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Focus on M. Allison Ogden

M.Allison Ogden, MD is an assistant professor of otolaryngology (commonly referred to as ear, nose and throat) and the medical director at the ENT Center at West County. Her areas of specialty include sialendoscopy, salivary gland disease,allergies, sinus disease, and head and neck surgery in adults and children.

Dr Ogden sees patients at
  • Ear, Nose and Throat Center at the Center for Advanced Medicine, 4921 Parkview Place, 11th floor, Suite A.
  • St. Louis Children’s Hospital, One Children’s Hospital, 3rd floor.
  • West County office, 605 Old Ballas Road, Suite 124.
FOR AN APPOINTMENT, PLEASE CALL:
314-362-7509: Center for Advanced Medicine
314-454-6162: St. Louis Children’s Hospital
314-432-4110: West County

What happened in the course of schooling to influence you to choose otolaryngology (ear, nose and throat) as your specialty?

Otolaryngology is a field not many people know about until they need an otolaryngologist or have a friend or family member who needs care from one.

I’ve always been interested in a surgical specialty and the breadth of otolaryngology is what drew me to the field itself. We treat ear and sinus disease, voice disorders, neck masses, cancers, benign conditions -- the whole gamut in children and adults.

What brought you to Washington University?

The more accurate question is probably, “why did I never leave?” I worked in labs at Washington University shortly before I started medical school here in 1998. My residency was here and I stayed on as faculty. During transitions in my training when I looked at other places locations and options -- it was a reawakening of what a fantastic medical center and great institution this place is.

Drs Allison Ogden and Terry Myckatyn after completing Vancouver Half Marathon
Your undergraduate major was in religion. How did you make the jump to medicine?

I went to Amherst College, which is a small liberal arts college in Massachusetts. It was always my intention to go to medical school, so I majored in religion as an undergrad because it was an opportunity to study something I find interesting that is completely different than biology and chemistry. I still find the topic of religion very fascinating.

Which aspect of your practice is most interesting?

My practice as a general otolaryngologist covers a broad spectrum of the field as opposed to being very specialized. I see some patients regularly and get to know them very well over the years. There is a variety in terms of the diseases and people we see – I find that very attractive.

It would be hard to know what I like the best -- that may be how I ended up as a general otolaryngologist. There was no one particular part of the field I wanted to give up.

What are some new developments in your field you are excited about?

I have focused in salivary gland disease and salivary gland problems over the last several years.We can now treat salivary stones and obstruction within the salivary gland. Sialendoscopy is a relatively new procedure -- it allows us to fix the problem by removing stones when they are small, potentially before it turns into a chronic condition.

Other patients without stones, but with chronic salivary gland disease can also be benefited by sialendoscopy when they do not have many other good treatment options. As a physician, it’s very exciting to be able to make a big change like that.

What causes salivary stones?

Salivary stones exist in the major salivary glands – the parotid (in front of the ear) and the submandibular glands (underneath the jaw). We don’t really know why they form.

We see stones more often in patients who don’t have good saliva flow or may have chronic disease in general. The stones can be seen more frequently in smokers.

The stones can be just a minor nuisance, or they may cause blockage of saliva and difficulties that lead towards chronic problems with the gland itself.

What kinds of problems do salivary stones cause?

The problems include chronic pain, swelling, infection within the glands. If there is chronic blockage, it’s like a beaver dam effect within the duct system.

The channel where the saliva is supposed to flow out gets plugged by the stone and there is a back flow of saliva filling that gland. Some people get swelling and pain every time they eat because they are trying to produce saliva to help with the food.

The severity of the problem depends on the size of the stone, where it is, and how long it’s been there. The stones are certainly seen more in adults than children, but they are still not common by any stretch of the imagination.

We also treat patients with chronic salivary problems that have nothing to do with stones, such as those who have problems from radioactive iodine injury (treatment for certain thyroid cancers) to the glands. We can see it as part of certain rheumatologic disorders as well. There are other instances where we don’t know why the glands are chronically affected.

