Gregory Randolph, MD

Specialty: Otolaryngology
Telephone: 617-573-4115

About Dr. Randolph

Gregory W. Randolph MD FACS FACE is a Professor of Otolaryngology Head and Neck Surgery and the Claire and John Bertucci Endowed Chair in Thyroid Surgical Oncology at Harvard Medical School in the Department of Otolaryngology Head and Neck Surgery and Surgeon at Massachusetts Eye & Ear Infirmary. He trained at Cornell and Harvard Medical Schools. He serves as Director of the General Otolaryngology Division and founded and directs the Division of Thyroid and Parathyroid Endocrine Surgery. Dr. Randolph has a thyroid and parathyroid surgical practice focused on thyroid cancer, benign thyroid surgery and hyperparathyroidism exclusively and sees patients and operating at both Mass Eye and Ear Infirmary and Mass General Hospital. Dr. Randolph has focused the bulk of his research on recurrent laryngeal nerve anatomy, preservation and monitoring during thyroid cancer surgery with focus on importance of laryngeal exam, recognition of lymph node metastasis and revision cancer surgery. He has lead thyroid surgical missions to thyroid surgical units in St. Petersburg, Russia, Guangzhou, China, Kenya, rural India and in the Chernobyl region of the Ukraine. He founded and directs the Harvard Thyroid and Parathyroid Surgery Course for surgeons and has directed international surgical courses in Italy, Germany, Switzerland and Russia. He has received board certification from the European Union’s Board of Surgery in Neck Endocrine Surgery. He has published an endocrine surgical text: “Surgery of the Thyroid and Parathyroid Glands” published by Elsevier Saunders now in its second edition as well as a text centered on surgery of the recurrent laryngeal nerve “The Recurrent and Superior Laryngeal Nerves” published by Springer Publishers. He served as President and Director of International Affairs for the American Academy of Otolaryngology Head and Neck Surgery. He has served as Treasurer and on the executive board of the American Thyroid Association. He currently serves as chair of the Endocrine Surgery Section of the American Head and Neck Society and the Surgical Liaison for the American Association of Clinical Endocrinology.

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Credentials

Education and Training
Cornell Medical College graduated 1883
Residency in Otolaryngology Head and Neck Surgery, Harvard Medical School; 1992
Fellowship in Thyroid Surgical Oncology , MEEI-MGH ; 1993
Current Academic Appointment
Professor of Otolaryngology Head and Neck Surgery and the Claire and John Bertucci Endowed Chair in Thyroid Surgical Oncology at Harvard Medical School in the Department of Otolaryngology Head and Neck Surgery and Surgeon at Massachusetts Eye & Ear Infirmary. He trained at Cornell and Harvard Medical Schools. He serves as Director of the General Otolaryngology Division and founded and directs the Division of Thyroid and Parathyroid Endocrine Surgery.
Board Certification
Otolaryngology Head and Neck Surgery 1993

Locations

Massachusetts Eye and Ear
243 Charles Street
Boston, MA 02114
Directions

Appointments

Dr. Randolph is currently accepting new patients.

Appointment Hours:

Monday 9-5
Tuesday 9-5
Wednesday 9-5
Thursday 9-5
Friday 9-5
Saturday
Sunday

Research

Gregory W. Randolph MD FACS FACE is a Professor of Otolaryngology Head and Neck Surgery and the Claire and John Bertucci Endowed Chair in Thyroid Surgical Oncology at Harvard Medical School in the Department of Otolaryngology Head and Neck Surgery and Surgeon at Massachusetts Eye & Ear Infirmary. He trained at Cornell and Harvard Medical Schools. He serves as Director of the General Otolaryngology Division and founded and directs the Division of Thyroid and Parathyroid Endocrine Surgery. Dr. Randolph has a thyroid and parathyroid surgical practice focused on thyroid cancer, benign thyroid surgery and hyperparathyroidism exclusively and sees patients and operating at both Mass Eye and Ear Infirmary and Mass General Hospital.

