White Plains Hospital is expanding its Otolaryngology/ENT services by recruiting a team of well-known, highly specialized physicians to treat complex head, neck and ENT disorders.
Patients in the Lower Hudson Valley and surrounding communities have enjoyed significant access to specialty otolaryngology services for years, thanks to White Plains Hospital’s affiliations with local ENT specialists.
At the same time, White Plains Hospital has continued to explore opportunities to expand and improve its tertiary care capabilities. As part of this initiative, the hospital has brought on board experienced and highly trained ENT affiliate physicians as members of White Plains Hospital Physician Associates (WPHPA) — a division of the Hospital. Now, the Hospital can offer advanced treatments close to home, sparing local patients and their family members the burden of frequent visits to New York City.
“Patients can receive the same care at White Plains Hospital that they would expect to receive in Manhattan, without traveling nearly as far,” says Ameet Kamat, MD, Director of Sinus and Skull Base Surgery at White Plains Hospital. “Because we’re located in the Hudson Valley, we offer some of the most advanced otolaryngology care south of Albany, north of NYC.”
Dr. Kamat says joining the staff of White Plains Hospital was not a difficult decision, given its dedication to outstanding care.
“My affiliation with the hospital has become much closer over the past six years, and it became obvious during that time that White Plains Hospital is truly invested in patient outcomes,” he says. “After getting to know the physicians here, it was clear to me they wanted to make a team effort to improve the care of patients. That’s why my colleagues and I joined the hospital staff.”
Board-certified otolaryngologist and fellowship-trained laryngologist Craig Berzofsky, MD, Director of Voice and Swallowing at White Plains Hospital, uses the latest in direct in-office imaging through awake endoscopies to help correctly diagnose his patients.
A Team of Experts
Leading the team is Jk Rasamny, MD, Chief of Otolaryngology at White Plains Hospital. Dr. Rasamny is a local pioneer in transoral robotic surgery (TORS) and has worked with the hospital for more than six years as a member of its medical staff.
“When I was presented with the chance to further develop the Otolaryngology/ENT Department at White Plains Hospital and serve as head of the program, I jumped at the opportunity,” he says. “My colleagues and I are building something exceptional on an excellent foundation.”
Craig Berzofsky, MD, Director of Voice and Swallowing at White Plains Hospital, rounds out the expanded otolaryngology physician team. All three physicians are board-certified and collaborate closely with specialists in other fields at White Plains Hospital to provide personalized, comprehensive care that includes surgical and nonsurgical approaches.
“This new arrangement gives us a more pronounced and robust presence at White Plains Hospital,” Dr. Berzofsky says. “Before we joined the hospital, our time was split among many different health systems. Now, we have a base of operations that allows us to focus on our patients and services while improving communication among providers.”
Jk Rasamny, MD, Chief of Otolaryngology at White Plains Hospital, treats patients with endocrine tumors involving the parathyroid and thyroid glands as well as tumors of the major and minor salivary glands.
Cutting-Edge Imaging Capabilities
The Otolaryngology team leverages a broad spectrum of advanced imaging techniques and equipment to aid diagnosis. High-definition 4K video footage, which is recorded by endoscopic cameras, helps physicians make accurate diagnoses and optimal treatment recommendations while also empowering patients with a clearer understanding of the science behind their conditions and the treatment methods.
“I can perform a live assessment of a patient’s pharynx or vocal cords to see how they behave when the patient speaks,” Dr. Berzofsky says. “The footage is recorded and shown on a video screen so patients can see what’s going on, which helps them grasp the cause of the problem as well as establish treatment goals. Ultimately, that promotes greater patient compliance and overall experience.”
Among the noteworthy imaging techniques Dr. Berzofsky uses is videostroboscopy, which helps him break down the movement of the vocal cords to find the cause of dysfunction. The stroboscopic light illuminates the vocal cords from multiple angles in rapid succession, enabling Dr. Berzofsky to view the vocal cords with an almost slow-motion effect.
“I can see if one or both vocal cords are moving correctly, locate places where they might be tied together and identify lesions,” he says. “This imaging technique allows me to observe the functional deficiencies of the cords and determine the source of the problem.”
Ameet Kamat, MD, a board-certified, fellowship-trained sinus and endoscopic skull base surgeon and Director of Sinus and Skull Base Surgery at White Plains Hospital, reviews a patient’s endoscopic exam prior to scheduled sinus surgery. His practice emphasizes safe, innovative, minimally invasive techniques in sinus and skull base surgery.
High-definition endoscopic imaging technology also aids advanced procedures and complex surgical cases, as well as more common procedures such as sinus surgery.
“Many general ENTs can perform balloon sinuplasty, but we can perform it here in the office using image guidance technology and 4K video endoscopy, which is rare,” Dr. Kamat says. “We have a better view of the sinuses using this technology, which provides improved contrast that allows us to more clearly identify differences in the coloration of tissues.”
Dr. Rasamny uses a nerve monitoring system during parotidectomies and the removal of benign and malignant thyroid, parathyroid, and salivary gland tumors, as well as lymph nodes. While this system is not classified as an imaging technology, it allows him to avoid damaging nerves and more accurately determine which lymph nodes to remove during surgery.
Drs. Berzofsky and Rasamny discuss a patient’s treatment plan at White Plains Hospital Medical & Wellness in Armonk.
Exceptional ENT Expertise
The expanded Otolaryngology team can perform many procedures that are unavailable elsewhere in the Lower Hudson Valley and other communities north of New York City. These procedures include endoscopic skull base surgery for complex sinonasal and intracranial conditions, performed by Dr. Kamat, as well as TORS, performed by Dr. Rasamny.
