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Zeitels Laryngeal Surgery Group

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Overview

The Zeitels research team in the Laryngeal Surgery and Voice Center at Mass General has interdisciplinary clinical collaborations with Thoracic, Endocrine, and Cardiovascular Surgery, treating disorders of the vocal cords that lead to voice, airway, and swallowing dysfunction. They have long-term research collaboration in biomaterials with the Langer Labs at MIT and with Rox Anderson’s Labs in the MGH Wellman Center for Photomedicine. The team’s research interests are focused on the design of new endoscopic and open surgical procedures to treat early and advanced laryngeal cancer, precancerous dysplasia, intubation-related laryngeal airway injuries, HPV respiratory papillomatosis, nerve disorders of the vocal cords, and singers’ injuries. Zeitels’ surgical engineering lab has a long history of instrument design, development of new laser technology, implantable biomaterials, implantable neuromuscular stimulating devices, and the use of antiangiogenesis agents to treat mucosal disease of the larynx. The team has been supported for over two decades by the Voice Health Institute (VHI), a 501(c)(3) nonprofit founded by Zeitels’ cancer patients in 2003. The overview above has been comprehensively chronicled in a book (Voice Journeys) that will be released in the fall of 2026 in collaboration with the VHI. This book is designed to educate the general public, voice professionals, physicians, and singers. It includes many unique patient stories from well-known individuals who gave permission to chronicle their laryngeal stories to help others.

Research Projects

PLATFORMS
  1. Comprehensive treatment of intubation-related injuries and laryngeal nerve function loss. The team has created and developed state-of-the-art procedures to treat most forms of impaired vocal cord mobility, whether resulting from a laryngeal nerve impairment or from mechanical injury to the cricoarytenoid joint, leading to stenosis or diastasis. These treatments include new minimally invasive endoscopic techniques and open transcervical procedures. The team created and developed the first treatment approach for laryngeal diastasis in teenagers and young adults whose laryngeal injury resulted from prolonged intubation in premature infancy.
  2. The use of antiangiogenesis agents combined with angiolytic lasers for the treatment of proliferative HPV recurrent respiratory papillomatosis (RRP). The team created and developed this novel approach. They integrated this unique chemical platform technology with 585 nm, 532 nm, and 455 nm lasers to deliver optimal outcomes for patients with airway and voice problems resulting from RRP. This approach evolved through mentorship from Judah Folkman, who shared his experience with bevacizumab (Avastin), and from Rox Anderson, who shared his theories of selective photothermolysis for treating dermatologic vascular malformations.
  3. Treatment of rare cartilage tumors (Sarcomas) of the Larynx. The team has the most comprehensive experience and the largest cohort of laryngeal sarcomas over the past 50 years. This includes chondrosarcomas, myosarcomas, rhabdomyosarcomas, and synovial cell sarcomas. This expertise in treating these neoplasms optimizes airway, voice, and swallowing function.
  4. Use of cryopreserved aorta homografts for reconstructing large cartilage framework deficits resulting from cancer treatment. This treatment was designed in collaboration with John Wain in Thoracic Surgery and introduced a reliable surgical method to decannulate individuals with diminished laryngeal airway caliber resulting from cancer treatment or stenosis.
  5. Neuromuscular stimulation of laryngeal and pharyngeal muscles to enhance voice and swallowing dysfunction. Under the leadership of James Heaton in our Laryngeal Surgical Engineering Lab, the team has conducted extensive investigations into reanimating paralyzed or paretic laryngeal or pharyngeal muscles using implantable neurostimulation devices and electrodes.
  6. Assessment and redefining the conventional understanding of progressive voice loss in aging populations in Western societies. It has become clear to the team that, due to the dramatic successes in medicine, surgery, anesthesia, imaging, molecular biology, and preventive health care, older patients', quality of life and contributions to society require an optimal voice for personal and professional communication. The importance of this issue is growing rapidly due to society’s dependence on vocal communication to express what is in people's minds and the interdependence with voice-generated technology and artificial intelligence. The team has redefined the understanding of the etiology of an “aging voice” and, consequently, the surgical procedures to treat it.
INVESTIGATION OF CANCER
  1. Investigation and design of optimal strategies for preserving and/or restoring voice, airway, and swallowing function in patients suffering from early, mid-size, and advanced laryngeal cancer. The team has redefined optimal functional outcome in the treatment of laryngeal cancer through novel endoscopic and open-neck treatment. This function-preserving approach is performed as a single-modality treatment, or it can be combined with radiotherapy and medical treatment based on the size and location of the primary cancer and the presence of neck metastasis.
  2. Investigation of novel new surgical procedures to treat laryngeal cancer patients who have had successful organ-preservation treatment from radiotherapy and adjuvant chemotherapy but have sustained substantial loss of voice, airway, or swallowing function. The team has redefined laryngeal function restoration in this population through novel, minimally invasive surgical procedures, given the complexity, risks, and complications associated with open-neck surgery in these patients. This is one of the most active areas of investigation of the team since there is a very large cohort of underserved patients who are cancer-free, and frequently, there are not highly effective restorative treatment options available for them.
  3. Investigation of the evolving demographic transformation of glottic cancer in older smoking patients to nonsmoking patients and in younger individuals during the past 25 years. This project has been examining the distinct demographic transformation of glottic cancer from a near-exclusive tobacco-related disease in the 20th century resulting from mass-produced cigarettes, to a mixed cohort highlighting the impact of HPV-induced glottic malignancies in the 21st century that is younger. The team was the first to report this evolving transformation.
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Research Team
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Visit Dr. Zeitels profile
https://connects.catalyst.harvard.edu/Profiles/display/Person/70217

