Otolaryngologist, Oral & Maxillofacial Surgeon
26 years of experience
Video profile
Accepting new patients
Lakeshore Ear, Nose, Throat Center
1202 Walton Blvd
Ste 201
Rochester, MI 48307
248-652-0044
Locations and availability (3)

Education ?

Medical School Score
Wayne State University (1984)
  • Currently 1 of 4 apples
Residency
Detroit Medical Center - Wayne State University (1989) *
Otolaryngology
Fellowship
University of California Irvine Medical Center (1990) *
Plastic Surgery Within the Head and Neck
* This information was reported to Vitals by the doctor or doctor's office.

Awards & Distinctions ?

Awards  
Hour Detroit Magazine's Top Docs *
Triologic Research Training Award American Academy of Otolaryngology-Head and Neck Surgery *
Appointments
William Beaumont Hospital-troy (2003 - Present)
Chief of Otolaryngology-Head and Neck Surgery
Pprom-east Lansing, Mi (2004 - Present)
Physician Reviewer
Associations
American Board of Facial Plastic and Reconstructive Surgery
American Head and Neck Society
American Academy of Facial Plastic and Reconstructive Surgery
American Board of Otolaryngology
American Academy of Otolaryngology: Head and Neck Surgery
American College of Surgeons

Affiliations ?

Dr. Arden is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • Crittenton Hospital Medical Center *
    Otolaryngology
    1101 W University Dr, Rochester, MI 48307
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital, Grosse Pointe
    Otolaryngology
    468 Cadieux Rd, Grosse Pointe, MI 48230
    • Currently 4 of 4 crosses
    Top 25%
  • St. John Hospital & Medical Center *
    Otolaryngology
    22101 Moross Rd, Detroit, MI 48236
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital,Troy *
    Otolaryngology
    44201 Dequindre Rd, Troy, MI 48085
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital, Royal Oak
    Otolaryngology
    3601 W 13 Mile Rd, Royal Oak, MI 48073
    • Currently 3 of 4 crosses
    Top 50%
  • William Beaumont Hospital-Grosse Pte *
  • Publications & Research

    Dr. Arden has contributed to 13 publications.
    Title Transcolumellar Transcrural Approach to Transsphenoidal Hypophysectomy.
    Date November 1999
    Journal The Laryngoscope
    Title Facial Nerve Rehabilitation After Radical Parotidectomy.
    Date June 1999
    Journal The Laryngoscope
    Excerpt

    OBJECTIVE: Examine functional outcomes in patients undergoing radical parotidectomy and facial nerve grafting. Identify factors that may affect rehabilitation in these patients. STUDY DESIGN: Retrospective chart review and photographic analyses of 12 patients undergoing radical parotidectomy with interposition nerve grafts for facial nerve reconstruction. METHODS: Data obtained for each patient regarding age, sex, histology of parotid neoplasm, cable graft source, administration of postoperative radiotherapy, and treatment for eye rehabilitation. Functional outcomes were assessed with the House-Brackmann grading system at 6 months, 1 year, and 2 years after surgery. RESULTS: All nerve grafts were harvested from cervical plexus sensory nerves with microscopic epineural repair performed for all neurorrhaphies. Overall, 9 of 12 patients achieved a grade III 2 years after surgery. All patients under age 30 obtained a grade III. Of the seven patients receiving postoperative radiation, five achieved a grade III. Older patients often required surgical procedures to facilitate eye closure. CONCLUSIONS: Facial nerve rehabilitation after radical parotidectomy can be successfully achieved with cervical plexus interposition nerve grafts. Postoperative radiotherapy did not appear to affect return of function, and younger patients consistently achieved good functional outcomes after nerve grafting. Older patients frequently require surgical procedures for eye rehabilitation after radical parotidectomy.

    Title Nasal Alar Reconstruction: a Critical Analysis Using Melolabial Island and Paramedian Forehead Flaps.
    Date April 1999
    Journal The Laryngoscope
    Excerpt

    OBJECTIVES: To qualitatively and quantitatively describe aesthetic and functional outcomes following Mohs ablative surgery involving the alar subunit, using a paramedian or subcutaneous melolabial island flap. STUDY DESIGN: Retrospective review. METHODS: A single surgeon's results in 38 consecutive patients were analyzed. Objective measures (alar rim thickness, donor scar width and length), subjective assessment (seven aesthetic parameters) by three academic otolaryngologists, and patient satisfaction questionnaires were evaluated. Student t test was used to ascertain statistically significant differences between reconstructive groups. RESULTS: Questionnaire results demonstrate a significant (P = .026) difference in donor site rating favoring melolabial group responses. Objective scar measurements and subjective ratings of textural quality and alar notching also favored melolabial reconstructions. CONCLUSIONS: More favorable aesthetic and functional outcomes are seen with single subunit cutaneous alar defects reconstructed with the melolabial island flap than with deep composite or extensive unilateral nasal defects reconstructed with the paramedian forehead flap.

