The Department of Otolaryngology - Head and Neck Surgery offers research opportunities for medical students and residents throughout the year. For more information regarding any of the current open projects listed below, email an inquiry to ENT-Research@umc.edu.
Jeff Carron, MD
Ankyloglossia SurveySurvey of ASPO members about views on ankyloglossia and frenulectomy, emphasizing new literature on posterior tongue tie.
Association of enlarged vestibular aqueduct with headaches/migrainesProject will compare patients with EVA and cochlear implants to patients with normal inner ear anatomy and implants and ask, via interview or questionnaire, about frequency/symptoms of headaches as well as balance disorder. Where possible, vestibular testing will be included.
Cartilage Button Graft Size and Air-bone GapAssess the relations between button graft size and air-bone gap closure.
Effect of Frenulectomy on AspirationThe objective would be to see if frenulectomy alone can improve aspiration. Evaluation of pre- and post-procedure modified barium swallow will put results in 3 categories: resolved, improved, or unchanged.
Outcomes of Early Cochlear ImplantationThe project will compare children implanted before first birthday with a control group implanted after 12 months, looking at education setting, what age child was mainstreamed, and language outcomes. Collaboration with audiologist required.
Oxymetazoline versus ciprofloxacin/dexamethasone or ofloxacin for prevention of post-tympanostomy tube otorrheaThis would be a retrospective study of ear tube patients looking at the efficacy of 3 different drops for preventing tube otorrhea in children with clear middle ears at tube insertion. A secondary arm could look at ciprofloxaxin/dexamethasone versus ofloxacin when used in the presence of middle ear effusions.
Bluetooth Technology as a Factor in Hearing Aid Use Compliance in Adolescents and AdultsStudy will examine if advanced technologies related to Bluetooth increase compliance and use of hearing aids.
Pain Management in the Cancer PatientLooking at both acute pain management algorithms and chronic pain management algorithms. Develop new pain management protocols and compare those to what we do now. This project may involve working with Anesthesia and Tongue Strength.
Frailty in Head and Neck Cancer PatientsEstablish tongue strength as a reliable measure of frailty in head and neck cancer patients.
Application of the validated Swallowing Outcomes After Laryngectomy scoring system for the detection of esophageal stenosis The primary aim of this study is to apply the validated SOAL questionnaire in a clinical fashion to determine if it has the unique ability to identify patients at risk for esophageal stenosis.
Does depth of invasion of oral cavity cancer seen on computed tomography correlate with pathologic depth of invasion?One of the changes seen with the release of the AJCC 8th edition was the inclusion of depth of invasion (DOI) in the T staging with respect to oral cavity tumors. There is little to no evidence in the literature describing the correlation or relationship between pathologic DOI and DOI measured on computed tomography (CT). We plan to prospectively measure DOI on CT and compare this to pathologic DOI in patients with oral cavity SCCa. Because there are issues with dental artifact on CT with respect to assessing oral primary tumors, we will also assess the feasibility of measuring DOI on CT as a secondary outcome (as some patients may benefit from an MRI).
ERAS Protocol for Head and Neck Cancer PatientsExamining aspects of patient care to include in an ERAS (enhanced recovery after surgery) protocol for head and neck cancer patients.
Incidence of HPV-positive oropharyngeal squamous cell carcinoma rates at a tertiary care center, a 10-year reviewTo review the incidence of HPV-related oropharyngeal carcinoma in Mississippi and compare it to the national incidence.
Closed Reduction of Nasal Fractures with Internal StentReview of case series with respect to outcomes, need for re-operation and description of a technique.
Intra-operative CT and Zygomatic arch fracturesTo report the utility of the use of intra-operative CT scanning for verification of closed reduction of zygomatic arch fractures. Chart review examining outcomes, operative time, etc. Would compare cases done before intra-operative CT was available at UMMC with those after it became available.
Orbital Floor Fractures and the Oculocardiac Reflex: Experience from a Level I Trauma CenterThe oculocardiac reflex (OCR) is a well described phenomenon that occurs when traction is placed on the extraocular eye muscles, resulting in bradycardia. This most commonly occurs in strabismus surgery, but can also occur with entrapment of the inferior rectus muscle as a result of an orbital floor fracture. There are several case reports documenting the OCR with regards to facial trauma; however, there are no large-scale reviews documenting the incidence and what it means for the morbidity of the patient. We plan to perform a retrospective chart review analyzing our experience with orbital floor fractures, particularly identifying our incidence of OCR and preoperative morbidity (need for atropine, etc).