There’s a whole category of chronic salivary gland problems that never really had a good interventional treatment option – there are some medications that could be used, but aren’t necessarily effective or tolerated in every patient. Sialendoscopy is really expanding the options of what can be done, and it’s very exciting.

How do you remove these stones?

During the minimally invasive, outpatient procedure (sialendoscopy), an endoscope is inserted into ducts that travel from the mouth into the salivary gland itself. If there is a stone, we try to lasso and remove it through the duct system or with some minor open approach.

We can also dilate strictures or narrowings within the gland to flush out the stone or relieve blockage. If necessary, a steroid is applied directly to the gland itself.

When was sialendoscopy developed?

This technique was developed in Geneva, Switzerland over 10 years ago by Francis Marchal, MD, PhD and also by several otolaryngologists in Erlangen, Germany. It is becoming more common in the United States over the last three to five years.

Previously there was no other alternative -- people either had to live with the problem or have the salivary gland removed – which has risks. Now we have more options in terms of preserving the glands and restoring normal salivary flow and function.

Brian Nussenbaum, MD, one of the other otolaryngologists here and I started performing this procedure in 2009, after training with Dr. Marchal in Geneva. Since then, we’ve done over 100 cases.

I’m fortunate to have had the opportunity to become involved in this technique relatively early in my career.

Switching the topic to snoring in children, how does a parent know when to take the child to the doctor?

Pediatric obstructive sleep apnea is relatively different than adult obstructive sleep apnea. A lot of children snore, but it becomes a concern when that snoring is actually blocking or obstructing the airway and breathing.

The first step for parents who are concerned about a child’s snoring is to watch him or her sleep. If there are pauses or gasps in the breathing, then further discussion with the pediatrician or an otolaryngologist would be the way to go.

A sleep study, or polysomnogram, can give further information about whether sleep apnea exists. It’s not for everyone, however, in circumstances where we are concerned that the child may have very severe sleep apnea, or if there other medical conditions, it may be necessary.

Sleep apnea in children is often something we treat with tonsillectomy and adenoidectomy – often with very good surgical results.

Where are you from?

I grew up in Rochester, New York, and moved to St. Louis after attending college in Massachusetts. I guess after 15 years here, basically all of my adult life, I need to get used to saying I’m from St. Louis.

Rochester is very pretty, and I like to visit my parents there – in the summer.

Is there a particular award or achievement that is most gratifying?

The achievement that is most gratifying is being able to enjoy my children, my practice, and my contribution to medical care. Certainly, there are times when it is very challenging, but for those few moments when I can sit down and reflect on what I’m able to accomplish in a given week, personally and professionally, it’s very satisfying.

What is the best advice you’ve received?

Some of the best advice I had during residency, in terms of being a physician, was to always be honest, wash your hands in front of your patients, and keep up with charting and dictations.

In terms of life in general, it was to not take yourself too seriously, take a deep breath, move forward and realize the next day will happen. This is what I try to remember when I’m feeling overwhelmed and stressed. It will all be fine and it will all work out.

Are you involved in any professional organizations?

For the past few years Ida Fox, MD, and I have been involved with coordinating the Forum for Women Surgeons. Initially under the direction of Susan McKinnon, MD, this is a group of Washington University women surgeons from the department of surgery, otolaryngology, orthopedics and neurosurgery. We have speakers and informal gatherings where we discuss issues and concerns, how to balance personal and professional life, or ideas for improvements within the university.

We also bring medical students together with the residents, faculty and fellows to talk about what it’s like to be a woman surgeon.

Coordinating the events takes effort, but it’s fun and we typically get good support from the surgical departments.

If you weren’t a doctor, what do you think you’d be doing?

Lately, my fantasy dreams are to be a beekeeper or an organic sustainable farmer. My children would have a lot of fun with farming as long as we could have animals and chickens. However, I don’t know if being a beekeeper with small children running around would be a good idea -- I should probably stick with being a doctor for right now.
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Copyright 2013 Washington University School of Medicine