THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OTOLARYNGOLOGY REPORT WINTER 2016
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
Message from the Chair
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
OHIO STATE & FAYETTE COUNTY MEMORIAL HOSPITAL PILOT ENT TELEMEDICINE SERVICE Joint program offers virtual otolaryngology visits to patients in rural Ohio
Greetings to all our friends and colleagues from the beautiful campus of The Ohio State University Wexner Medical Center: We have had a spectacular year in the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University. As you may recall, we set a bold goal to become a top five program in Otolaryngology within five years. During this first year, we have already made significant progress toward achieving this goal!! Specifically, we recruited tremendous talent into our department in both the clinical and research divisions. Drs. James Rocco, Oliver Adunka, Alex Farag and Stephen Kang have joined our clinical team and are welcomed additions. Furthermore, we have added tremendous scientific talent through the recruitment of several PhD scientists, including Drs. Kai Zhao, Derek Houston, Loni Arrese and Edmund Mroz. Our faculty has also been highly successful this year in obtaining additional R01 support, despite a highly competitive NIH funding environment. With the addition of six new R01s and an R21, our NIH research portfolio continues to expand dramatically. Beyond grants and recruits, we are paving the way with innovation in telemedicine, and we have been fortunate to receive exceptional philanthropic support. As you will read in this newsletter, our department at present has a remarkable wealth of expertise, and given our current pace of growth, our future is bright and limitless!! Perhaps the most important news of this last year, however, was the retirement of Dr. David Schuller from The Ohio State University after 44 years of exemplary service. To celebrate this momentous occasion, our department worked with the university community to surprise Dr. Schuller with a retirement party that was attended by hundreds of alumni, friends and patients from all over the country. To permanently honor him, the “David E. Schuller, MD Laboratories” were created and the “David Schuller, MD Endowment” was established to fund research in perpetuity for Otolaryngology – Head and Neck Surgery at Ohio State. We will forever be grateful for Dr. Schuller’s leadership in our department, our cancer program and in the field of otolaryngology. We wish Dr. Schuller and his wife, Carole, a happy and healthy retirement. I hope you enjoy this newsletter and we encourage you to come visit our department to see first-hand all of the tremendous progress we are making. Theodoros Teknos, MD Professor and Chair, Department of Otolaryngology – Head and Neck Surgery The David E. Schuller, MD, and Carole Schuller Chair in Otolaryngology Medical Director of Development, The James Campaign The Ohio State University Wexner Medical Center The James Cancer Hospital and Solove Research Institute
A new telemedicine program, partnering The Ohio State University Wexner Medical Center and Fayette County Memorial Hospital ENT will allow patients who don’t have local access to an ENT specialist to receive an otolaryngology consultation at the push of a button. The pilot is led by a team of physicians and administrative professionals from Ohio State’s Wexner Medical Center, including Garth Essig Jr., MD, Nolan Seim, MD, and Mark Inman, chief operating officer from the Department of Otolaryngology – Head and Neck Surgery; and Brittany Locklear, OSUWMC senior outreach coordinator. Together with mid-level providers and primary care physicians from Fayette County Memorial Hospital, located nearly 50 miles southwest of the Ohio State campus, Dr. Essig will provide convenient and comprehensive virtual care to patients who need evaluation for a variety of ear, nose and throat problems, including sinusitis, vocal cord lesions, enlarged tonsils and septal deviation. Not only will Dr. Essig be able to talk to the patient and the provider in real-time, he will have instant access to images captured via otoscopes, nasal scopes and other diagnostic instruments. “Our expectation is that the virtual clinic will be as good as someone seeing an ENT doctor in their office,” says Dr. Essig, who adds that they’re testing the entire experience to ensure they will deliver on that promise.
“We will start by performing the consults with a physician on-site, monitoring many factors involved with the visit,” Dr. Essig explains. “We’ll compare these factors to our standard ENT visit and assess whether patients are uncomfortable with any portion of the telemedicine experience. By analyzing these factors, we can improve the patient experience, better understand what types of consults work best in this model, and learn what kind of volume we can accommodate.” Telemedicine programs are already benefitting patients and providers alike, saving precious time that would otherwise be spent traveling two or more hours round-trip to provide or receive care in person. They also have shown to be a cost-effective model for healthcare delivery. According to Dr. Essig, Fayette County Memorial Hospital was an ideal partner—and not just because it’s located in a rural community. Otolaryngologists from Ohio State were already driving there to see patients, and the two organizations are on a shared radiology PACS system. “Fayette is already part of a telestroke program with Ohio State’s stroke team that uses similar technology and equipment,” says Dr. Essig. “The clinicians and leadership at Fayette are forward thinking—they want to improve access and quality of care for the patients they serve, and they are not afraid to try new things.” Dr. Essig says while he and his team are laying the groundwork for a general ENT telemedicine program, they’re keeping an eye on future growth, both geographically and clinically. “There is a wealth of sub-specialty ENT care at Ohio State that could be applied to telemedicine, including expertise in neurotology, head and neck cancer, pediatrics, facial plastics and laryngology,” he explains. “In building a model that best serves patient needs, it’s exciting to think we may eventually be able to offer sub-specialty consultations and cover all aspects of the field at a distance.”
page I 3
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
PROLIFIC OHIO STATE RESEARCHER SECURES THIRD R01 GRANT THIS YEAR
OHIO STATE APPOINTS NEW RESEARCH FACULTY
Funding will support Dr. Quintin Pan’s head and neck cancer research
Dr. Loni Arrese laying the groundwork for important dysphagia research
It’s been a monumental year for cancer researcher Quintin Pan, PhD. Dr. Pan is vice chair of research and director of the Schuller research laboratories within The Ohio State Comprehensive Cancer CenterArthur G. James Cancer Hospital and Richard J. Solove Institute. While fulfilling those dual roles, he has also secured three highly competitive R01 grants from the NIH in 2015.
