Faculty Research

Background: Photoimmunotherapy (PIT) is a new cancer-targeted therapy. PIT is a combination drug and device anti-cancer treatment that utilizes monoclonal antibodies conjugated to a dye, that can be activated upon nonthermal 690 nm red light illumination to induce rapid cell death only at cells expressing the antigen and only after antibody binding to the cellular antigen. The requirement of light-induced activation and antigen-antibody binding to induce cell death enables the selective and specific destruction of tumor cells with minimum damage to healthy tissue surrounding the tumor cells.

PIT requires two treatment steps in sequence: (i) the administration of the experimental drug by infusion and (ii) the illumination of the tumor with 690 nm nonthermal red light using sufficient energy to induce cell death. Light illumination is administered 24 ± 4 hours post-ASP-1929 infusion. The lag is intended to enable drug distribution within the tumor prior to drug activation by the application of light.

The experimental drug therapy targets epidermal growth factor receptor (EGFR) antigens. EGFR is highly expressed in squamous cell carcinomas of the head and neck.

Objectives: This global, multi-centered trial evaluates the efficacy and safety of PIT as monotherapy for the treatment of locoregional, recurrent HNSCC in patients who have failed or progressed on or after 2 lines of therapy.

Background: Venous thromboembolism (VTE) is a disease process characterized by blood clot formation in the deep veins of the lower extremities, known as deep vein thrombosis. In some, a blood clot may dislodge and travel into the vessels of the lungs causing a pulmonary embolism (PE). The incidence of this disease is increased by factors that 1) cause damage to blood vessels, 2) decrease blood circulation, and 3) increase thickness of the blood.

Head and neck cancer patients who undergo surgical procedures requiring extensive tissue removal and reconstruction are prone to VTE risk factors and appear to have a higher incidence of venous thromboembolism than other surgical patient populations. The incidence of VTE in head and neck cancer patients undergoing cancer resection followed by reconstructive procedures, including microvascular anastomosis, is shown to be as high as 5.8 %. This is in accordance with the investigators’ observations in their own clinical practice of head and neck cancer patients that undergo resection with microvascular reconstruction.

Objectives: The purpose of this study is to compare the incidence of VTE and PE in UIC head and neck cancer patients who 1) did not have a reconstruction procedure following cancer resection and 2) those that did have a reconstruction procedure following cancer resection. We hypothesize that the incidence of VTE will be higher in patients that underwent resection and microvascular free tissue transfer reconstruction than in head and neck cancer patients who did not undergone this type of reconstruction. Further, we hypothesize that the Caprini scores of the patients that developed VTE will be higher than those that did not.

Abstract: Bell’s Palsy is the most common cause of facial nerve paralysis. Recent clinical studies have suggested that the causative feature may be a long term thickening of the facial nerve sheath in the mastoid air cell system. Computed Tomography (CT) can easily identify the diameter of the vertical facial nerve in the mastoid – the putative site of compression. This retrospective study will examine the effectiveness of a single, blinded neuro-radiologist in identifying widened vertical facial nerve canals on thin cut high resolution CT scans. In the first phase of the study, the neuroradiologist will measure the diameters of facial nerve canals in the mastoid region bilaterally in patients who were not diagnosed with facial nerve pathology.  A second set of specific CT scans will be provided to a radiologist with no information or medical history of the subject. These CT scans will include subjects with and without Bell’s Palsy. The study PI will compare the radiologist’s measurements of the vertical facial nerve canal diameter with the known facial nerve status. Results of the study will be recorded and shared with the medical community through presentation and/or publication.

Objectives: The purpose of this research is to determine 1) the range and average diameters of the vertical facial nerve canal in the mastoid region of normal/control patients using thin cut, high resolutions CT, 2) the range and average diameters of the vertical facial nerve canal in the mastoid region of patients diagnosed with Bell’s Palsy using thin cut, high resolutions CT. A neuroradiologist will use CT scans to measure facial nerve diameter and to determine whether the nerve has a normal or enlarged diameter. The study will involve a single, blinded neuro-radiologist performing these measurements on fine-cut CT imaging. The study will in include both a control group and a test group in order to obtain more powerful data.