Dr. Randolph has focused the bulk of his research on recurrent laryngeal nerve anatomy, preservation and monitoring during thyroid cancer surgery with focus on importance of laryngeal exam, recognition of lymph node metastasis and revision cancer surgery. He has lead thyroid surgical missions to thyroid surgical units in St. Petersburg, Russia, Guangzhou, China, Kenya, rural India and in the Chernobyl region of the Ukraine.  He founded and directs the Harvard Thyroid and Parathyroid Surgery Course for surgeons and has directed international surgical courses in Italy, Germany, Switzerland and Russia. He has received board certification from the European Union’s Board of Surgery in Neck Endocrine Surgery. He has published an endocrine surgical text:  Surgery of the Thyroid and Parathyroid Glands published by Elsevier Saunders now in its second edition as well as a text centered on surgery of the recurrent laryngeal nerve The Recurrent and Superior Laryngeal Nerves published by Springer Publishers.  He served as President and  Director of International Affairs for the American Academy of Otolaryngology Head and Neck Surgery. He has served as Treasurer and on the executive board of the American Thyroid Association. He currently serves as chair of the Endocrine Surgery Section of the American Head and Neck Society and the Surgical Liaison for the American Association of Clinical Endocrinology.

Selected Publications

Annotated Bibliography                                                                Gregory W. Randolph MD 9-11-15

Recurrent laryngeal nerve monitoring and management during thyroid surgery

  1. Puram S, Chow H, Wu CW, Heaton J, Phelan E, Gouti K, Chiang FY, Dionigi G, Barczynski M, Dralle H, Schneider R, Lorenz K, Randolph GW Neural monitoring  RLN Electrophysiologic EMG changes reliably predict Vocal Cord Paralysis  with RLN Compressive Injury in a Canine  Model accepted Head and Neck

This investigation in the canine helped to define the acute intraoperative electrophysiologic correlates of compressive nerve injury. We defined critical amplitude and latency changes of acute compressive injury that correlate with postoperative vocal cord paralysis.

  1. Caragacianu D, Kamani  D, Randolph GW Intraoperative Recurrent Laryngeal Nerve Monitoring during Thyroid Surgery:  The Electrophysiologic Normative Reference Range Associated with Normal Postoperative Vocal Cord Function Laryngoscope. Laryngoscope. 2013 Dec;123(12):3026-31. doi: 10.1002/lary.24195. Epub 2013 Aug 5.

The study introduces normative electrophysiologic criteria that allows surgeons to predict normal vocal cord function post thyroid surgery. These criteria have been incorporated in the International Neural Monitoring Study Groups standards guidelines statement (below).

  1. Randolph GW, Dralle H and the International Neural Monitoring Study Group.  Electrophysiologic Recurrent Laryngeal Nerve Monitoring During Thyroid and Parathyroid Surgery:  International Standards Guidelines Statement:  Laryngoscope 2011; 121:S1-S16.

This work was the product of a large multidisciplinary international group and represents the first and only existing guidelines available for intraoperative neural monitoring during thyroid surgery and was the most frequently cited paper for Laryngoscope for the year.

  1. Phelan E, Dralle H, Lorenz K, ,Schneider R, Potenza A, Kamani D, Sritharan N, Shin J, Randolph GW Continuous Vagal Intraoperative Monitoring prevents Recurrent Laryngeal Nerve paralysis in patients by revealing initial EMG Changes of Impending Neuropraxic Injury: A Prospective, Multicenter Study Laryngoscope. 2014 Jun;124(6):1498-505. doi: 10.1002/lary.24550. Epub 2014 Feb 6.

This work represents one of the first publications investigating intraoperative diagnosis of neuropraxic states which may be helpful in the prevention of neural injury during surgery through novel continuous intraoperative vagal monitoring.

  1. Randolph GW (ed).  Surgery of the Thyroid and Parathyroid Glands.  2nd edition Philadelphia, PA:  Elsevier Saunders, 2013.

This text has been widely acknowledged as the definitive modern thyroid and parathyroid surgical text with a widely referenced chapter on recurrent laryngeal anatomy and monitoring. It has been well accepted in both otolaryngology and general surgical communities and was the publisher’s bestselling text at the American College of Surgeons in its first year of its publication. It has been widely referenced especially as it relates to neural monitoring and neural anatomy. The text has been placed on the required reading list for endocrine surgical fellows of the American Association of Endocrine Surgeons, the premier general surgical organization in the US. Leslie DeGroot a well-known endocrinologist wrote in Trends in Endocrinology and Metabolism 2004 wrote, “A nice feature is the careful well-balanced attention given to competing approaches to therapy. For example in the discussion of nontoxic goiters there are presentations about suppressive therapy using thyroxine, the use of radioactive iodine to treat large multinodular goiters, and the rationale for surgical resection … The sections on thyroid carcinoma are especially strong … surgical technique and problems related recurrent nerve are more thoroughly examined than in any analysis with which I am familiar … The book is for people with a specific interest in thyroid and parathyroid disease. However the book could also be basic reading for every endocrine fellow who if they truly master its content could manage their patients with knowledge that they would usually gain only by years of practice.” The publisher requestedthis second edition which is expanded from 46 chapters to 70 chapters with well over 150 contributors, 17 online full-length videos of surgical procedures.