“Our goal is to uncover the genetic differences between regular cancer cells and CICs,” adds Dr. Pan. “If we can find out what makes CICs so special, then we may be able to find a way to kill them.”
Unusual Success in a Challenging Climate Since joining Ohio State seven years ago, Dr. Pan has built an important head and neck cancer research lab, as well as a growing reputation for his efforts to discover better treatments for patients with aggressive head and neck cancers. His hard work is paying off. Any scientist would be honored to receive funding from the NIH, but to receive three R01 grants in the span of just one year is uncommon validation of the importance of Dr. Pan’s research. Dr. Pan says the funding environment has become noticeably more difficult, in part because there is a larger pool of people applying for a pot of money that has not grown during the last decade. “When I was in grad school, the success rate for receiving funding was 20 to 25 percent, and today it’s running about nine to 10 percent,” says Dr. Pan. “I think the translational nature of my research, my aim to move
page I 4
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
findings from the lab to the clinic in order to directly benefit patients, has been key to my continued success.” Game-Changing Potential Throughout his career, Dr. Pan’s research has focused on the variety of genes that contribute to cancer development and progression, and whether those genes can be targeted with novel drugs that inhibit their performance. His most recent R01 grant (R01CA193590) will support research to better understand a unique type of cancer cells, called cancer initiating cells (CIC), that not only are resistant to therapy but also have the potential to repopulate a tumor. “The working theory is that within a tumor mass there are different kinds of cells, including both CICs and cells that may be abnormal but do not initiate tumors,” says Dr. Pan. He explains that if you treat a tumor with chemotherapy, you essentially kill the cells that cannot initiate cancer, but leave behind drug-resistant CICs. Initially the tumor shrinks in size, but over time the CICs repopulate the tumor and it grows again. “Our goal is to uncover the genetic differences between regular cancer cells and CICs,” adds Dr. Pan. “If we can find out what makes CICs so special, then we may be able to find a way to kill them.” Another of Dr. Pan’s R01 grants (R01DE023555) showing
remarkable promise is related to drug development for HPVpositive head and neck cancers, which he says have increased dramatically over the last 10 years. During an initial phase of work that was also NIH-funded, Dr. Pan’s team designed a drug that can specifically target HPV-positive cancer cells, by reactivating two key tumor suppressors called p53 and RB. “We recently created a second generation molecule that is in the process of being licensed to a European biotech company,” says Dr. Pan. “While they take over the crux of the drug development, our next step here is to continue researching that molecule and, working with the FDA, to hopefully initiate clinical trials in patients by 2018.” Looking Ahead Dr. Pan ended 2015 on a high note, with activation of his third R01 grant (R01GM117921) in December. As he heads into another productive year, he reflects on the work he and his team have accomplished so far. “I have to credit the university for being such a strong advocate of research,” he says. “The environment here is very collegial and we’ve had tremendous support from OSUCCC – James, including investments into the head and neck oncology program. I’ve been fortunate in my career in many ways, and look forward to what the next chapter here brings.”
Having already established her reputation at The Ohio State University as a clinician, division manager and doctoral candidate, Loni Arrese, SLP, PhD, has added another title to her growing collection: research scientist. The speechlanguage pathologist and recent PhD recipient, who joined the Department of Otolaryngology – Head and Neck Surgery in September 2015, plans to spend the next phase of her career investigating new treatment options for dysphagia. Dr. Arrese was introduced to the head and neck cancer population during graduate school, and says from that point on she was compelled to work with patients suffering with dysphagia. “Not only is dysphagia common among head and neck cancer patients, the incidence is growing,” says Dr. Arrese, adding that head and neck cancer has become an epidemic due to the HPV virus. “We’re seeing a much younger population of survivors, many of whom are living with treatment-induced dysphagia. We need to continue identifying better treatment techniques, to ensure these patients can still enjoy a good quality of life.” During her 13 years as a practicing clinician, Dr. Arrese says she often encountered clinical questions that didn’t have readily available, evidence-based answers. Turning an obstacle into an opportunity, she began her doctoral work at The Ohio State University’s Department of Speech and Hearing Science in 2011–while simultaneously running the busy ENT-Speech Division within The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Dr. Arrese’s dissertation work assessed the relationship between patientreported swallowing severity and objective clinician ratings of swallowing function in individuals with head and neck cancer. She says her motivation behind this work is to find a practical and reliable way of using subjective reports of swallowing to predict pathophysiology, measure airway safety impairments or monitor progression of dysphagia in the head and neck cancer population. Dr. Arrese says her new faculty appointment will allow her to expand upon her dissertation, as well as dive into new projects, such as examining the relationship between swallowing function and respiration. “I’m grateful for the opportunity to help create a new area of research at Ohio State,” she says. “I’ve got a lot of work ahead of me, such as submitting grant proposals and writing IRBs, but it’s exciting work. We have the potential to expand treatment options across the dysphagia population–not just in head and neck cancer, but within other disordered populations as well.” page I 5
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
OHIO STATE AND NATIONWIDE CHILDREN’S HOSPITAL AMONG FIRST IN THE NATION TO PERFORM PEDIATRIC AUDITORY BRAINSTEM IMPLANTS Dr. Oliver Adunka provides hope and hearing to children born without cochlear nerves
“These 25 cases have given us an opportunity to refine our diagnostic criteria and pinpoint which children will benefit from an ABI,” says Dr. Adunka
September 24, 2015 was a day unlike any other for a threeyear-old hospital patient and his parents. The energetic toddler– who was born deaf–heard sound for the first time after surgeons from The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital “turned on” his new auditory brainstem implant (ABI). And so began the remarkable journey of a child who can now react to and interpret sound and learn new ways of communicating with those around him. It was also a monumental day for the medical team members, as together they represent only the fifth institution in the United States to perform a pediatric ABI. The Evolution of ABIs Auditory brainstem implants are among the latest generation of assistive hearing devices, providing hope to deaf children who are not candidates for cochlear implants. The device consists of a microphone and transmitter, worn on the side of the head, and an internal receiver implanted on the brainstem. The external transmitter converts sound into electrical signals, which bypass the inner ear and travel directly to the hearing centers within the brain via the implanted receiver.
page I 6
ABIs are not a new technology–an early version of the device was first used in the U.S. more than 30 years ago. However, they’ve only been approved for use in adults with a hearing disorder called neurofibromatosis type 2, or NF2. Given Ohio State’s long-time status as a center of excellence for patients with NF2, naturally it became one of the few medical centers to perform auditory brainstem implants in adults.
