Innovating since 1914
years
THE DEPARTMENT OF OTOLARYNGOLOGY 1914 - 2014
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
OTOLARYNGOLOGY REPORT WINTER 2014
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
A note from the Department of Otolaryngology 2013 has been an eventful year in the Department of Otolaryngology at Ohio State. •
We welcomed Dr. Aaron Moberly, who strengthens our neurotology division with his expertise in cochlear implantation, Dr. Prashant Malhotra, who leads our pediatric hearing program at Nationwide Children’s Hospital, and Teresa Matzke, CNP, who adds to the excellent care of our sinus and allergy division.
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We celebrated a patient satisfaction score in the 90th percentile by Press Ganey as we continue our work toward a 99th percentile goal.
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Our head and neck division was selected as the head and neck tissue source site for the Genome Atlas Project, thanks to the leadership of Dr. James (Jas) Lang.
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Dr. Kris Jatana was featured in a lead story on Yahoo for calling attention to the hazards of the button battery.
• Dr. Subinoy Das was the 2013 recipient of the prestigious Edmund Prince Fowler Award from the Triological Society for his thesis, “Improving patient care via a proteomics based diagnostic test for microbe-specific detection of chronic rhinosinusitis.” •
Dr. Greg Wiet received the College of Medicine Innovation Excellence Award for his role in developing the temporal bone surgical simulator
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Dr. David E. Schuller received the College of Medicine Distinguished Professor Award for his tremendous career of service and record of accomplishments at Ohio State.
All this and much more we share with you in this edition of our Otolaryngology Newsletter.
Read about our Comprehensive Cranial Base Surgery Center’s contributions to destination medicine; Dr. Arick Forrest’s work to protect the voices of vocal talent; partnerships, publications and promising discoveries; and historical highlights of ear, nose and throat care at Ohio State. We hope you’ll enjoy this update and wish you all the best for the New Year. Go Bucks!
OSU DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2014
DR. D. BRADLEY WELLING RESEARCHES NONSURGICAL TREATMENT FOR NF2 WITH DOD GRANT D. Bradley Welling, MD, PhD, chair of the Department of Otolaryngology – Head and Neck Surgery and professor of Otolaryngology at The Ohio State University Wexner Medical Center, has been focused on the devastating effects of neurofibromatosis type 2 (NF2) on patients for more than 20 years — loss of hearing, balance and facial nerve control. “The tumors associated with this disease simply need better treatment,” he says. Treatment options for NF2associated tumors, particularly vestibular schwannomas and meningiomas, include surgery and radiation. But both carry risks. Before 2009, no clinical trials existed for NF2. Today, there are nine, and Ohio State’s Wexner Medical Center is involved in four of them. “In collaboration with Dr. LongSheng Chang, of Nationwide Children’s Hospital, and Dr. ChingShih Chen, of Ohio State’s Medicinal Chemistry and Pharmacognosy group, we have had increasing success in identifying drugs with activity against NF2-related tumors,” says Dr. Welling. “Recently, a drug called AR-42 has moved from the lab into clinical trials.” Ohio State’s Wexner Medical Center has done preclinical studies of AR-42, a histone deacetylase inhibitor, in mice and cell cultures and is conducting a phase I study with multiple myeloma, lymphoma, leukemia and some solid tumors. These studies are led by Amir Mortazavi, MD, in the Division of Medical Oncology. “Now, our hope is that AR-42 will block tumor pathways in vestibular
schwannoma and meningioma tumors in patients,” says Dr. Welling. Dr. Welling has been awarded a Department of Defense (DOD) grant for three years to study the effects of AR-42 on the growth of those tumors. Participants will receive AR42 for three weeks, and their tumors will be surgically removed and studied to determine the effects of the drug on the tumors. In addition to Ohio State, participating centers are Johns Hopkins, Mayo Clinic and Stanford University. “We hope to learn if AR-42 is getting into the tumors in sufficient concentration and hitting the desired targets to stop tumor growth,” says Dr. Welling. “While NF2-associated tumors are relatively rare, the corresponding sporadic tumors are not so rare. We hope that treatments being designed for NF2 may be applicable to those more common tumors. A drug that would affect NF2 and sporadic vestibular schwanommas and meningiomas would greatly reduce morbidity and mortality. “I see what these patients go through and how their disease negatively affects their quality of life. It will be a happy day when they have effective nonsurgical treatment options. Our translational research is a step in the right direction. The next step will be to have phase II trials.” This grant is Dr. Welling’s second current DOD grant. His first DOD grant studies the regrowth of perforated tympanic membranes. He also will co-chair the Children’s Tumor Foundation 2014 NF Conference in Washington, D.C., in June.
