & FESS / Skull Base Videos."
current and past fellows
William E. Bolger, MD (PENN 1992); Eugenia M. Vining, MD (PENN 1993); Dean M. Clerico, MD (PENN 1994); David H. Henick, MD (PENN 1994); Maurice Roth, MD (PENN 1995); Brent A. Senior, MD (PENN 1996); Peter H. Hwang, MD (PENN 1997); Richard R. Orlandi, MD (PENN 1998); Erin Wright, MD, (PENN 1999); Ryan Gallivan, MD (Cleveland Clinic 2002); Pete S. Batra, MD (Cleveland Clinic 2003); Samer Fakhri, MD (Cleveland Clinic 2004); John W. Alldredge, MD (SNI 2008); Victoria A. Epstein, MD (SNI 2009); Annie S. Lee, MD (SNI 2010); Alla Y. Solyar, MD (SNI 2011); Jeb M. Justice, MD (SNI 2012); Adil Fatakia, MD (2013)

requirements for appointment
Applicants must be either board certification or board eligible for the American Board of Otolaryngology; We requires an on-site SNI Interview; Florida State Medical License

application deadline
February 1

contact information
Donald C. Lanza, M.D., M.S.
Sinus & Nasal Institute of Florida, p.a.
550 94th Avenue North
St. Petersburg, FL 33702
(O) 727-573-0074
(F) 727-573-0076
dclanza@sniflmd.com; www.sniflmd.com