Otolaryngologists
15 years of experience

Accepting new patients
Northeast Ann Arbor
Ann Arbor Veterans Affairs Medical Center
2215 Fuller Rd
Ann Arbor, MI 48105
734-769-7100
Locations and availability (6)

Education ?

Medical School Score
Wayne State University (1995)
  • Currently 1 of 4 apples

Awards & Distinctions ?

Awards  
Patients' Choice Award (2008 - 2009, 2012 - 2013)
Compassionate Doctor Recognition (2012 - 2013)
Top 10 Doctor - State (2014)
Michigan
Otolaryngologist
Associations
American Academy of Otolaryngology: Head and Neck Surgery
American Rhinologic Society
American College of Surgeons
American Board of Otolaryngology

Affiliations ?

Dr. Zacharek is affiliated with 5 hospitals.

Hospital Affilations

Score

Rankings

  • University of Michigan Hospitals & Health Centers
    Otolaryngology
    1500 E Medical Center Dr, Ann Arbor, MI 48109
    • Currently 4 of 4 crosses
    Top 25%
  • Henry Ford Hospital
    Otolaryngology
    2799 W Grand Blvd, Detroit, MI 48202
    • Currently 3 of 4 crosses
    Top 50%
  • Henry Ford Macomb Hospitals
    Otolaryngology
    15855 19 Mile Rd, Clinton Township, MI 48038
    • Currently 2 of 4 crosses
  • Ann Arbor Veterans Affairs Medical Center
    2215 Fuller Rd, Ann Arbor, MI 48105
  • University of Michigan Health System
  • Publications & Research

    Dr. Zacharek has contributed to 14 publications.
    Title Wound Healing in the Rabbit Paranasal Sinuses After Coblation: Evaluation for Use in Endoscopic Sinus Surgery.
    Date July 2009
    Journal American Journal of Rhinology & Allergy
    Excerpt

    Bipolar radiofrequency can be used surgically to excise and cauterize tissue simultaneously. It has potential for use in endoscopic sinus surgery (ESS). This study was performed to determine the extent and pattern of injury in the paranasal sinuses with bipolar radiofrequency and evaluate wound healing.

    Title Community-acquired Methicillin-resistant Staphylococcus Aureus: an Emerging Cause of Acute Bacterial Parotitis.
    Date March 2009
    Journal Southern Medical Journal
    Excerpt

    Staphylococcus aureus has long been recognized as a cause of acute bacterial parotitis. A case of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) parotitis is presented, highlighting the emergence of this increasingly important pathogen to cause a wide variety of infections. Also reviewed are the salient clinical and microbiologic features of this novel infection.

    Title Allergic Rhinitis and Rhinosinusitis.
    Date May 2008
    Journal Otolaryngologic Clinics of North America
    Excerpt

    A relationship between allergic rhinitis and acute and chronic rhinosinusitis has been postulated for many years. Epidemiologic evidence suggests that such a relationship is likely. In addition, evidence of a common pathophysiologic mechanism linking these diseases is compelling and continues to evolve. Although a clear and definitive causal relationship remains to be elucidated, an increasing number of studies support the plausibility of this link. The current paradigm of the "unified airway" and evidence to support this model further strengthen this link. This article reviews the literature relating allergic rhinitis and acute and chronic rhinosinusitis.

    Title Image-guided Frontal Trephination: a Minimally Invasive Approach for Hard-to-reach Frontal Sinus Disease.
    Date November 2006
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    OBJECTIVES: Peripherally located frontal sinus pathology may be unreachable with standard endoscopic techniques. Patients with superiorly or laterally based lesions often undergo osteoplastic flap with or without obliteration. Image-guided frontal trephination (IGFT) can localize pathology and provide excellent exposure. We present 13 patients in whom this technique was applied. STUDY DESIGN: Medical records of 13 patients undergoing IGFT were retrospectively reviewed. RESULTS: The patients' mean age was 49.2 years, (range 14-79); follow-up time was 29.9 months (range 12-39). Indications for IGFT were superiorly or laterally based mucoceles (3), fibrous dysplasia or osteoma (3), type 4 frontal cells (3), and frontal recess stenosis or ossification (4). In five patients, IGFT was combined with endoscopic transethmoid frontal sinusotomy; eight patients were treated through a trephination approach, and three patients underwent trephination with unilateral frontal sinus obliteration. One patient required revision; all others remain symptom free. CONCLUSIONS/SIGNIFICANCE: IGFT offers an attractive alternative to osteoplastic flap.

    Title An Approach to the Diagnosis and Management of Acute Bacterial Rhinosinusitis.
    Date March 2006
    Journal Expert Review of Anti-infective Therapy
    Excerpt

    The management of patients presenting with nasal congestion, rhinorrhea and facial pressure poses a challenge due to the nonspecific nature of these symptoms. A systematic approach to diagnosing acute bacterial rhinosinusitis is essential prior to offering therapies. This review offers an overview of current definitions, diagnostic algorithms and medical therapies available for the management of acute bacterial rhinosinusitis. Antimicrobial use for acute bacterial rhinosinusitis is substantial and carries a major impact on regional resistance patterns.