Perfecting the Procedure in Children Dr. Adunka says about 25 children in the U.S. have received an ABI, but that number will likely grow, especially once the FDA approves the device for use in children born without cochlear nerves. Until then, most insurance companies won’t cover the procedure. “These 25 cases have given us an opportunity to refine our diagnostic criteria and pinpoint which children will benefit from an ABI,” says Dr. Adunka. “We’ve also learned a lot from the European medical community. An Italian surgeon named Dr. Vittorio Colletti began performing ABIs in children 10 years ago, and since then about 100 kids worldwide have received an implant.” While the FDA deliberates, Dr. Adunka and his team will continue building the pediatric ABI program,
a joint effort between Ohio State and Nationwide Children’s Hospital. They will perform at least two more pediatric procedures in 2015, and will continue to study outcomes and refine clinical protocols. Changing Lives, One Child at a Time The Ohio State and Nationwide Children’s Hospital program is the first of its kind in the Midwest, reducing travel and expenses for some patients and their parents. Until now, children in need of an ABI had to go to Los Angeles or the East coast. “I can’t tell you how rewarding it is to work with these kids, to give them a tool that will profoundly change the way they interact with the world,” says Dr. Adunka. “I look forward to the day when this procedure is readily available to all children who need it.”
“Patients with NF2 often have tumors growing in both ears, on the nerves that control hearing,” says Oliver Adunka, MD, director of Neurotology at Ohio State’s Department of Otolaryngology – Head and Neck Surgery and the surgeon who, together with pediatric neurosurgeons Jeffrey Leonard, MD, and John McGregor, MD, performed the toddler’s implant. “To remove the tumors, surgeons may have to cut the cochlear nerve, which eliminates the possibility of a cochlear implant to restore hearing,” explains Dr. Adunka. “While adults often regain partial hearing after an ABI, we’re seeing much better results among young kids who didn’t have a cochlear nerve to begin with, and don’t have the added problem of tumors getting in the way.”
Colton, born without his cochlear nerve, can now hear sound thanks to his auditory brainstem implant
page I 7
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
CURRENT NIH FUNDING Lauren Bakaletz, PhD
09/30/1999–07/31/2020
ACTIVE RESEARCH FUNDING NIH/NIDCD
R01DC003915
Oliver Adunka, MD
NIH/NIDCD
R01DC11818
Lauren Bakaletz, PhD (Co-PI) 11/01/2013–10/31/2015 The Ohio State University, Public Health Preparedness Biofilms in human medicine for Infectious Diseases
Determinants of H.influenzae Virulence in Otitis Media
Lauren Bakaletz, PhD
07/20/2011–06/30/2016
Novel immunotherapeutics for the management of otitis media due to H. influenzae
Derek Houston, PhD
8/14/2015--6/30/2020
NIH/NIDCD R01DC008581
Infant-directed speech and language development in infants with hearing loss
Pawan Kumar, MS, PhD 07/02/2014-06/30/2016 NIH/NCI R21CA178649 Role of Tumor-Associated Enothelial Cells in Chaperoning Tumor Cells
Quintin Pan, PhD
04/08/2015–03/31/2020
NIH/NCI
R01CA193590
Cancer initiating cells and treatment resistance
Quintin Pan, PhD
05/06/2015–04/30/2020
NIH/NIDCR
R01DE023555
Role of P300 in HPV-positive head and neck cancer
p53/Rb reactivation modulators for HPV-positive head and neck cancer
James Rocco, MD, PhD
07/01/2011–04/30/2016 NIH RO1 R01DE022087 08/05/2011–07/31/2016
02/01/2015–Present
Kris Jatana, MD
R01DC011321
01/01/2012-03/12/2014
Technology Development Fund Grant
Development of new surgical safety devices
Pawan Kumar, PhD (PI of Correlative Studies)
12/18/2013–12/17/2017
NCCN Clinical Trial
Phase I/II clinical trial of sorafenib in combination with cisplatin and docetaxel in patients with recurrent/metastatic squamous cell carcinoma of the head and neck
08/01/2014–07/31/2016 Triological Society Career Development Award
Personalizing aural rehabilitation for adults with Cochlear implants
01/2013–Present
OSUCCC Viral Oncology Program Research Award
Enhancement of oncolytic herpes virus (34.5ENVE) activity in head and neck squamous cell carcinoma with bortezomib
Theodoros Teknos, MD NIH/NIDCD
Technology Development Fund Grant
Improving tracheostomy tube care
Matthew Old, MD
BCL-2 as a biomarker for prognosis and therapy of head and neck cancer
Gregory Wiet, MD
Kris Jatana, MD
Aaron Moberly, MD
Quintin Pan, PhD (Co-PI) 12/1/2015-11/30/2020 NIH/NIGMS R01GM117921
05/26/2011–05/25/2015 MED-EL North America
Development of an intraoperative recording system during cochlear implantation
2010–2015
NCCN Clinical Trial
Phase I clinical trial to determine the efficacy of vorinostat in oropharyngeal cancer
Virtual temporal bone surgery: defining and translating standardized metrics
Kai Zhao, PhD
12/1/2014–11/31/2018
NIH/NIDCD R01DC013626
Objective evaluation of conductive olfactory losses and nasal obstruction symptoms
NEW PHYSICIANS Alexander Farag, MD is an assistant professor specializing in benign and malignant sinonasal diseases, as well as minimally invasive skull base and orbital surgery.
