Overview

Dr. Paydarfar is Chief, Division of Otolaryngology, Audiology and Maxillofacial Surgery at the Dartmouth-Hitchcock Medical Center, Associate Professor of Surgery—Otolaryngology at the Dartmouth Geisel School of Medicine, and Adjunct Associate Professor of Engineering, Thayer School of Engineering at Dartmouth. His clinical specialty and interests are in head and neck oncologic and reconstructive surgery, trans-oral laser microsurgery, and trans-oral robotic surgery. His research interests include wound complications in head and neck surgery, minimally invasive approaches and surgical navigation in head and neck surgery.

Research Interests

Wound complications in head and neck surgery; minimally invasive approaches; surgical navigation in head and neck surgery

Education

• BSE, Electrical Engineering, Duke University 1989
• MD, Duke University 1996

Awards

• Department of Surgery Chair’s Award for Highest Patient Satisfaction, DHMC, 2014
• Patients' Choice Award, Vitals.com, 2012 – 2013
• Teaching Excellence in Continuing Medical Education Award, 2013
• Top Doctor in Otolaryngology, New Hampshire Magazine’s Top Doctors Poll, 2013
• Top Doctor in Otolaryngology, New Hampshire Magazine’s Top Doctors Poll, 2011
• Leading Physician in Otolaryngology, New Hampshire Magazine’s Top Doctors Poll, 2008

Research Projects

• Enabling technologies for effective image-guided surgical navigation in trans-oral cancer surgery

  Enabling technologies for effective image-guided surgical navigation in trans-oral cancer surgery

  Throat cancers have been increasing in incidence worldwide. Despite advances in surgical and non-surgical management of these cancers, treatment continues to be associated with significant functional and cosmetic morbidity. More minimally invasive trans-oral surgical (TOS) approaches have reduced treatment morbidity and complications. However, one drawback of TOS is the difficulty in intraoperatively assessing tumor extent and locating major vascular structures. Surgical navigation with image guidance has shown improved safety and efficacy with other surgical procedures; however it is currently not feasible in TOS due to the soft tissue and airway deformation that occurs with placement of instruments needed to access the throat, thus rendering preoperative scans unusable in the intraoperative setting.

  The overarching objective of our research is to develop enabling technologies that allow for surgical navigation with image guidance for TOS. Our research strategy is to acquire intraoperative imaging during TOS in order to develop models of upper aerodigestive tract deformation that reflect the intraoperative state. This, in turn, would allow for registration of preoperative images to the intraoperative state. We are well equipped to solve this problem due to the unique intraoperative CT and MR imaging resources available at the Dartmouth Center for Surgical Innovation. We have successfully developed a 3D printable polymer laryngoscopy system which, unlike standard metal laryngoscopes, is CT and MRI compatible. We have also acquired preliminary intraoperative imaging data during laryngoscopy procedures. The next steps in this research will be to further quantify and characterize tissue deformation that occurs during TOS and ultimately develop a surgical navigation platform for trans-oral procedures.

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Selected Publications

• Paydarfar JA, Wu X, Halter RJ. MRI- and CT-compatible polymer laryngoscope: A step toward image-guided transoral surgery. Otolaryngol Head Neck Surg. 2016 Aug;155(2):364-6
• Li SX, Polacco MA, Gosselin BJ, Harrington LX, Titus AJ, Paydarfar JA. Management of the thyroid gland during laryngectomy. J Laryngol Otol. 2017 Jun 8:1-5
• Polacco M, Pintea A, Gosselin B, Paydarfar J. Parotidectomy Using the Harmonic Scalpel: Ten Years of Experience at a Rural Academic Health Center. Head and Face Medicine 2017 May 11;13(1):8
• Paydarfar JA, Freed GL, Gosselin BJ. The anterolateral thigh fold-over flap for total and subtotal glossectomy reconstruction. Microsurgery 2016 36 (4), 297-302
• Paydarfar JA and Patel U. Submental Flap Versus Radial Forearm Flap for Oral Reconstruction: Comparison of Outcomes. Arch Otolaryngol Head Neck Surg. 2011; 137(1):1-6
• Paydarfar JA, Birkmeyer NJ. Complications in head and neck surgery: A meta-analysis of postlaryngectomy pharyngocutaneous fistula. Arch Otolaryngol Head Neck Surg. 2006;132:1-6.
• Paydarfar JA and Paniello RC. Functional study of four neurotoxins as inhibitors of post-traumatic nerve regeneration. Laryngoscope 2001; 111:844-850