Abstract: Postoperative infection following rhinoplasty is rare but can have detrimental effects on patient outcomes. Although routine use of postoperative antibiotics after rhinoplasty is a widely accepted practice, there is limited data on whether its use in preventing postsurgical complications is efficacious. This retrospective study will involve a medical record review of patients who had a rhinoplasty or septorhinoplasty surgery at UI Health between January 1, 2019 and June 1, 2020. Specifically, the review will focus on whether patients did or did not receive postoperative antibiotics after surgery and whether they had post-operative complications due to infection. This study seeks to reveal trends in antibiotic usage and infection rate after rhinoplasty. Results of the study will be recorded and shared with the medical community through presentation and/or publication.

The experimental drug therapy targets epidermal growth factor receptor (EGFR) antigens. EGFR is highly expressed in squamous cell carcinomas of the head and neck.

Objectives: The primary aim of the retrospective study is to evaluate the relationship between post-operative antibiotic use and infection rate following rhinoplasty or seporhinoplasty surgery. The research team will review medical records of patients that had either a rhinosplasty or septorhinoplasty procedure at UI Health to determine whether the patients received post-operative antibiotics and whether they had any post-operative infectious complication. If there is found to be a difference in postoperative infection rates, potential secondary endpoints include factors influencing infection rate other than antibiotic use. This includes surgical technique, sterile procedure, pre- and postoperative colonization, comorbid conditions, primary or revision nature of the surgery. Based on current existing data, we hypothesize that there will be no difference in infectious complication rates between those receiving postoperative antibiotics and those who do not receive postoperative antibiotics.

Background: A cerebrospinal fluid (CSF) leak from the nose is termed CSF rhinorrhea. Forty percent of cases are idiopathic, meaning the cause is unknown. Numerous studies have demonstrated that the best way to repair CSF rhinorrhea is to utilize multiple layers of closure. Nevertheless, even after an optimal repair, some patients have persistent CSF rhinorrhea. There is a lack of information and understanding regarding the wound healing process involving CSF rhinorrhea.

Objectives: The aim of this preclinical study is to induce CSF rhinorrhea in a rat model, surgically repair the defect using various methods, and assess healing at specific time points. The results of the study will be used to gain a better understanding into the mechanism involved in CSF rhinorrhea repair

Background: There is a need to prospectively collect outcomes data on patients with sinonasal pathology.  Such a database is extremely useful as it provides a continuously expanding resource for research projects and data mining.

Objective: To develop a REDCap sinonasal outcomes database to prospectively collect standardized clinical outcomes information on patients presenting to UIC with sinonasal pathology.

Background: It is important from a surgical planning standpoint to continue identifying anatomic variants on imaging that have relevance to surgical planning.  In our experience, certain variants are commonly seen but underreported in the literature, and this is the focus of these research efforts.

Objective: To evaluate specific anatomic characteristics on imaging important for endonasal endoscopic approaches, in particular defining them, determining their prevalence, and identifying associated features.

Background: Viral upper respiratory infections can progress to sinusitis and contribute to sinonasal symptom exacerbations, resulting in significant morbidity.

Objective: To characterize the immune response of various sinonasal cell types when exposed to viral upper respiratory pathogens.

Background: Idiopathic intracranial hypertension is a syndrome of high intracranial pressure of unclear cause.  There is increasing evidence associating the presence of idiopathic intracranial hypertension with the incidence of spontaneous cerebrospinal fluid leaks.

Objective: Evaluate the association of idiopathic intracranial hypertension and spontaneous cerebrospinal fluid leaks using a novel institutional diagnostic protocol

Background: Allergic and non-allergic rhinitis, rhinosinusitis, and asthma are poorly understood diseases that affect millions of people each year. These conditions co-exist in many patients and often, onset of one is associated with exacerbation of the other. The apparent relationship of the diseases has led to the consideration of the controversial ‘one airway’ theory. The key, or link to understanding the relationship and cause of these various diseases may be found in the tissues they affect.