Stephen Kang, MD is an assistant professor specializing in the comprehensive management of benign and malignant head and neck tumors.
Dr. Farag grew up in Mansfield, Ohio. He obtained a bachelor’s degree in chemistry from the College of Wooster, and attended medical school at the University of Toledo College of Medicine. Following medical school, he completed his residency in Otolaryngology at the University of North Carolina at Chapel Hill, then completed his fellowship in advanced sinus and skull base surgery at Thomas Jefferson University in Philadelphia, PA.
After completing medical school and residency training in otolaryngology – head and neck surgery at the University of Michigan, he completed an additional year of advanced training as a fellow at The James, specializing in management of head and neck cancer, transoral robotic surgery and free tissue transfer/reconstructive microsurgery. He currently serves as director of Medical Student Education and is the assistant residency program director.
Dr. Farag’s clinical interests include sinusitis and sinus surgery, nasal congestion, empty nose, epistaxis, cerebrospinal fluid leaks, vasomotor and allergic rhinitis as well as fungal sinusitis. He also has a great interest in dacryocystorhinostomy and orbital tumors, including skull base pathologies (infratemporal fossa, clivus, planium, sellar and para-sellar pathologies).
Dr. Kang’s clinical interests include head and neck cancer, melanoma and other cutaneous malignancies, microvascular reconstruction, transoral robotic surgery, salivary gland tumors, head and neck paraganglioma and surgical management of thyroid disease. Dr. Kang also has research interests in optimizing functional outcomes of microvascular reconstruction, outcomes with transoral robotic surgery, and clinical and biologic predictors of outcomes in cutaneous malignancy.
We welcome Dr. Farag back to the buckeye state and to the Otolaryngology team.
page I 8
Dr. Kang is a great addition to the Oncology division and to the Otolaryngology team.
page I 9
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
HIGHLIGHTED PUBLICATIONS Kucur C, Durmus K, Gun R, Old MO, Agrawal A, Teknos TN, Ozer E. The safety and efficacy of concurrent neck dissection and transoral robotic surgery. Head Neck. 2015 Mar 17. doi: 10.1002/ hed.24033. [Epub ahead of print] Agrawal A, Civantos FJ, Brumund KT, Chepeha DB, Hall NC, Carroll WR, Smith RB, Zitsch RP, Lee WT, Shnayder Y, Cognetti DM, Pitman KT, King DW, Christman LA, Lai SY. [(99m) Tc]Tilmanocept Accurately Detects Sentinel Lymph Nodes and Predicts Node Pathology Status in Patients with Oral Squamous Cell Carcinoma of the Head and Neck: Results of a Phase III Multi-institutional Trial. Ann Surg Oncol. 2015 Feb 11. [Epub ahead of print] Kucur C, Durmus K, Uysal IO, Old M, Agrawal A, Arshad H, Teknos TN, Ozer E. Management of complications and compromised free flaps following major head and neck surgery. Eur Arch Otorhinolaryngol. 2015 Jan 10. [Epub ahead of print] Nogan, S., Jandali, D., Cipolla, M., and deSilva, BW. “The Use of Ultrasound Imaging in Evaluation of Peritonsillar Infections”. The Laryngoscope 2015 May 6. [Epub ahead of print] Grischkan JM, Garrett MR, Karanfilov B, Elmaraghy CA, Jatana KR. Radiographic anatomical findings and clinical correlates in pediatric periorbital infections. International J Otorhinolaryngology 2015 Jan;2(1):1-5. Yoo, J; Yu, J; Kaka, A; Pan, Q; Kumar, P; Kumar, B; Zhang, J; Mazar, A; Teknos, TN; Kaur, B; Old, MO, “ATN-224 enhances antitumor efficacy of oncolytic herpes virus against both local and metastatic head and neck squamous cell carcinoma”. Molecular ThearpyOncolytics. Vol. doi:10.1038/mto.2015.8, doi:10.1038/mto.2015.8. 2015. Kumar B., Yadav A., Lang J.C., Teknos T.N. and Kumar P*. Suberoylanilide hydroxamic acid (SAHA) reverses chemoresistance in head and neck cancer cells by targeting cancer stem
page I 10
cells via the downregulation of nanog. 2015, Genes and Cancer, 6(3-4), 169-181. Saunders ND, Nichols SD, Antiporda MA, Johnson K, Walker K, Nilsson R, Graham L, Old M, Klisovic RB, Penza S, Schmidt CR., “Examination of unplanned 30-day readmissions to a comprehensive cancer hospital.”. J Oncol Pract. Vol. 2, 177-81. 2015. Dziegielewski PT, Durmus K, Ozer E. Transoral robotic surgery for the excision of base of tongue vascular lesions. Head Neck. 2015 Mar 9. doi:10.1002/hed.24029. [Epub ahead of print] PubMed PMID: 25752267. Zhang, M; Piao, L; Datta, J; Lang, JC; Xie, X; Teknos, TN; Mapp, AK; Pan, Q, “miR-124 regulates the epithelialrestricted with serine box/epidermal growth factor receptor signaling axis in head and neck squamous cell carcinoma”. Molecular Cancer Therapeutics. Vol. pii: molcanther.1071.2014, pii: molcanther.1071.2014. 2015. Yarlagadda BY, Deschler DG, Rich DL, Lin DT, Emerick KS, Rocco JW, Durand ML. Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project. Head Neck. 2015 Jan 12. doi: 10.1002/hed.24005. Puram SV, Yarlagadda BB, Sethi R, Muralidhar V, Chambers KJ, Emerick KS, Rocco JW, Lin DT, Deschler DG. Transfusion in Head and Neck Free Flap Patients: Practice Patterns and a Comparative Analysis by Flap Type. Otolaryngol Head Neck Surg. 2015 Jan 27. Mroz EA, Tward AM, Hammon RJ, Ren Y, Rocco JW. Intra-tumor Genetic Heterogeneity and Mortality in Head and Neck Cancer: Analysis of Data from The Cancer Genome Atlas. PLoS Med. 2015 Feb 10;12(2):e1001786. Dillon MT, Adunka OF, Anderson ML, Adunka MC, King ER, Buchman CA, Pillsbury HC. Influence of age at revision cochlear implantation on speech perception outcomes. JAMA Otolaryngol Head Neck Surg 2015, Epub Jan 22.