“Endoscopic skull base surgeons tend to gravitate toward academic positions in Manhattan,” Dr. Kamat says. “That’s why there are only two or three surgeons who can do these types of surgeries in the Hudson Valley, including myself.”
During skull base surgeries, Dr. Kamat uses the nose as a conduit to the skull and brain. He can create small openings in the rear portion of the nose to access and resect benign and malignant skull base tumors, such as those found on the pituitary gland. In the past, this type of surgery required an open approach that was painful for patients and necessitated long recovery times. These open techniques include craniotomies, facial degloving and brain retraction — procedures that often result in significant scarring and an increased possibility of complications.
“Open skull base surgery requires a full day in the OR and a hospital stay of one to two weeks,” Dr. Kamat says. “With the minimally invasive approach through the nose, skull base surgeries now take four to six hours to complete and often two to three days of hospitalization. Pituitary surgeries are even shorter, lasting two to three hours at most. There are no cuts on the face, and the procedure is very safe.”
Offices in Armonk, Somers and White Plains provide patients access to the team of expert physicians collaborating on complex care for ear, nose and throat disorders.
A Closer Look at TORS
Similar to the skull base surgeries that Dr. Kamat performs, TORS procedures focus on using another natural conduit — the mouth — to facilitate minimally invasive surgery, resulting in improved recovery times, fewer complications and improved outcomes for patients.
TORS uses three robotic arms to visualize and remove tumors from the tonsils and tongue base: One arm is equipped with a camera, another serves as a grasper, and the third is equipped with a tool to resect the tumor. Dr. Rasamny operates all three arms from a surgical console and collaborates with a pathologist to confirm successful resection of the entire tumor through the mouth. Afterward, sutures are used to close off any defects, and patients typically return home in two to three days.
“Historically, small cancers of the tonsils and tongue base were treated with chemotherapy and radiation, but because of technological advancements, surgery has begun to play a more pivotal role,” Dr. Rasamny says. “By removing tumors through the mouth, we can help patients avoid chemotherapy, which is one of the great benefits of TORS. Furthermore, in the past, open operations to remove tumors could take 10 to 12 hours, whereas TORS takes only one to two hours.”
For patients, avoiding chemotherapy reduces or eliminates a host of side effects, including fatigue, hair loss, problems with concentration and damage to cells in the mouth and digestive tract.
Dr. Rasamny not only has extensive experience with TORS, but he also helped bring the procedure to the Lower Hudson Valley.
“I was the first person to perform TORS in Westchester, about seven years ago,” he says. “No other surgeon between Manhattan and Albany currently performs TORS for the treatment of cancer.”
Though all three specialists are skilled surgeons, they are equally knowledgeable about conservative treatment options.
“Most people come to me with complaints of hoarseness or dysphagia,” Dr. Berzofsky says. “Whenever possible, we use conservative treatments before moving on to minimally invasive or open surgical procedures to address those and other conditions.”
Dr. Berzofsky and his colleagues tailor treatments to patients’ needs and lifestyles. For example, a professional singer may opt for surgery over a more conservative treatment option if it means quicker results, whereas others may prefer voice therapy.
Similarly, when recommending treatment for sinus symptoms, Dr. Kamat looks at the three primary causes of those symptoms: inflammation, infection and impaired mucociliary clearance. If a patient has been living with recurring sinus infections, for example, it may be due to preexisting inflammation. Dr. Kamat often relies on topical medications and sinus rinses rather than surgery in these cases. Even when surgery is indicated, he enhances its efficacy through a multipronged approach that also includes rinses and topical medications, such as steroids.
The team’s high level of expertise can also keep patients from undergoing more invasive procedures than are necessary. An example is Dr. Kamat’s approach to the treatment of sleep apnea. While White Plains Hospital does offer surgery to directly address symptoms of sleep apnea, such as snoring, Dr. Kamat often can perform relatively minor procedures that facilitate better use of standard treatment devices, such as CPAP machines.
“A lot of times, I can simply make CPAP masks more tolerable for patients, and they don’t need another procedure after that,” he says.
“We treat the patient as an individual — not every individual gets the same therapy from me,” Dr. Kamat says. “We maximize medical therapy first. If additional treatment is necessary, we can offer a wide range of treatments, from office procedures to innovative surgeries.”
Now that Drs. Rasamny, Kamat and Berzofsky are members of WPHPA, they can partner more closely with other physicians whom patients see regularly. If a patient’s primary care provider notices an issue that could benefit from the capabilities of the Otolaryngology team, he or she can make a referral to one of the specialists seamlessly and efficiently.
“Our new roles mean we have easier access to patients, and they have easier access to us,” Dr. Rasamny says. “The coordination of care is more streamlined, especially since we are now using the same EHR system as the rest of WPHPA and have rapid access to patient records.”
Having the Otolaryngology team on-site also allows Dr. Rasamny and his colleagues greater opportunities to participate in multidisciplinary tumor boards, which are held weekly among specialists from different departments to review patient cases and upcoming procedures.
“Tumor boards facilitate discussions among oncologists, radiation oncologists, myself and other specialists to precisely tailor a treatment plan for each patient,” Dr. Rasamny says. “We can weigh the risks and benefits of surgery, radiation, chemotherapy and other treatments while respecting the desires of the patient. For example, some patients may have a natural bias against surgery, which we would consider in our recommendations.”
Patients also have access to additional advanced treatments and procedures through the Hospital’s affiliation with Montefiore Health System.
“Our partnership with Montefiore allows us to facilitate care for patients who might need a referral to another specialist,” Dr. Rasamny says. “If patients are dealing with an advanced middle ear disease or certain pediatric problems, for example, we can easily transfer them for further care.”
For additional information, visit wphospital.org.