    Title Volume-length Impact of Lateral Jaw Resections on Complication Rates.
    Date February 1999
    Journal Archives of Otolaryngology--head & Neck Surgery
    Excerpt

    OBJECTIVE: To study the relationship between soft tissue volume loss and bone resection length following lateral segmental mandibulectomy with plate reconstruction and complication rates. DESIGN: Retrospective case review of 31 patients (1989-1996), with average follow-up of 37.2 months, who were treated by lateral composite resection for oral cavity and/or oropharyngeal malignancy with primary reconstruction by defect-bridging plates. SETTING: Academic tertiary care referral center. INTERVENTIONS: Thirty patients had stainless steel and 1 patient a vitallium reconstruction plate to restore mandibular continuity. Soft tissue defects were repaired with pectoralis myocutaneous flaps (n = 25), skin grafts (n = 4), a radial forearm free flap (n = 1), or primary closure (n = 1). All patients received preoperative (n = 6) or postoperative (n = 25) radiation therapy. MAIN OUTCOME MEASURES: Overall and hardware-related complications. RESULTS: All 31 initial soft tissue repairs were successful. Subsequent complications occurred in 14 patients (45%), which included plate exposure (29%), loosened screws requiring hardware removal (29%), fistula (14%), local wound infection (14%), osteomyelitis (7%), and plate fracture (7%). Average time to complication was 7.7 months. Complication rates were 81% for bone defects greater than 5.0 cm, and 7% for those less than 5.0 cm. Bivariate analysis indicated bone resection lengths greater than 5.0 cm to be a significant predictor of both hardware-related (P = .02) and overall complications (P = .005), whereas soft tissue volume resections greater than 240 cm3 were found only to be marginally significant (P = .04) for overall complications. CONCLUSION: Extirpative losses involving more than 5 cm of bone, or tissue volume greater than 240 cm3, are associated with unacceptably high complication rates when reconstructed with solid screw stainless steel plates and this warrants consideration of alternative techniques for long-term stability.

    Title Carotid Resection and Replacement with Autogenous Arterial Graft During Operation for Neck Malignancy.
    Date July 1998
    Journal Annals of Vascular Surgery
    Excerpt

    Carotid artery resection as part of the management of advanced head and neck cancers remains controversial. Since 1991, 30 patients have undergone resection of the carotid artery with immediate reconstruction using superficial femoral artery as replacement conduit. There was one stroke/death. Forty-three percent developed neck wound problems but no grafts failed or hemorrhaged. Mean follow-up was 20 months (3-76) and mean life expectancy was 16 months from the time of surgery. Fifty-eight percent were free of local recurrence at the time of death. There was a 35% disease-free survival rate at 2 years. These results compare favorably with alternative therapy including carotid ligation or shaving tumor from the carotid artery. Given the importance of cerebral perfusion and local tumor control we offer superficial femoral artery as a durable conduit for immediate extracranial carotid reconstruction in the often hostile environment associated with cancer resection in the neck.

    Title Mandibular Aneurysmal Bone Cyst Associated with Fibrous Dysplasia.
    Date January 1998
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Title Survival of Composite Chondrocutaneous Grafts by Vessel Implantation: a Study in the Rabbit Ear Model.
    Date January 1996
    Journal The Laryngoscope
    Excerpt

    Composite chondrocutaneous graft reconstruction or reattachment has limited applicability, is traditionally restricted to small segmental losses, and is dependent on the status of the recipient bed and graft periphery for successful revascularization. Surgical enhancement of composite graft survival was experimentally investigated in the rabbit ear model through transposition and appositional placement of an adjacent vascular pedicle. Fluorescein-derived surface-survival determinations, microangiographic vessel-counting methods, and histologic analysis were used to study the effects of vascular augmentation, pedicle design variations, and angiogenic substance in sixty 8-cm2, full-thickness auricular grafts. A statistically significant survival advantage was demonstrated for the implanted grafts, secondary to perivascular angiogenesis from the implanted pedicle.