D. Bradley Welling, MD, PhD
“I see what these patients go through and how their disease negatively affects their quality of life. It will be a happy day when they have effective nonsurgical treatment options...”
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DR. QUINTIN PAN JOINS EDITORIAL BOARD OF CANCER RESEARCH
About Dr. Pan
Quintin Pan, PhD, has been appointed to the editorial board of Cancer Research. Dr. Pan is an associate professor in The Department of Otolaryngology at the Ohio State University Wexner Medical Center and research director of the Head and Neck Oncology Program at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). Cancer Research is the most frequently cited cancer journal in the world. Editorial board members are considered experts in the field and appointed by invitation only. As an editorial board member, Dr. Pan will review and assess the quality and novelty of cancer-focused papers submitted for consideration for publication in the journal.
“I look forward to my new post at Cancer Research. This appointment has enhanced my reputation and visibility and will afford me the platform to discuss the exciting new developments in the head and neck cancer field. page I 4
Dr. Pan’s lab develops new drugs for head and neck cancer by understanding genetic alterations that occur in cancer cells, studying genes that are hyperactive and designing drugs to inhibit these genes’ activities. In the last two years, he and his colleagues have published four high-impact manuscripts in publications including Oncogene and Molecular Therapy. The researchers have: • Studied the role of miR-107 in head and neck cancer cells and were the first to report that the loss of miR-107 promotes head and neck cancer development. • Used a nanoparticle delivery system to restore miR-107 in head and neck cancer cells and successfully blocked the growth of head and neck cancer cells in vitro and in preclinical animal models. • Discovered a mechanism by which human papillomavirus (HPV) causes head and neck cancer — a protein produced by the virus inactivates the host p53 tumor suppressor gene — and designed a therapeutic strategy to block this mechanism and functionally reactivate p53. • Identified a biochemical pathway in cancer stem cells that is essential for promoting head and neck cancer via the protein Nanog.
As a postdoctoral fellow in translational oncology at the University of Michigan Medical School, Dr. Pan was focused on breast cancer. His postdoctoral mentor, a breast cancer oncologist, was working with head and neck cancer surgeon Theodoros Teknos, MD, then also at Michigan. Now at Ohio State, Dr. Teknos urged Dr. Pan to switch his research focus to head and neck cancer. Dr. Pan has transitioned to head and neck cancer with great success. His research has been funded through agencies such as the National Cancer Institute, American Cancer Society, Flight Attendant Medical Research Institute, Joan Bisei Fund for Head and Neck Oncology Research and Mary E. and John W. Alford Cancer Research Endowment Fund. “Innovative research in head and neck cancer has been limited because it is a less common type of cancer, but our work has helped to advance the field,” says Dr. Pan. “I look forward to my new post at Cancer Research. This appointment has enhanced my reputation and visibility and will afford me the platform to discuss the exciting new developments in the head and neck cancer field.” Dr. Pan is also on the editorial boards of BioMed Research International, Anaplastology, ISRN Oncology and American Journal of Otolaryngology.