Publications

View all Dr. Zeitels’ publications

Key Selected Publications

Textbook: Zeitels, S.M. Atlas of Phonomicrosurgery and Other Endolaryngeal Procedures for Benign and Malignant Disease. Singular, San Diego. 2001 [single author]

Review: Zeitels, S.M., Healy, G.B. Laryngology and Phonosurgery: Past Present and Future. New England Journal of Medicine 2003; 349:882-892

Voice Journeys: a hybrid surgical memoir (scheduled publication - Fall 2026)

Original Reports

  1. Zeitels, S.M. [Dissertation or Thesis] Premalignant Epithelium and Microinvasive Cancer of the Vocal Fold: The Evolution of Phonomicrosurgical Management. Laryngoscope. 1995, 105: Part 2:1-51. Supplement 67
  2. Zeitels, S.M. Phonomicrosurgical Treatment of Early Glottic Cancer and Carcinoma in Situ. American Journal of Surgery. 1996; 172:704-709
  3. Zeitels, S.M. Universal Modular Glottiscope System: The Evolution of a Century of Design & Technique for Direct Laryngoscopy. Annals of Otology, Rhinology, and Laryngology. 1999; 108: Part 2:1-24. Supplement 179
  4. Zeitels, S.M., Hillman, R.E., et al. Voice & Treatment Outcome from Phonosurgical Management of Early Glottic Cancer. Annals of Otology, Rhinology and Laryngology. 2002; 111: Part 2:3-20. Supplement 190
  5. Zeitels, S.M., Dailey, S.H., Burns, J., Hillman, R.E., Anderson, R.R. Office-based Treatment of Glottal Dysplasia and Papilloma with the 585nm Pulsed Dye Laser & Local Anesthesia. Annals of Otology, Rhinology and Laryngology. 2004; 113:265-276
  6. Zeitels, S.M., Blitzer, A., Hillman, R.E., Anderson, R.R. Foresight in Laryngology and Laryngeal Surgery: A 2020 Vision. Annals of Otology, Rhinology and Laryngology. 2007; Supplement 198 Sept p.1-16
  7. Zeitels, S.M., Hochman, I.L., Hillman, R.E. Adduction Arytenopexy: A New Procedure for Paralytic Dysphonia & its Implications for Medialization Laryngoplasty. Annals of Otology, Rhinology and Laryngology. 1998, 107: Part 2:1-24. Supplement 173
  8. Zeitels, S.M., Anderson, R.R., et al 585nm Pulsed-Dye Laser Treatment of Glottal Papillomatosis. Annals of Otology, Rhinology and Laryngology. 2002; 111:486-492
  9. Zeitels, S.M., Hillman, R.E., et al. Voice & Treatment Outcome from Phonosurgical Management of Early Glottic Cancer. Annals of Otology, Rhinology and Laryngology. 2002; 111: Part 2:3-20. Supplement 190
  10. Zeitels, S.M., Hillman, R.E., Desloge, R., Mauri, M., Doyle, P.A. Phonomicrosurgery in Singers and Performing Artists: Treatment Outcomes, Management Theories, and Future Directions. Annals of Otology, Rhinology and Laryngology. 2002, 111: Part 2:21-40. Supplement 190
  11. Zeitels, S.M, Mauri, M., Dailey, S.H. Medialization Laryngoplasty With Gore-Tex For Voice Restoration Secondary to Glottal Incompetence. Annals of Otology, Rhinology and Laryngology. 2003; 112:180-184
  12. Zeitels, S.M., Akst, L.A., Burns, J.A., Hillman, R.E., Broadhurst, M.S., Anderson, R.R. Pulsed Angiolytic Laser Treatment of Ectasias and Varices in Singers. Annals of Otology, Rhinology and Laryngology. 2006; 115: 571-580