2015 AWARDS AND RECOGNITIONS Benninger MS. Manzoor N. Ruda JM. “Short and long term outcomes after silastic medicalization laryngoplasty: Are arytenoid procedures needed?.” Voice. Vol. 29, no. 2. (Mar 2015): 236-40. Campbell RG, Prevedello DM, Ditzel Filho LF, Otto BA, Carrau RL. Contemporary Management of Clival Chordomas. Curr Opin Otolaryngol Head Neck Surg. 2015 Apr. Ditzel Filho LF, Prevedello DM, Jamshidi AO, Dolci RL, Kerr EE, Campbell R, Otto BA, Carrau RL. Endoscopic Endonasal Approach for Removal of Tuberculum Sellae Meningiomas. Neurosurg Clin N Am. 2015 Jul. PMID: 26141355. Hauser L, Chiang T. “The Acute Pediatric Airway.” ENT Secrets, 4e. 324-331, 2015. Sitapara Jigar B, Mahida Justin B, McEvoy Timothy P, Elmaraghy Charles A, Deans Katherine J, Minneci Peter C, Grischkan JM. “Using the MaxillaryNasal Angle to Evaluate Congenital Nasal Pyriform Aperture Stenosis.” JAMA Otolaryngology- Head & Neck Surgery. Vol. epub ahead of print, (Apr 2015): 1. Essig GF, Porter K, Schneider D, Walz PC, et al. Fine needle aspiration and medullary thyroid carcinoma: the risk of inadequate preoperative evaluation and initial surgery when relying upon FNAB cytology alone. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2015;19(6): 920-927 Beyea JA, Moberly AC. Squamous cell carcinoma of the temporal bone. Otolaryngologic Clinics of North America, 48:281-292, 2015. Novotny, L.A., Clements, J.D., Bakaletz, L.O. (2015). Therapeutic transcutaneous immunization with a bandaid vaccine resolves experimental otitis media. Clin Vaccine Immunol, 22(8):867-874. PMCID: PMC4519716.
Dr. Amit Agrawal; Dr. Brad deSilva; Dr. L. Arick Forrest; Dr. Aaron Moberly; Dr. Matthew Old; Dr. Bradley Otto; Dr. Enver Ozer; Dr. Theodoros Teknos Ranked within the top 10% nationally for patient satisfaction Oliver Adunka, MD Honorable Mention, Clinical Research ‘Round window electrocochleography before and after cochlear implant electrode insertion’ Triological Society Thesis Lauren Bakaletz, PhD • Appointed to and serving on the advisory board for the National Institutes of Health, Host Interactions with Bacterial Pathogens (HIBP) Study Section • Invited and serving as review editor on the editorial board for the journal Frontiers in Immunology Ricardo Carrau, MD, Enver Ozer, MD & Ted Teknos, MD Newsweek’s Cancer 2015 “Best Doctors” List Derek Houston, PhD Appointed and serving as an associate editor of the journal Language and Speech Kris Jatana, MD Received Ellen M. Friedman Foreign Body Award, American Broncho-Esophagological Association, PI for project
• Model Committee Award for Distinguished Service to the American Academy of Otolaryngology – Head and Neck Surgery’s Allergy, Asthma and Immunology Committee • Appointed to the WIO Awards Committee as a voting member and reappointed as a voting member to the AAO-HSN Allergy, Asthma and Immunology Committee through September 2017 • Serving as lead chair for Home Study Course Trauma and Critical Care Section for the AAO-HSNF Nolan Seim, MD Received an AAO-HNSF Humanitarian Travel Grant for mission work in Honduras Ted Teknos, MD • Founding editorial member and associate editor, World Journal of Otorhinolaryngology – Head and Neck Surgery • Founding Fellow, International Academy of Oral Oncology • American Head & Neck Society Representative to the American College of Surgeons Board of Governors • Chair of external committee for the external review of the Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, 2015
Quintin Pan, PhD • Keynote speaker and session co-chair at 1st International Symposium on Tumor-Hosted Interactions in Head and Neck Cancer held in Essen, Germany • Faculty, American Head and Neck Society 2015 Translational Research Meeting Hafiz Patwa, MD Poster “Far Medical Transoral Approach to the Infratemporal Fossa: An Anatomic Feasibility Study for a Multi-Portal Approach to the Infratemporal Fossa” voted 2nd best at the 2015 NASBS meeting Minka Schofield, MD
page I 11
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
NEW HOUSE STAFF: Fellows
NEW HOUSE STAFF: Residents
Pediatric Otolaryngology
Head and Neck Oncology
Abdullah Ibrahim Aljasser, MD
James Bekeny, MD
Otolaryngology PGY-1 Residents
Hometown: Riyadh, Saudi Arabia
Hometown: Westlake, Ohio
Jaron Densky, MD
Medical School: King Saud University College of Medicine
Undergrad: Northwestern University
Hometown: Morristown, TN
Residency: Saudi Board and King Saud University ORL HN Joint Program
Medical School: Vanderbilt University
Clinical Experience: Pediatric Otolaryngology, King Abdulaziz University Hospital; Riyadh, Saudi Arabia
Hobbies/Interests: Travel, outdoor activities, eating, fitness
Hobbies/Interests: Fishing, squash, volunteering
Facial Plastic & Reconstructive Surgery
Skull Base Surgery
Residency: Vanderbilt University
Hobbies/Interests: playing pretty much every sport, fishing, kayaking, hiking, being outdoors
Alexander Rock, MD
Hometown: Halifax, Nova Scotia, Canada
Hometown: Salt Lake City, UT
Hometown: Beirut, Lebanon Medical School: Saint Joseph University School of Medicine
Graduate: MSc in cytogenetics, University of Guelph
Residency: University of Miami/ Jackson Memorial Hospital program
Medical School: Dalhousie University, Halifax NS
Hobbies/Interests: Tennis, snowboard, soccer, swimming
Medical School: University of Tennessee College of Medicine
Matthew Brace, MD
Undergrad: BSc honours in biomedical science, University of Guelph
Ralph Abi-Hachem, MD
Undergrad: Bachelor of Science in chemistry, University of Tennessee
