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

1. Research Opportunities in the Department of Otolaryngology-Head and Neck Surgery Kibwei A. McKinney, MD Yu-Tung Wong, MD Scott Shadfar, MD

2. Outline • Funding opportunities • Subspecialty Areas • Clinical/Research Faculty • Areas of Interest • Examples

3. ENT Residency Application • Step 1 USMLE Score • Medical School GPA • Extra-curricular Activities • Research

4. Duration of Research • 2 months – Projects completed during the summerin between the 1st and 2nd yr • 1 year – Projects completed during a year off in between the 3rd and 4th years of medical school

5. 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)

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

7. 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

8. Cancer Cachexia • Loss of weight, muscle atrophy, catabolism associated with end-stage cancer • Significant cause of morbidity

9. 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 occurcellularproliferationtumor • AlsoInflammation (possibly leading to cachexia)

10. 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?

11. Putting Resveratrol to the Test Day 0 –Tumor Inoculation Days 1-17 Document Cachexia/Treat with Resveratrol Sacrifice and Harvest

12. Outcomes • Tumor size • Body weight • Tissue NFκB levels • Cardiac echo readings

13. 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

14. Facial Plastic and Reconstructive Surgery • William Shockley, MD • Interests: Microtia repair, nasal defects and rhinoplasty, congenital anomalies • Clinical Outcomes Research

15. 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

16. 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

17. Laryngology • Robert Buckmire - Medical Robotic System for Laser Phonomicrosurgery • Joint venture with UNC/NC State Dept. of Biomedical Engineering • Image Guidance in Laryngeal Surgery

18. 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

19. 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

20. 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 PPF PPF GPC GPC Mucosa Mucosa

21. 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