Tissues samples harvested from patients as a standard course of their medical treatment will be saved for future, histopathologic, and immunohistochemical evaluation. The cellular examination of tissues would be correlated with clinical, endoscopic and radiologic findings from the patients permanent medical record. The information will be consolidated and organized in a computer program in order to compare patient diagnosis, treatment, results, as well as tissue/cellular findings of the various treatment groups (rhinitis vs. rhinosinusitis vs. asthma).

Objectives: The objectives of this research is to generate a data bank of patients that present with rhinitis, rhinosinusitis, and/or asthma. Tissue samples will be saved for future evaluation to help determine: 1) how the various diseases are related, 2) how the onset and rate of progression of disease correlates to type, duration, and length of treatment, and 3) how histopathological results relate to the stage and severity of disease found in each patient.

Background: In the US, African Americans and Latinos are overrepresented among cases of and deaths from COVID-19.  Minority communities may be more susceptible to severe forms of COVID-19 because of existing disparities in underlying conditions. Sinopulmonary conditions (asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, chronic sinusitis, and allergic rhinitis), which are exacerbated by respiratory viruses, have not been well studied in COVID-19.

Objective: Examine the effect of sinopulmonary conditions on COVID-19 risk and severity and explore the early relationship between COVID-19 and healthcare utilization among patients with sinopulmonary conditions.

Background: There are social disparities in morbidity and mortality for sinonasal conditions.  Identifying the contributing factors to these disparities is critical so they can be addressed.

Objective: To identify if certain social determinants of health are associated with specific healthcare utilization patterns for sinonasal conditions.

Background: Infections in CRS may be related to a decrease in native and an increase in pathogenic bacteria.  Topical probiotics outcompete pathogenic bacteria via a variety of mechanisms, including creating suboptimal environmental conditions, competing for cell surface receptors and thus limiting pathogen adherence, and producing antibacterial metabolites.  In doing so, topical probiotics can restore the native microbiome.

Objective: Assess if topical probiotic sinus irrigations can improve outcomes compared to standard treatments in patients with recalcitrant chronic rhinosinusitis.

Background: Approximately one-third of the global work force requires the integrity of the voice in order to work efficiently. Voice disorders often result in changes in vocal quality, loudness, and pitch. This disruption can inhibit an individual’s ability to communicate effectively. While voice problems of singers, professional speakers, and teachers, have been well studied, voice issues of pastors, priests, and other various clergy have not been extensively evaluated.

Objectives: The purpose of this research is to identify various factors that may place clergy at risk for voice disorders. The study will focus specifically on voice use, vocal habits, drinking habits, building acoustics, congregation size, whether amplification devices are generally used, and how many services per day/per week are performed. In addition, part of the questionnaire will include a validated screening index for voice disorders (SIVD) as to tool to allow quantification and stratification of risk across the study groups.

Background: The term vocal cord dysfunction has been used by clinicians to describe a variety of conditions including paradoxical vocal fold motion disorder (PVFM). There has been prior documentation of a relationship of mental health issues, primarily anxiety, and PVFM. As a result of this information our clinical practice began incorporating mental health screening tools into our assessments for patients diagnosed with PVFM. The tools used in our practice include the Life Events Checklist (LEC) and the PTSM Checklist (PCL).

Objectives: The purpose of this 16 patient retrospective pilot study is to determine if there is a trend between patients what have experienced emotional trauma as described in the Diagnostic and Statistical Manual (DSM-V) and PVFM.

Background: Approximately one-third of the global work force requires good voice function in order to work efficiently. Voice Disorders are typically caused by disruptive structural changes in the vocal cords of the larynx (voice box). The changes can affect loudness, pitch, projection, and overall of quality thereby impairing an individual’s ability to communicate effectively. Teachers have previously been identified as a group of voice professionals for whom the risk of voice disorders is high. Moreover, some research suggests that voice quality of a teacher can have a significant impact on the ability for students to learn. This research will compare voice risks based on classroom size, vocal load during the day, use of amplification, and design of the classroom, as well as factors related to voice use outside of teaching activities.