PRP and IntegraTM for Single Stage Repair of Full Thickness Scalp DefectsThe use of IntegraTM and split thickness skin grafting for the treatment of full thickness scalp defects is well established, but current technique requires a return to the operating room at 2-3 weeks for placement of the STSG. This project would seek to determine the feasibility of single stage repair using platelet rich plasma in combination with IntegraTM. The project would require the acquisition of a centrifuge to prepare the PRP, and might be best designed as an animal model before proceeding to use in patients.
Sialendoscopy OutcomesReview of our series of sialendoscopy cases over a 10-year period with attention to outcomes of resolution of symptoms, gland preservation, combined approaches and re-operations.
Trans-oral removal of large submandibular sialolithsRetrospective review of outcomes for the trans-oral removal of large submandibular sialoliths; technique video.
Variations in hyaluronidase concentrations required for degradation of newer cross-linked hyaluronic acide fillersThe objective of this study is to establish standard amounts of hylauronidase that are required to completely degrade an equal volume of each hyaluronic acid (HA) filler.
Skin Cancer Repair Expenses and Expenditures. Study will examine trends in Medicare payments across type of procedures.
Cost Analysis between Tympanostomy Tube Placement and Eustachian Tube Balloon Procedure for Managing Eustachian Tube DysfunctionDetermine the difference in the cost of a tympanostomy tube placement vs. an eustachian tube balloon Procedure for managing eustachian tube dysfunction.
Outcomes of INSPIRE Implantation using the ADHERE databaseRetrospective Chart Review
Fluid Management in the Newborn LarynxThis is a complex histologic analysis of the management of fluid, water, and inflammation by the vocal folds in newborns through the first year of life. This will be broken down into multiple ongoing portions.
Hearing Health and Cardiometabolic DiseaseThis project is to generate hypotheses and analyze data prospectively collected by the faculty sponsor from the Jackson Heart Study. Currently, the results of a comprehensive audiometric examination and hearing health survey in 1,600 African-Americans can be correlated to 206 data points in 18 categories of cardiometabolic health.
Synaptopathy, Noise, and PerceptionIt has been shown that rodents experiencing a large robust Temporary Threshold Shift (TTS) from noise exposure can experience primary damage to the synapse of afferent neural fibers without overt damage to cochlear hair cells. Here we will examine smaller repeated TTS more consistent with human changes and effect on cochlear and synapse function and anatomy.
Modified Vestibular Caloric for Prevention of Hearing LossCisplatin and aminoglycosides are the more ototoxic drugs used in the United States. We have previously demonstrated that local cooling and warming of the ear canal can alter susceptibility to cisplatin-induced hearing loss and loss of hair cells. Here we continue this work in a repeated dosing paradigm and examination of mechanisms of protection.
NHANES Otolaryngology Epidemiology. The NHANES is a cross-sectional dataset from which generalizations can be made to the prevalence and characteristics of health in the United States. The NHANES includes specific ENT variables on hearing, balance, smell, taste, and head-neck cancer.
Pharyngeal Cyst Case Study
Cost of Inefficiency in the OR Due to Lack of Dedicated StaffThe lack of a dedicated, skilled OR team (circular, scrub tech, CRNA, anesthesiologist) contributes to inefficiency in the OR via delayed starts, extended turnover times, prolonged case times, and wasting supplies. The study will quantify the cost of each of these factors as compared to the cost of recruiting and retaining adequate staffing levels with appropriate experience to maintain a trained and effective staff.
Effects of Standardized Pain Management Strategy on Postoperative Opioid Use in Sinonasal SurgeryThe primary purpose of this study is to evaluate the effect of a standardized pain management strategy on the use of opioids prescribed postoperatively, for sinonasal surgery. A secondary aim is to document how opioids may have been previously over-prescribed following sinonasal surgery.
Natural History of Paranasal Sinus Mucous Retention CystsPatients are frequently sent to the otolaryngologist due to the finding of a mucous retention cyst resulting in inconvenience to the patient and increased costs in the health system. Patients and primary care physicians are often worried about the lesions. Otolaryngologists generally advise against any therapy in the absence of specific symptoms, which are rare. The natural history of mucous retention cysts and their relationship to a prior history of RARS or CRS is not clear. The study will involve reviewing our past CT or MRI scans to identify isolated mucous retention cysts, differentiate them from polypoid changes in the sinuses, correlate with symptomatology, and to note the progress or resolution over time in those cases with multiple imaging studies.
Objective Measurement of Nasal Volume Compared to Surgeon Perception of Sinus Surgery Difficulty Related to Nasal Cavity SizeObjective measurement of nasal volume compared to surgeon perception of sinus surgery difficulty related to nasal cavity size.
Relationship of Race to Access to Endoscopic Sinus SurgeryRace has been demonstrated to be a factor in access to thyroid surgery and site of surgery. A national database will be used to determine if there is a relationship to race and access to sinus surgery, sinus surgery type, and location of surgery.