Residency: Dalhousie University, Halifax NS Hobbies/Interests: Spending time with my wife and playing with my three daughters, listening to music, collecting vinyl records, playing my guitars, surfing the Nova Scotian waves
Otology, Neurotology and Cranial Base Surgery
Tom Zhou, MD Hometown: Minneapolis, MN Undergrad: Bachelor of Arts in mathematical methods in the social science and economics, Northwestern University Medical School: University of Minnesota Hobbies/Interests: long-distance running, repairing cars, working on home improvement projects, collecting beer bottles and rooting for the Twins, Vikings and Bulls
Undergrad: University of Utah Medical School: The George Washington University Hobbies/Interests: cycling, triathalons, skiing, hiking, camping
Jeffrey Straub, MD Hometown: Prairie Village, KS Undergrad: Bachelor of Science in biochemistry, Tulane University Medical School: University of Kansas School of Medicine Hobbies/Interests: singing, piano, beatboxing, tennis, soccer, pingpong, international cuisine, other languages/cultures, chess, card games, trivia
Michael Harris, MD Hometown: Milwaukee, WI Undergrad: Carleton College Medical School: Medical College of Wisconsin Residency: Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine Hobbies/Interests: Scuba, hot pepper growing, jazz guitar page I 12
page I 13
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
ESTEEMED PHYSICIAN, RESEARCHER AND EDUCATOR RETIRES AFTER 44 YEARS AT OHIO STATE New programs, endowment honor Dr. David E. Schuller’s legacy of service The David E. Schuller, MD Professorship for Patient Compassion Dr. Schuller is beloved among the thousands of patients and their families who, over the course of 44 years, turned to him for lifesaving head or neck cancer treatment.
David E. Schuller, MD, retired in June 2015 after devoting more than four decades to The Ohio State University’s College of Medicine, Wexner Medical Center and Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James). His friends, colleagues, and former students and patients decided to pay tribute by establishing several new initiatives in his honor–including a $10 million endowed fund. The David E. Schuller, MD Endowment for the Department of Otolaryngology – Head and Neck Surgery Dr. Schuller served 21 years as chair of Ohio State’s Department of Otolaryngology – Head and Neck Surgery. Thanks to his leadership, today the department enjoys a national reputation for outstanding patient care and research, including recognition by U.S.News & World Report as one of the top ear, nose and throat programs in the country. page I 14
“Dr. Schuller ushered in an era of modern otolaryngology to Ohio State,” says Ted Teknos, MD, current department chair and holder of the David E. Schuller, MD, and Carole Schuller Chair in Otolaryngology. “When he took over the department, it was small in both size and scope, comprised only of generalists. He created the divisions that exist today after hiring the department’s first subspecialists, including neurotologists, laryngologists and head and neck oncologists.” A new endowed fund named in Dr. Schuller’s honor was established with the goal of raising $10 million. The endowment will support programmatic and research efforts within the Department of Otolaryngology – Head and Neck Surgery. More than $750,000 has been raised so far, including $300,000 from the department that will continue as an annual gift until the funding goal has been reached.
The Walter Family Foundation will fund the David E. Schuller, MD Professorship for Patient Compassion, which acknowledges the kind, thoughtful care Dr. Schuller is known for. This new professorship will help enhance caregiver training by teaching skills that are essential to providing compassionate patient care. The David E. Schuller, MD Laboratories Throughout his career, Dr. Schuller devoted much of his time to research. His efforts to better understand the development and progression of head and neck cancers, along with his ongoing evaluation of new therapeutic strategies and surgical approaches, helped inform his clinical practice and ensured his patients had access to the latest evidencebased treatments. Now, a new generation of oncology physicians and scientists may make breakthrough discoveries that are linked to Dr. Schuller’s legacy. Laboratory space in the Tzagournis Building on the Wexner Medical Center campus has been named the David E. Schuller, MD Laboratories.
James Leadership Society Induction In addition to his many years leading the Department of Otolaryngology – Head and Neck Surgery, Dr. Schuller and his wife Carole were instrumental in helping develop and grow the OSUCCC – James one of the nation’s leading cancer centers. Dr. Schuller served as the first director of the original James Cancer Hospital when it opened in 1990,
and led funding and development efforts for the new 21-story James Cancer Hospital and Solove Research Institute that opened in December 2014. The couple has been inducted into the James Leadership Society, which recognizes those who have demonstrated leadership to Ohio State’s cancer program through exceptional public service, philanthropic activity or both. Membership in this Society is the
highest recognition bestowed upon supporters of the OSUCCC – James.
“The impact Dr. Schuller has had on Ohio State can’t be measured,” says Dr. Teknos. “We’ll certainly miss seeing him on campus, but it goes without saying that his retirement is well deserved. We wish him all the best as he starts this new chapter in life.”