    Title Sagittal and Coronal Dimensions of the Ethmoid Roof: a Radioanatomic Study.
    Date November 2005
    Journal American Journal of Rhinology
    Excerpt

    BACKGROUND: Understanding the anatomy of the ethmoid roof is critical to safe surgical outcomes. Normative data regarding the height and slope of this region have been somewhat limited, derived primarily from cadaveric coronal computed tomography (CT) studies. With triplanar imaging programs, precise multidimensional measurements of the ethmoid roof are now possible. We present a radioanatomic study to characterize normative sagittal and coronal dimensions of the ethmoid roof. METHODS: Bilateral measurements were taken in 100 consecutive sinus CT scans using ThinClient 3D software. In the sagittal plane, the height of the ethmoid roof was measured in quadrants at five equidistant points between the frontal beak and sphenoid face, referencing the nasal floor. In the coronal plane, the ethmoid roof was measured at three points at the level of the anterior ethmoid artery and at two points at the junction of the posterior ethmoid and sphenoid sinuses. RESULTS: When examined sagittally, the right side showed significantly lower skull base heights in the anterior ethmoid compared with the left side (59.0 mm versus 59.8 mm, p = 0.017; 53.7 mm versus 54.5 mm, p = 0.0004). Coronal measurements of the anterior ethmoid roof showed similar significant differences. The anterior ethmoid roof had greater asymmetries of height compared with the posterior ethmoid roof, which was fairly constant. CONCLUSION: This study provides numerical correlates to accepted concepts regarding the shape and slope of the ethmoid roof. Differences in height of the skull base between right and left sides, especially in the anterior ethmoid sinus, may be an important surgical consideration. The posterior ethmoid roof appears to be relatively constant and should serve as a reliable surgical landmark.

    Title The Office Management of Recalcitrant Rhinosinusitis.
    Date July 2004
    Journal Otolaryngologic Clinics of North America
    Excerpt

    The patient referred to the otolaryngologist for the treatment of CRS has received many therapies for the condition. Newer therapies available focus on the anti-inflammatory therapies and local application of antimicrobial and antifungal agents to the sinus cavities. Much clinical work remains to be done to prove the efficacy of currently available treatments. The recent advances in the understanding of allergic and immune mechanisms may allow eventual intervention at the level of cytokines and other immunomodulators of inflammation. The complex cascade of interleukins and proinflammatory agents in CRS patients may some day allow "silver bullet" therapies in the properly selected patient. Until then, a systematic approach to the evaluation of these patients and management with the currently available treatment modalities may help relieve the symptoms in patients with CRS.

    Title Activity in the Dorsal Cochlear Nucleus of Hamsters Previously Tested for Tinnitus Following Intense Tone Exposure.
    Date March 2004
    Journal Neuroscience Letters
    Excerpt

    Chronic increases in spontaneous multiunit activity can be induced in the dorsal cochlear nucleus (DCN) of hamsters by intense sound exposure (Kaltenbach and McCaslin, 1996). It has been hypothesized that this hyperactivity may represent a neural code that could underlie the sound percepts of tinnitus. The goal of the present study was to determine whether hyperactivity could be demonstrated in animals that had previously been tested for tinnitus, and, if so, whether animals differing in their behavioral evidence for tinnitus also differ in their levels of spontaneous activity. The results showed not only that levels of activity in exposed animals were higher than those in control animals, but the degree to which the activity was increased was related to the strength of the behavioral evidence for tinnitus. These findings are consistent with the hypothesis that hyperactivity in the DCN may be a physiological correlate of noise-induced tinnitus.

    Title The Role of Allergy in Chronic Rhinosinusitis.
    Date December 2003
    Journal Current Opinion in Otolaryngology & Head and Neck Surgery
    Excerpt

    Issues surrounding the cause and pathogenesis of chronic rhinosinusitis (CRS) remain controversial. Various models involving physiologic factors and anatomic obstruction have been offered to explain the pathogenesis of this common disease. More recently, the role of chronic inflammatory processes has been demonstrated. These findings may modify the current paradigm of this disease and transform the diagnosis and management of patients with CRS. This review focuses on the role of allergy and inflammation in the pathogenesis of CRS.

