Research Opportunities in the Department of Otolaryngology-Head and Neck Surgery

Kibwei A. McKinney, MDYu-Tung Wong, MDScott Shadfar, MD

Outline

• Funding opportunities• Subspecialty Areas• Clinical/Research Faculty– Areas of Interest

• Examples

ENT Residency Application

• Step 1 USMLE Score• Medical School GPA• Extra-curricular Activities• Research

Duration of Research

• 2 months – Projects completed during the summer in between the 1st and 2nd yr

• 1 year – Projects completed during a year off in between the 3rd and 4th years of medical school

Grants/Funding Opportunities

• 2 months – Research Training in Otolaryngology Program (8-12 weeks)– Application online at Carolina Medical Student Research

Program website: www.med.unc.edu/rschofc/omsr/cmsrp.htm

– Due Feb. 8th, 2010• 1 year - https://cgibd.med.unc.edu/omsr/oppor.php– Research Training in Otolaryngology– Doris Duke Clinical Fellowship Program– American Otologic Society Research Fellowship (T32)– Howard Hughes Medical Institute Training Fellowship– Holderness Fellowship (4 Yearly)

Otolaryngology Subspecialty Areas

• Head and Neck Surgery (Cancer Research)• Otology/Neurotology• Facial Plastic Surgery• Rhinology/Sinus Surgery• Laryngology• Anterior Skull Base Surgery• Pediatric Otolaryngology

Head and Neck Surgery• Marion Couch, MD, Ph. D.

– Cancer Cachexia• Neil Hayes, MD, MPH –

Molecular pathogenesis of head and neck Cancers

• Mark Weissler, MD – Outcomes Research in Head and Neck Cancer

• Carol Shores, MD – EBV related Head and Neck Cancer in Lilongwe, Malawi

Cancer Cachexia

• Loss of weight, muscle atrophy, catabolism associated with end-stage cancer

• Significant cause of morbidity

Cancer Cachexia

• Historically thought to be mediated by increased energy expenditure by rapidly proliferating cancer cells

• Increasing body of evidence attributing cachexia to pathophysiologic mechanisms at the cellular level

• NF-κB – ubiquitous protein complex that controls DNA replication– When constitutively active, proper regulation does not

occurcellular proliferationtumor– AlsoInflammation (possibly leading to cachexia)

Resveratrol

• Potential NF-κB Inhibitor• Natural compound found in

red wine, red grapes• Increased life span of

nematode and short-lived fish

• If good enough for the nematode, why not for us?

Putting Resveratrol to the Test

Day 0 –Tumor Inoculation

Days 1-17 Document Cachexia/Treat with Resveratrol

Sacrifice and Harvest

Outcomes

• Tumor size• Body weight• Tissue NFκB levels• Cardiac echo readings

Otology/Neurotology• Doug Fitzpatrick, Ph. D. – Preservation of

residual hearing in cochlear implantation• Paul Manis, Ph. D. – Cellular

mechanisms/neural networks of hearing• John Grose, Ph. D. – Age-Related decline

in temporal processing• Craig Buchman, MD – Auditory

Neuropathy, CI Outcomes• Oliver Adunka, MD – Electroacoustic

Stimulation (EAS); Intraoperative electrophysiology

• Joe Hall Ph. D./Emily Buss – Psychoacoustics

• Joseph Roche, MD – SNHL and synaptic plasticity in Te1

Vestibulocochlear system of the Mongolian Gerbil; animal model used in electroacoustic studies

Facial Plastic and Reconstructive Surgery

• William Shockley, MD• Interests: Microtia

repair, nasal defects and rhinoplasty, congenital anomalies

• Clinical Outcomes Research

Rhinology/Sinus Surgery

• Julia Kimbel, Ph. D. – computational fluid dynamics, particle uptake deposition

• Brent Senior, MD – MIPS Outcomes Research, Sleep Research

• Charles Ebert, MD – QOL Outcomes for sinus surgery, Allergic Fungal Rhinosinusitis

Allergic Fungal Rhinosinusitis

• Disease process characterized by fungal proliferation, inflammation and deformation of the normal bony anatomy

• Presents unilaterally in over 40% of patients

• Hypothesis: These patients represent a genetic chimera with differential expression on the contralateral sides of the nose

• Microarray analysis will be used to characterize these differences

Laryngology

• Robert Buckmire - Medical Robotic System for Laser Phonomicrosurgery– Joint venture with UNC/NC State Dept. of

Biomedical Engineering• Image Guidance in Laryngeal Surgery

Laryngeal Phonomicrosurgery

• Group of Complex surgical techniques that leverage the use of endoscopic tools

• Surgical laser (CO2) under the control of a micromanipulator

• Problem: poor ergonomics

Laryngeal Phonomicrosurgery

• Hypotheses: – Different user interfaces

may be advantageous in providing increased fine motor manipulation of the laser.

– A trained robot may make more precise, uniform cuts than those made by a human

Skull Base Surgery• Adam M. Zanation, MD

– Molecular biology of sinonasal tumors, radioanatomic analysis of the pediatric skull base, outcomes research in endoscopic skull base surgery

Mucosa

GPC

PPF

Mucosa

GPC

PPF

Pediatric Otolaryngology

• Amelia Drake, MD• Austin Rose, MD• Carlton Zdanski, MD, FACS• Rose Payapilli, MD

(resident) – clinical outcomes in patients with cochlear malformation after CI