OHIO STATE APPOINTS NEW RESEARCH FACULTY By studying the wonders of the nose, Dr. Kai Zhao plans to improve treatment options for people with nasal disorders When Kai Zhao, PhD, joined the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University College of Medicine in August 2015, he came prepared to help Ohio State rhinologists develop breakthrough treatments for nasal sinus disease. Dr. Zhao brings with him a $1.5 million, four-year grant from the NIH (R01DC013626) to study the relationship between nasal airflow obstruction and smell loss. He also brings his unique credentials– including a PhD in bioengineering with a focus on respiratory biofluid mechanics, and experience as a scientist at the Monell Chemical Senses Center in Philadelphia, one of the few institutions in the world dedicated to smell research. “I became fascinated with nasal function during my doctoral research, when I realized nobody was really doing 3-D, computational modeling of the nose,” says Dr. Zhao. “The nose and its roles
in breathing and smell are complicated and challenging, and I wanted to better understand those functions from an engineering perspective.” Over time, Dr. Zhao became drawn to the clinical implications associated with nasal physiology. He says, “A collaboration between ENT surgeons and a bioengineer may lead to targeted new ways of treating patients, if we can create a methodology that validates symptoms and their causes.” Dr. Zhao and his team will evaluate whether computational fluid dynamics modeling can help physicians predict surgical outcomes in patients with smell loss thought to be caused by nasal obstruction. If surgeons can confirm whether a patient’s loss of smell truly is caused by blocked airflow, versus a problem with the sensory nerves in the nose, the implications are enormous and range from refined treatment options to cost
savings achieved by eliminating unnecessary surgeries. “I’m excited to embark on this next phase of my career at Ohio State,” says Dr. Zhao. “I was looking for a place that would allow me to get more involved in patient care, and the clinicians here are eager to participate in research. It’s a winwin relationship, where ultimately patients will benefit.”
page I 15
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
NEW ENDOWED CHAIR AT OHIO STATE BOLSTERS HEAD AND NECK CANCER RESEARCH Dr. James Rocco aims to unlock the secrets of head and neck cancer origin
James Rocco, MD, PhD, is one step closer to predicting treatment response and outcomes in patients with head and neck cancer, thanks to philanthropic funding that will support his research efforts at The Ohio State University Wexner Medical Center.
Dr. Rocco says his diverse background in electrical engineering, biophysics, otolaryngology and genomics–combined with a lifelong love of science– has allowed him to approach cancer research from a unique perspective. His attempts to understand, from a molecular level, why some head and neck cancer patients fail radiation or chemotherapy treatment have earned him two active NIH grants, including R01 funding (R01DE022087) to study the Bcl-2 “anti-death” protein as a biomarker for prognosis in patients with oropharyngeal squamous cell carcinoma.
Along with his recent appointment as director of the Division of Head and Neck Oncology, Dr. Rocco is holder of the Mary E. and John W. Alford Research Chair in Head and Neck Cancer. The $2 million endowed chair will allow Dr. Rocco and his team to explore promising ideas that have implications not just for head and neck cancer, but for other tumor types including breast cancer.
“Because of Dr. Rocco’s most recent discoveries related to intra-tumor heterogeneity, we’re beginning to use genomic data to determine which tumors are likely to respond to therapy versus those that aren’t,” says Ted Teknos, MD, professor and chair, Department of Otolaryngology – Head and Neck Surgery. “The extra funding provided by the Alford Research Chair will allow him to continue down this path–and it may lead to targeted new therapies and higher cancer cure rates.”
Building on past achievements Prior to joining Ohio State in May 2015, Dr. Rocco spent more than 15 years in various clinical, research and teaching roles at the Massachusetts Eye and Ear Infirmary (MEEI), Massachusetts General Hospital (MGH) and Harvard Medical School. In addition to maintaining a busy practice as senior surgeon in a multi-disciplinary head and neck cancer clinic, he led the combined head and neck cancer research program at MEEI and MGH.
“As federal funding gets tighter, endowed chairs provide an invaluable way for scientists to explore new ideas that might not otherwise earn support,” says Dr. Rocco. “With certain projects, we’re confident that even though the idea is still in the discovery phase today, it has the potential to make a big impact in the future. The generosity of the Alford family allows us to get some of these key projects off the ground.” The first of many new endeavors One such project involves a tumor suppressor gene called p16, which is almost always “turned off” in patients diagnosed with cancer. Dr. Rocco and his team hope to learn how to “turn on” the p16 gene, as its protective properties are able to stop cancer cells from growing.
“We knew there was one protein from an adenovirus that could turn on p16, so we broke the protein into four pieces and found out which specific piece turned on the gene,” says Dr. Rocco. “This allowed us to identify CtBP, or C-terminal binding protein as a critical regular of p16 expression. What we need to do next is figure out when the gene gets turned on. In other words, how does the cell know that a cancer has started growing? We think CtBP regulation is a critical piece of the puzzle.” Dr. Rocco says the funding provided by the Alford Research Chair will be a great way for him and his team to take that work to the next level. “If we can identify how p16 is regulated, we will gain insights that could be key to effectively treating a tumor–or preventing it from occurring in the first place.”
Accelerating new projects Dr. Rocco notes there were many reasons he joined the faculty at Ohio State, including the ability to provide care in a high-volume program and the chance to serve in a leadership role. He also appreciates the opportunity to help further grow the head and neck cancer research program with the aid of an endowed chair.