  13. Zeitels, S.M., Blitzer, A., Hillman, R.E., Anderson, R.R. Foresight in Laryngology and Laryngeal Surgery: A 2020 Vision. Annals of Otology, Rhinology and Laryngology. 2007; Supplement 198 Sept p.1-16
  14. Zeitels, S.M. Concepts and Culture of Surgical Innovation: 2006 Chevalier Jackson Lecture of the American Broncho-Esophagological Association. Annals of Otology, Rhinology and Laryngology. 2007; 116: 479-482
  15. Zeitels, S.M., Burns, J.A., Lopez-Guerra G, Anderson, R.R , Hillman, R.E., Photoangiolytic Laser Treatment of Early Glottal Cancer: A New Management Strategy. Annals of Otology, Rhinology and Laryngology. 2008; 117: Supplement 199 July, 1-24
  16. Zeitels, S.M., Lopez-Guerra G, Burns, Lutch, M., Friedman, A.M. Hillman, R.E., Microlaryngoscopic and Office-Based Injection of Bevacizumab (Avastin) to Enhance 532-nm Pulsed KTP Laser Treatment of Glottal Papillomatosis: Annals of Otology, Rhinology and Laryngology. 2009; 118: Supplement 201 September, 1-24
  17. Zeitels, S.M., de Alarcon, A., Burns, J.A., Lopez-Guerra, G., Hillman, R.E., Posterior glottic diastasis: mechanically deceptive and often overlooked. Annals of Otology, Rhinology and Laryngology 2011 Feb 120:71-80
  18. Zeitels, S.M., Burns, J.A., Wain, J.C., Wright, C.D., Rosenberg, A.E., Function Preservation Surgery in Patients with Chondrosarcoma Of The Cricoid Cartilage. Annals Of Otology, Rhinology and Laryngology 2011 120: 603-607
  19. Zeitels, SM, Barbu AM, Landau-Zemer T, Lopez-Guerra G, Burns JA, Friedman AD, Freeman MW, Halvorsen YD, Hillman RE. Local Injection Of Bevacizumab (Avastin) And Angiolytic KTP Laser Treatment Of Recurrent Respiratory Papillomatosis Of The Vocal Folds: A Prospective Study. Annals Of Otology, Rhinology And Laryngology 2011 120:627-634
  20. Zeitels, S.M., Wain, J.C., Barbu, A.M., Bryson, P.C., Burns J.A. Aortic Homograft Reconstruction of Partial Laryngectomy Defects: A New Technique. Annals Of Otology, Rhinology And Laryngology. Annals of Otology, Rhinology, and Laryngology 2012; 121(5): 301-306.
  21. Zeitels, SM, Burns, JA. Oncologic Efficacy of Angiolytic KTP Laser Treatment of Early Glottic Cancer. Ann Otol Rhinol Laryngol. 2014 123(12):840-6
  22. Zeitels, SM. Glottic Cancer: A Metamorphosing Disease. Annals of Otology, Rhinology & Laryngology. 2016; 125(6):452
  23. Zeitels SM, Lombardo PJ, Chaves JL, Faquin WC, Hillman RE, Heaton JT, Kobler JB. Vocal Fold Injection of Absorbable Materials: A Histologic Analysis With Clinical Ramifications.. Ann Otol Rhinol Laryngol. 2019 Mar;128(3_suppl):71S-81S.
  24. Zeitels SM. The Art and Craft of Phonomicrosurgery in Grammy Award-Winning Elite Performers. Ann Otol Rhinol Laryngol. 2019 Mar;128(3_suppl):7S-24S.
  25. Zeitels, SM, Baird, BJ. Surgical Treatment Strategies for Laryngeal Chondrosarcomas: A Single Institution Investigation Laryngoscope. 2022 Jan;132(1):169-176
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