Topical concentrations epinephrine for sinus surgeryTBD
Opiod Stewardship Protocol and time spent in Post-anesthesia Care Unit. This study will examine the impact of an Opioid Stewardship Protocol in time spent in PACU and use of medications and anesthesia.
Computerized Tomography Findings for Sinus Complaints.This study will examine the rate of denials and positive findings for CT ordered for sinus complaints ordered prior to or after the clinic visit.
Cochlear Efferent SystemA molecular investigation into the cochlear efferent system’s role in protection against noise-induced hearing loss, what genes/molecules are involved, when are they expressed, and what cellular functions do they impact.
Zika Effects on the Cochlea and HearingInvestigation into the effects of systemic Zika infection on cochlear structure and function, and on gene expression profiles.
Cochlear HPA-Equivalent System Function in the Cochlea or Vestibular PeripheryA molecular investigation into the cochlear HPA-equivalent system’s role in protection against noise-induced hearing loss. Investigation into the roles of CRF receptor expression in the inner ear, including both cochlear and vestibular systems.
CRF and CRFR Expression Along the Central Auditory PathwaysAn anatomical investigation into the developmental and adult expression of corticotropin-releasing factor and its receptors along the central auditory pathways of the brain.
Inner and Outer Hair Cell Fate Decisions in Cochlear DevelopmentGenetic manipulation of neonatal mouse cochlear hair cells results in many of the inner hair cells adopting outer hair cell-like characteristics. To further understand the role of our gene of interest in the differentiation and development of cochlear hair cells, we plan to delete it at several different developmental stages and examine the expression of inner and outer hair cell specific proteins. Discovery of such a gene that promotes outer hair cell specific attributes will no doubt be of use in regenerative strategies.
Effects of Magnetic Field on Vestibular FunctionIt has been shown that high magnetic field (e.g. MRI bore) activates vestibular end organs and induces dizziness and vertigo in humans and animal models. The goal of the project is to elucidate the underlying neural mechanisms and design effective paradigms to minimize its negative effects. We will 1) fully characterize magnetic-field induced eye movements; 2) obtain high resolution imaging of labyrinth in vivo; 3) determine the relationships between nystagmus null orientation and the labyrinth geometry; 4) characterize subjective vertigo and its relationship to nystagmus; 5) imaging labyrinth and measuring nystagmus in patients with vestibular disorders; and 6) characterize effects of magnetic field on motion perception and smooth pursuit.
Frequency Tunings of the cVEMP and oVEMP in Healthy Human Subjects and Patients with Vestibular DisordersThis project examines how sound activates different vestibular end organs and develops discriminative VEMP testing protocols.
Terminal Innervation Patterns of the Accessory Nerve in the Human Neck MusclesSCM will be harvested from cadavers and tissues treated for imaging nerve terminals along the muscle.
Ataxia and Vestibular FunctionAtaxia is associated with vestibular symptoms such as vertigo. The project is to use transgenic ataxia mice model to study the vestibular function. The vestibulo-ocular reflex (VOR) and the vestibulo-collic reflex (VCR) are to be assessed in ataxia transgenic mice by measuring their gains to whole body rotations and body-under head rotations, respectively.
Blast Overpressure-induced Vestibular DeficitsAs an air-filled structure and directly exposed to the surrounding air, unprotected ears are among the most frequently damaged sites during blast exposure. Vestibular symptoms, such as dizziness and imbalance, are common complaints among patients with blast-induced traumatic brain injuries (TBI). However, little is known about how and to what extent blast damages the peripheral and central vestibular system. Using a rodent model, aim 1 is to examine the effects of blast exposure on the peripheral vestibular structures and functions; aim 2 is to examine the blast exposure-induced structural damages and functional deficits of the central vestibular nuclei; and aim 3 is to use behavioral paradigms to assess effects of blast exposure on the vestibular functions (i.e., the vestibulo-ocular reflex, VOR and the vestibulo-collic reflex, VCR).
Neural Mechanisms of Sound Activation of the Vestibular SystemOverall objective is to provide the neural basis for human VEMP testing (vestibular evoked myogenic potentials) by rigorously examining vestibular afferent responses to clinical VEMP stimuli. Using a rodent model, we examine single unit vestibular afferent responses from identified organs to air-conducted and bone-conducted sound stimuli that are used clinically. We will determine if certain sound stimuli preferentially activate specific vestibular end organs. The project is funded by NIH RO1.
Noise-induced Vestibular DeficitsLoud sound not only affects the auditory system, but it may also cause deficits of the vestibular system. The goal of this study is to employ morphology, neurophysiology and behavioral approaches to evaluate noise exposure on the vestibular system.
Impact of Diabetes on Vestibular and Auditory Functioning Using a rodent model to study vestibular deficits in a spontaneous diabetes 2 model.