“Because of Dr. Rocco’s most recent discoveries related to intratumor heterogeneity, we’re beginning to use genomic data to determine which tumors are likely to respond to therapy versus those that aren’t,” says Ted Teknos, MD Front row left to right: Barb Cantlin, James Rocco, MD, PhD, April Turjanica Back row left to right:Theodoros Teknos, MD, Mike Cantlin, Caroline Rocco, Ron Alford, Michael Caligiuri, MD
page I 16
page I 17
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OHIO STATE DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2016
GRATEFUL COUPLE DONATES TO ADVANCE RESEARCH FOR HEAD AND NECK CANCER Cancer survivor Ed Merrell credits Ohio State for saving his life. Over 27 years ago, Ed Merrell received oral cancer treatment at Ohio State. This year, Ed and his wife, Bobbi, made a $500,000 estate gift to The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in support of head and neck research. “I owe my life to them. What more can I say?” says Ed, now 72, explaining his decision to give back to the medical center where he underwent a total glossectomy, neck dissection and major reconstruction followed by radiation therapy. Not a smoker nor much of drinker, Ed didn’t seem to display any of the typical oral cancer risk factors. “It was a two-and-a-half-year odyssey trying to figure out what was wrong with me,” Ed remembers. Headaches, earaches, neck aches and occasionally blood in his mouth sent him to four different ENTs without a diagnosis before he arrived at the office of Dr. David R. Kelly, then assistant professor at Ohio State. Dr. Kelly discovered an octopus-type growth at the base of Ed’s tongue, and a biopsy confirmed a diagnosis of squamous cell carcinoma of the tongue. Dr. Kelly performed Ed’s surgery, including a reconstructive chest flap procedure, in which he clipped
Ed’s left pectoral muscle, bringing it up through his throat to fill the floor of his mouth and serve as a new tongue. The years that followed were spent in various therapies—relearning to swallow, eat, drink and speak without his tongue and to move his left arm, which was impaired due to the clipped pectoral muscle and the neck dissection. A prosthodontist at Ohio State created two specially fitted oral prosthetics for him—one for eating and one for talking. Ed says he’s thankful that today he eats and drinks anything he wants, but it was a long road. The most difficult thing was relearning to swallow liquid, especially water because of its low viscosity, he says. It took months of practice in front of a mirror, choking and coughing, but he finally taught himself to swallow water. With time, he also relearned to eat solid food—using swizzle sticks. His oral prosthetic device serves as a platform for the food to sit on. Ed uses the swizzle stick to push the food around and then to move it to the back of his mouth when he’s ready to swallow. As part of the reconstruction, Dr. Kelly had placed part of the tip of his original tongue on the pectoral muscle, so Ed can still taste food. And surprisingly, Ed notes, the radiation didn’t destroy his saliva glands. Despite these tremendous challenges, Ed has overcome many of his handicaps and been successful. He still runs his own company doing real estate appraisal in the eminent domain arena. He regularly travels throughout the state appraising properties for public projects. He’s called upon for depositions and to testify in court as an expert witness—a communication feat that once would have seemed impossible for him.
Bobbi and Ed Merrell page I 18
Today, Ed and Bobbi are passionate Buckeyes. Ed sits on the board of the Joan Levy Bisesi Fund for Head and Neck Oncology Research, an endowment fund for research at the James. He’s also a dedicated member of Ohio State’s head and neck cancer support group, where he serves as an inspiration to other patients and survivors.
As for his estate gift, Ed says he’s been thinking about it for many years. “I’m very fortunate that I may be the poster boy for what happens when everything goes right,” Ed says. “I’m so thankful for Ohio State. They gave me an education
(class of 1965), then they saved my life. The money I’m giving will be used for head and neck cancer research. I have the greatest respect for these people who are working to solve the cancer problem, and I’m happy to do anything I can to facilitate that.”
OHIO STATE APPOINTS NEW RESEARCH FACULTY Derek Houston, PhD, aims to improve speech-language therapy for children with hearing loss
Seizing an opportunity to transition his research into clinical practice, Dr. Derek Houston joined the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University College of Medicine in July 2015. Working side-by-side with clinicians, including audiologists and speech-language therapists, he continues to investigate how young children with assistive hearing devices learn language differently than their peers with normal hearing. Dr. Houston’s quest to understand language development in children with hearing impairment began in 1999 while he was finishing his PhD in cognitive psychology at Johns Hopkins University. His research efforts caught the attention of a colleague at Indiana University (IU), who contacted Dr. Houston to discuss an emerging population that had not yet been studied–deaf babies who, for the first time, were allowed to receive a Cochlear implant during infancy. Dr. Houston was so intrigued, he joined the research team at IU’s School of Medicine. There, he created the world’s first lab dedicated to investigating speech perception and early language development in infants with Cochlear implants. Fifteen years later, he brings new insights and translational research funding to Ohio State, where he’s collaborating with clinicians from Nationwide Children’s
Hospital. Together, they’re studying how children with hearing loss develop the ability to learn words, in part through an NIH-funded project titled Infant-directed Speech and Language Development in Infants with Hearing Loss (R01DC008581). “Our long-term research indicates that the earlier an infant receives a Cochlear implant, the better they can learn associations between what they hear and what they see, which is critical to learning words and developing a vocabulary,” says Dr. Houston. “Our next step is to examine the factors that play into a child’s ability to learn words.” One of these factors, or “inputs,” is whether parents speak to their infant directly and frequently. According to Dr. Houston, it appears that the more parents speak to their children at an early age, especially during critical learning periods, the greater their child’s ability to process speech. He hopes to discover how these inputs influence children with a Cochlear implant or hearing aids, particularly their capacity for word-learning and language development. Dr. Houston says he’s eager to build a multidisciplinary translational research program that spans Ohio State and Nationwide Children’s Hospital. “What attracted me to Ohio State is its energy and enthusiasm for research, and their reputation for combining that research with clinical practice,” he says. “Here I’ll be able to develop ways to give parents evidence-based feedback about the various inputs they provide their children, and how those inputs impact their child’s language development.”
page I 19
FIRST CLASS P R E S O R T U. S . P O S TAG E P
The Ohio State University Wexner Medical Center Department of Otolaryngology – Head and Neck Surgery Eye and Ear Institute 915 Olentangy River Road, Fourth Floor Columbus, OH 43212 614-366-3687 ent.osu.edu
©2015 The Ohio State University Wexner Medical Center UHOS20150164
A
I
D
Columbus, Ohio Permit No. 711