Thyroid cancer nodal imaging detection and treatment

  1. Lesnik D, Cunnane MB , Zurakowski D, Acar GO, Ecevit C,  Mace A, Kamani D, Randolph GW Papillary Thyroid Carcinoma Nodal Surgery Directed by a Preoperative Radiographic  Map Utilizing CT Scan and Ultrasound in all Primary and Reoperative Patients Head Neck. 2014 Feb;36(2):191-202. doi: 10.1002/hed.23277. Epub 2013 Apr 2.

This paper puts forward a novel CT scan and ultrasound MEEI preoperative radiographic map for papillary carcinoma lymph nodes. Using this map we found surgical nodal disease in an additional 25% of papillary cancer patients beyond what current clinical preoperative analysis allows. This work and my lectures on this topic have influenced the surgical field of thyroid cancer surgery towards obtaining axial CT scan information on thyroid cancer patients and is reflected in the new 2015 ATA thyroid cancer guidelines (below).

  1. Randolph GW, Duh QY, Heller KS, Livolsi VA, Mandel SJ, Steward DL, Tufano RP, Tuttle RM.The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension (For The American Thyroid Association Surgical Affairs Committee’s Taskforce On Thyroid Cancer Nodal Surgery) Thyroid. 2012 Nov;22(11):1144-52.

This consensus statement from the ATA helps to introduce the concept of thyroid cancer nodal stratification based on microscopic versus macroscopic nodal disease. This stratification is associated with the introduction of our preoperative radiographic nodal mapping algorithm as defined by our CT and ultrasound nodal mapping manuscript above and is also incorporated in the new 2015 ATA thyroid cancer guidelines (below).

Laryngeal exam prior to thyroid surgery

  1. Randolph GW, Kamani D. The importance of laryngoscopy in all patients undergoing thyroidectomy: Voice, vocal cord function, and the detection of invasive disease.  Surgery 2006; 139:357-62.

This paper focuses on the importance of laryngeal exam prior to thyroid surgery. It emphasizes that the finding of preoperative vocal cord paralysis is highly correlated with invasive thyroid cancer. This paper has been referenced in the general surgical literature and in the AAO and ATA guidelines (below) in discussions on the rationale for preoperative glottic exam prior to thyroid cancer surgery.

  1. Chandrasekhar S, Randolph GW,  Seidman MS, Rosenfeld R,  Angelos P, Barkmeier-Kraemer J, S. Benninger M,  Blumin J, Dennis G, Hanks J, Haymart M, Kloos RT , Seals B, Schreibstein J M , Thomas T M , Waddington C, Warren B, Robertson PJ American Academy of Otolaryngology Head and Neck Surgery Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery. Otolaryngol Head Neck Surg. 2013 Jun;148(6 Suppl):S1-37.

I initiated this project through the AAO HNS guidelines task force. It is the first and only otolaryngology guidelines relating to thyroid surgery in the history of the AAO HNS. It describes the indications for laryngeal exam before and after thyroid surgery and references my work from 2006 onward.

  1. Haugen B, Alexander E, Bible K, Doherty G, Mandel S, Nikiforov Y, Pacini F, Randolph G, Sawka A, Schlumberger M, Schuff  K, Sherman S, Sosa J, Steward D, Tuttle M, Wartofsky L  2015 American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer The American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer accepted  Thyroid

This paper represents the main guidelines management document for medical endocrinology and surgery for thyroid nodules and thyroid cancer in the US and around the world.I was the lead writer for seven new surgical recommendations, in part resulting from my work, relating to preoperative assessment of voice, perioperative laryngeal exam, recurrent laryngealnerve management as well as preoperative nodal detection.