    Title Voice and Deglutition Functions After the Supracricoid and Total Laryngectomy Procedures for Advanced Stage Laryngeal Carcinoma.
    Date November 2003
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    OBJECTIVES: This investigation compared speech and deglutition functions after alternative surgical treatments for advanced stage laryngeal carcinoma: the supracricoid laryngectomy (SCL) versus the total laryngectomy (TL).Study design and setting Cohort investigation at Wayne State University School of Medicine. METHODS: Quantitative studies of laryngeal biomechanics, acoustic and speech aerodynamic features, and deglutition skills of these individuals were coupled to listener and patient self-impressions of speech and voice characteristics for group comparative analyses. RESULTS: Results revealed that patients from each subgroup performed comparably relative to speech intelligibility and voice quality disturbances. Videostroboscopy of the neoglottal mechanisms in these two populations helped to explain these outcomes. Acoustic and speech aerodynamic testing demonstrated variably abnormal features in both surgical subgroups. Whereas the SCL patients eventually achieved full oral diets, they required many sessions of swallowing therapy to obtain this objective and eliminate tube feeding supplementation. The TL patients did not evidence protracted swallowing difficulties or the need for specific exercises in order to remove their feeding tubes postoperatively. References to organ preservation strategies in lieu of surgical management are included for completeness purposes. CONCLUSIONS: The SCL and TL surgical procedures for advanced stage laryngeal carcinoma resulted in equivalent speech and swallowing functional outcomes.

    Title Effects of Cochlear Ablation on Noise Induced Hyperactivity in the Hamster Dorsal Cochlear Nucleus: Implications for the Origin of Noise Induced Tinnitus.
    Date March 2003
    Journal Hearing Research
    Excerpt

    Chronic increases in multiunit spontaneous activity are induced in the dorsal cochlear nucleus (DCN) following exposures to intense sound. This hyperactivity has been implicated as a neurophysiological correlate of noise induced tinnitus. However, it is not known whether this hyperactivity originates centrally, or instead, reflects an increase in the level of spontaneous input from the auditory nerve. In the present study we addressed this issue by testing whether hyperactivity, induced in the DCN by previous exposure to intense sound, persists after ipsilateral cochlear input to the DCN has been removed. To induce hyperactivity, Syrian golden hamsters were exposed under anesthesia to an intense pure tone (122-127 dB SPL at 10 kHz) for 4 h. Additional hamsters, which were anesthetized for 4 h, but not tone exposed, served as controls. Electrophysiological recordings of spontaneous activity were performed on the surface of the left DCN in animals in which the ipsilateral cochlea was either intact or ablated. The degree of cochlear removal was determined by microdissection and histologic evaluation of the cochlea after completion of each recording session. Comparisons between the levels of activity recorded in animals with and without intact cochleas revealed that the induced hyperactivity in the DCN persisted after both partial and complete cochlear ablations. These results indicate that the maintenance of hyperactivity is not dependent on input from the ipsilateral cochlea, implying that hyperactivity originates centrally.

    Title Clinical Problem Solving: Radiology. Radiology Quiz Case 2: Lemierre Syndrome.
    Date June 2002
    Journal Archives of Otolaryngology--head & Neck Surgery
    Title Functional Outcomes After Supracricoid Laryngectomy.
    Date October 2001
    Journal The Laryngoscope
    Excerpt

    OBJECTIVES: Local control and 5-year survival rates are similar for patients undergoing total laryngectomy and supracricoid laryngectomy for the treatment of advanced-stage laryngeal carcinoma. However, comprehensive studies of functional outcomes after supracricoid laryngectomy are lacking. STUDY DESIGN: Cohort study. METHODS: This investigation provides objective voice laboratory data, skilled listener impressions of voice samples, swallowing evaluations, and patient self-perceptions of speech ability obtained from 10 supracricoid laryngectomees. RESULTS: Results demonstrated variable acoustic and speech aerodynamic disturbances, hoarse-breathy vocal quality, and speech dysfluency. Patients' self-perceptions of voice revealed severe dysphonia that induced certain emotional, physical, and functional setbacks. However, blinded judges rated these individuals as possessing intelligible speech and communication skills. All patients demonstrated premature spillage of the bolus and varying degrees of laryngeal penetration, aspiration, and retention during swallowing studies. However, each patient used a compensatory strategy to protect the airway. Voice and swallowing abilities appeared to depend on the mobility of the arytenoid cartilages, base of tongue action, and residual supraglottic tissue for the creation of a competent neoglottal sphincter complex that vibrated during phonation efforts and protected the airway during deglutition. CONCLUSIONS: Supracricoid laryngectomy avoids the potential complications, limitations, and emotional problems associated with a permanent tracheostoma. All patients demonstrated intelligible voice and effective swallowing function postoperatively, supporting supracricoid laryngectomy as a suitable alternative surgical approach to the total laryngectomy in select patients.

    Title Wound Healing in the Paranasal Sinuses After Coblation, Part Ii: Evaluation for Endoscopic Sinus Surgery Using a Sheep Model.
    Date
    Journal American Journal of Rhinology & Allergy
    Excerpt

    A previous study on wound healing with a rabbit model showed thermal injury to sinus mucosa with complete respiratory re-epithelialization by postoperative day (POD) 29. This study was designed to further understand the pattern of injury using the bipolar radiofrequency plasma process used by the Coblator and evaluate postprocedure healing.


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