Objectives: The aim of this research is to identify and compare risk factors for voice disorders amongst teachers in an urban environment

Background: Symptoms of Voice Disorders involve a disruption in the loudness, pitch, and/or quality of an individual’s voice when attempting to talk or sing. This disruption may result in an inability to communicate effectively. Pain, increased effort to create sound, and fatigue are symptoms that accompany voice difficulties. Although there are well-validated instruments for measuring sound impairment (acoustic and aerodynamic measures) and functional problems of the voice system, the degree to which pain, effort, and fatigue contribute to voice disorders lacks thorough validation in the clinical population.

This research proposes to establish a protocol to elicit vocal effort, gather normative data on those with voice disorders and those without voice disorders, and compare the measure of vocal effort with other commonly used measures of voice impairment (acoustic measures and auditory perceptual measures of vocal quality as judged by expert listeners), as it relates to subjects with various voice disorders.

Objectives: The purpose of this study is to begin the process of validating a system that will aid in establishing a protocol for measuring vocal effort for various voice disorder groups, as well as a measurement for the degree in which pain, effort, and fatigue influence voice disorders. Specifically, the research has 3 specific aims: 1) establish a protocol for obtaining a measure of vocal effort for various voice disorder groups, 2) gather normative data on those with voice disorders and healthy control participants, and 3) compare measures of vocal effort with other commonly used measures of voice impairment.

Background: Hearing loss is a significant health burden in the United States with approximately 15% of American adults (18 years old and greater) reporting at least some trouble hearing. Sensorineural hearing loss is also the third leading cause of disability worldwide. Cochlear implants are often the best treatment for this disability. Determining cochlear implant candidacy involves both audiogram testing and AzBio Sentence testing. Currently there are suggested guidelines for cochlear implant candidacy based on audiogram results, however, the medical literature does not contain any studies evaluating the relationship of audiogram results to AzBio Sentence scores.

Objectives: The aim of this study is to objectively determine the relationship between various audiogram parameters and AzBio Sentence scores in order to determine the best predictors for cochlear implant candidacy. Establishing a relationship between the two testing methods may 1) improve the cochlear candidacy referral process while 2) decreasing time and cost associated with testing poor candidates. The end result may aid in improving referrals of appropriate candidates for CI evaluation as well as cut down on time and cost of testing poor candidates.

Background: The American Neurotology Society (ANS) is the national professional society that was created to provide education, present research and discuss needs for the field of neurotology, a subspecialty of otolaryngology. The field is predominately male. In 2017, female members from ANS, created a separate group named Women in Neurotology (WiN). With the formation of this group, an informal survey was created by four WiN members to capture demographic, academic and career information in an effort to understand who made up this group. The survey was created and sent via an online survey system (SurveyMonkey®). Survey results were returned anonymously and could not be traced back to members.

Currently, surgical antibiotic prophylaxis for head and neck cancer patients varies from institution to institution, as well as between surgeons of the same institution. To date, no one antibiotic regimen has been found to be superior for treating head and neck cancer patients with penicillin allergies.

Objectives: The aims of the study are to 1) summarize the characteristics and demographics of the women who make up Women in Neurotology, and 2) share the data findings with the medical community through presentations and publications.

Background: Obtaining informed consent from a patient prior to surgery is critically important for both the patient and the medical team performing the surgery. A properly executed consent document represents an understanding and acceptance between the patient and his physician about the procedure to be performed and the risks associated with the procedure. Failure to properly consent a patient prior to surgery could result in harm both to the patient as well as to the physician.

A recent audit conducted by UI Health found that only 21 percent of all surgical consents reviewed within a 30 day period were compliant with consent requirements. As a result of the audit, the department of otolaryngology is conducting a retrospective review of surgical consents to determine 1) the departments surgical consent compliance rate and 2) the reason for non-compliance for each consent failure, and the rate of non-compliance for specific items in the consent. Information gathered because of this study will be used as a training tool for staff members obtaining surgical consent in our department.