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Meet Eric Kezirian of Keck Medicine of USC

Today we’d like to introduce you to Eric Kezirian.

Eric, let’s start with your story. We’d love to hear how you got started and how the journey has been so far.
My entire career has been dedicated to the surgical evaluation and treatment of snoring and obstructive sleep apnea, and this interest started early. When I attended medical school, the University of Pennsylvania was one of the few places in the country that included sleep medicine in the classroom curriculum, so I had an exposure that piqued my interest then. I learned how snoring is common, but many patients not only snore but also have blockage in their breathing during sleep, a condition called obstructive sleep apnea. We learned about non-surgical treatments like CPAP then. Later in medical school during my rotation in otolaryngology—head and neck surgery (aka Ear, Nose, and Throat), I had the opportunity to work with one of the faculty members who was a sleep surgeon and was drawn even more to this area. I was struck by the opportunity that a disorder like obstructive sleep apnea could affect health, quality of life of the patient—and others, because these patients generally snore loudly—and for many patients there were no good options. It was at this time that newer surgical procedures were being developed for snoring and sleep apnea, and I had the unique opportunity to train with experts during my residency at the University of Washington and then a fellowship at Stanford.

During my 9 years on the faculty at the University of California, San Francisco, while treating patients with sleep apnea and snoring I had the chance to perform research that examined how surgeons select procedures to improve outcomes while minimizing risks. This work led to recognition as a leader in sleep surgery and work with established and startup companies developing new approaches for snoring and sleep apnea. All of this continued when I moved back home to Los Angeles 4 years ago and joined Keck Medicine of USC. Here I have continued my work combining world-class patient care and cutting-edge research to deliver results for patients with obstructive sleep apnea and snoring surgery.

Great, so let’s dig a little deeper into the story – has it been an easy path overall and if not, what were the challenges you’ve had to overcome?
At the conclusion of my training 15 years ago, sleep surgery was still in relative infancy.

New procedures and technologies were being developed to move the field beyond the single procedure and one-surgery-fits-all-patients approach that was doomed to failure, but there were very few surgeons specializing in this area and only limited research to help us apply these innovative approaches in the best way. Early in my career, colleagues (both surgeons and non-surgeons) would often dismiss the idea of surgery for sleep apnea or snoring without understanding how much progress had been made beyond what they are familiar with: what was state of the art in the 1980’s and 1990’s.

It was not easy, but we had a cohesive group of sleep surgeons from around the world that came together to conduct research and enhance the education of colleagues. Even today, most residency programs in otolaryngology—head and neck surgery offer only a very limited exposure to sleep surgery, so we as practicing sleep surgeons have assumed an important role in training practicing surgeons in sleep surgery with courses and lectures at scientific conferences. We have seen major advances in how we use surgery to treat snoring and sleep apnea and the awareness among medical professionals and the public that surgery can offer real benefits.

Keck Medicine of USC – what should we know? What do you guys do best? What sets you apart from the competition?
I am one of the relatively few dedicated sleep surgeons in the world. This specialization in the surgical evaluation and treatment of obstructive sleep apnea and snoring has allowed me to develop a unique experience and expertise that I believe offers real benefits for patients. Performing a wider range of evaluations and surgical procedures than most other surgeons enables targeted, effective snoring and sleep apnea surgery.

Different people with snoring and sleep apnea have different causes of their problem. There are now many procedures available to treat different parts of the breathing passages. The challenge with sleep surgery is that you want to perform surgery on the areas that are important causes of an individual person’s snoring or sleep apnea, so you need some way to guide your choices. Drug-induced sleep endoscopy involves having patients receive sedation in the operating room so that they start snoring and having blockage of breathing like they do in their own bed at night. During the sedation, I use a telescope to look inside their throat to see what is causing the blockage in breathing.

Drug-induced sleep endoscopy is one aspect of our innovative approach to treating snoring and sleep apnea. It is just one of the ways that I treat patients in approaches that are designed just for them: what is often called personalized or precision medicine.

What moment in your career do you look back most fondly on?
Sharing the information that I am well-known in my field sounds boastful and obnoxious, but the fact is that sleep surgery can be humbling. Like any surgery, the results are not perfect. What makes me proud is to know that I am performing high-quality research and leading international studies designed to improve our results in snoring and sleep apnea surgery while at the same time being open to the excellent research being done by colleagues around the world. As a young field, we as sleep surgeons are more open to new ideas than in many fields of medicine. I recently stepped down as President of the International Surgical Sleep Society after hosting our scientific meeting in Los Angeles in May 2017. I was so proud that the leaders in our field came together for outstanding lectures but also phenomenal discussions where we felt free to share our ideas and experiences and have constructive honest discussions in the name of improving results for patients with obstructive sleep apnea and snoring.

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Image Credit:
Ricardo Carrasco III

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