    Title Bacteriology of Sinusitis in Human Immunodeficiency Virus-positive Patients: Implications for Management.
    Date November 1995
    Journal The Laryngoscope
    Excerpt

    The bacteriology of sinusitis in human immunodeficiency virus (HIV)-infected patients has been only sporadically reported. In this study, we report the results of cultures taken from 12 HIV patients with refractory chronic sinusitis who underwent surgery. Nine of the 12 patients had positive cultures with 16 isolates and 5 patients having multiple isolates. Five of the 12 patients grew out atypical or opportunistic infections not responsive to standard medical therapy, including 3 patients with cytomegalovirus, 1 with Aspergillus fumigatus, and 1 with Mycobacterium kansasii. These results suggest the need for aggressive medical care for HIV-infected patients with sinusitis and early intervention for tissue cultures in patients who do not respond to standard antibiotic regimens.

    Title Carotid Artery Reconstruction Using Superficial Femoral Arterial Grafts.
    Date June 1994
    Journal The Laryngoscope
    Excerpt

    The indications, consequences, and value of resection of the carotid artery as part of an extended neck dissection has been discussed for many years. Many of the earlier reports have focused on the sequelae of carotid artery ligation and tests to predict patient tolerance for the procedure. Efforts to reconstruct the carotid artery have been limited primarily to vein grafts. The authors report on 11 cases of reconstruction of the carotid artery using the patient's superficial femoral artery. The femoral artery itself is reconstructed using a Gore-Tex graft. Free autografts of the superficial femoral artery in the carotid location have been found to be an excellent size match, mechanically stronger than a vein graft, and tolerant of bacterial contamination. Arteriography in 1 case with 14 months' follow-up demonstrates long-term patency.

    Title Cartilage Grafts in Open Rhinoplasty.
    Date June 1994
    Journal Facial Plastic Surgery : Fps
    Title Flap Reconstruction Techniques in Conjunctivorhinostomy.
    Date July 1990
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    Dacryocystorhinostomy is usually the standard approach to treat epiphora caused by lower lacrimal tract obstruction. When the pathologic condition lies in the upper lacrimal passage, however, alternate bypass or reconstructive options must be considered. Conjunctivodacryocystorhinostomy, using the Jones tube, can effectively bypass the upper tract, but the technique may be complicated by granulation tissue formation, infection from unapposed mucosal flaps, and inefficient passage of tears through scar as a result of healing by secondary intention. Canaliculodacryocystorhinostomy affords the advantages of a physiologic reconstruction, but is limited by availability of sufficient canaliculus, requires a lengthy and tedious dissection, and must be performed using a microsurgical approach. We describe an alternate technique of conjunctivorhinostomy that provides total lacrimal bypass and has the advantages of bipedicled mucosal flap apposition, temporary stenting, and symptomatic improvement of epiphora. Several case examples illustrate the indications, advantages, and disadvantages of this technique.

    Title Protein Associated with the Sensory Cell Layer of the Rainbow Trout Saccular Macula.
    Date July 1989
    Journal Brain Research
    Excerpt

    A protein has been detected that is associated with the saccular hair cell layer of the rainbow trout, Salmo gairdnerii R. By one- and two-dimensional SDS polyacrylamide gel electrophoresis, the molecular weight and isoelectric point of this protein are estimated to be 13.6 and 8.8 kDa, respectively. The 13.6 kDa protein cannot be detected electrophoretically in brain, gill, liver, and fractions containing the basal lamina, non-sensory epithelium, and saccular nerve. This protein does not bind antibodies to bovine myelin basic protein, while trout myelin basic proteins in the same molecular weight range do. In addition, the protein does not bind concanavalin A or react with the periodic acid-Schiff reagent. The 13.6 kDa band represents about 1% of the total protein in saccular sensory epithelium, and may be a marker protein for the hair cell layer.

    Title Temporalis Muscle-galea Flap in Craniofacial Reconstruction.
    Date December 1987
    Journal The Laryngoscope
    Excerpt

    With the advent of increasing technological and surgical sophistication in craniofacial surgery, reconstructive efforts are challenged to provide a reliable means of compartmentalization. When dural integrity is compromised in the face of nasopharyngeal or paranasal communication, the risk of ascending infection and potential life-threatening meningitis mandate cranial and facial compartments, separated by sufficient and healthy soft tissues. This paper describes a method of providing pedicled soft tissue coverage and support for the contents of the anterior cranial fossa using a temporalis muscle-galea rotation flap. The vascularized myofascial tissues, capable of carrying skin and bone grafts, are well suited to cover and protect large areas of the skull base. Several cases are described to show the advantages and disadvantages of the technique.


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