NEW PROVIDERS TO OHIO STATE’S DEPARTMENT OF OTOLARYNGOLOGY 2013-2014 Prashant Malhotra, MD, assistant professor of Otolaryngology, joins OSU Otolaryngology and Nationwide Children’s Hospital as the newest pediatric otolaryngologist. Dr. Malhotra received his medical degree from Case Western Reserve University, completed an internship in General Surgery at Thomas Jefferson University Hospital and completed his residency in Otolaryngology - Head and Neck Surgery at Thomas Jefferson University Hospital and Alfred I. DuPont Hospital for Children. Dr. Malhotra was a fellow and clinical instructor of Pediatric Otolaryngology at Lucile Packard Children’s Hospital, Stanford University. Board certified by the American Board of Otolaryngology, he comes to us from Cleveland Clinic where he was a pediatric surgeon in the Hearing Implant Program and a provider for the Vascular Malformations Clinic, CleftCraniofacial Clinic and Pediatric Hearing Management Clinic. We are pleased to welcome him aboard.
Prashant Malhotra, MD
Teresa Matzke, CNP, graduated from The Ohio State University in 2004 with a Master of Science in Nursing. She became certified as a Family Nurse Practitioner, working four years in a rural health clinic in North Carolina. She went on to work at a family medicine center in North Carolina for another four years before returning to Ohio. Teresa is board certified by the American Academy of Nurse Practitioners and has clinical interests in sinusitis and allergy. She is a great addition to the team. Aaron Moberly, MD, is a native of Indianapolis and completed his undergraduate degree in Biochemistry at Purdue University in West Lafayette. He obtained his medical degree from Indiana University School of Medicine, where he was ranked first in his medical school class, and completed residency training in Otolaryngology - Head & Neck surgery at Indiana University in Indianapolis. Upon completion of his residency training, he was awarded a twoyear fellowship in Neurotology in the Department of Otolaryngology - Head & Neck Surgery at The Ohio State University Wexner Medical Center under the guidance of D. Bradley Welling, MD, PhD, and Edward Dodson, MD. Dr. Moberly is board certified in Otolaryngology and holds privileges at The Ohio State University Hospital, The James Cancer Hospital and Solove Research Institute and Nationwide Children’s Hospital. The Department welcomes him as the newest assistant professor in Otology/Neurotology and Cranial Base Surgery.
Teresa Matzke, CNP
Aaron Moberly, MD, PhD
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BUTTON BATTERIES — MAKING STRIDES IN REDUCING HAZARDS TO PEDIATRIC PATIENTS A remote control is left on the family room coffee table. A curious toddler pulls out the unprotected button battery and swallows it. The clock starts ticking. Severe injury can occur within two hours without emergency medical care. Scenarios like this are reported at least 3,500 times a year in the United States. Incidence of severe injuries is on the rise as more battery-powered electronics are available on the consumer market. Children have access to button batteries in these manners: •
Obtain battery from an electronics device: 61.8%
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Battery is left sitting out or discarded: 29.8%
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Obtain battery from battery packaging: 8.2%
Dr. Jatana Is National Leader in Button Battery Injury Prevention Kris Jatana, MD, assistant professor of Otolaryngology – Head and Neck Surgery at The Ohio State University Wexner Medical Center and a pediatric otolaryngologist at Nationwide Children’s Hospital, is nationally recognized for expertise in button battery injury. He serves on the national Button Battery Task Force, which was established to pursue a multifaceted approach to injury prevention. Affiliated primarily with the American Academy of Pediatrics and American Broncho-Esophagological Society, Task Force membership includes representatives from medicine, public health, industry, poison control and government. Dr. Jatana is the chair of the Task Force’s Industry Collaboration and Redesign Subcommittee. “We work with the electronics industry to make safer battery compartments and safer battery packaging,” says Dr. Jatana. “Increasing awareness is important, but knowledge isn’t enough to prevent serious injuries. We need to reduce the potential hazard through product redesign.”
Dr. Jatana says the Task Force has made progress. “Electronics manufacturers have been cooperative in helping to mitigate this hazard,” he says. “Voluntary efforts on the part of the button battery and electronics manufacturers have led to warning labels on batteries, safer packaging that allows access to only one battery at a time and improved security standards for battery compartments.”
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Additionally, in collaboration with the National Capital Poison Center, Dr. Jatana is researching button battery injuries that result in vocal cord paralysis. He was the first author on a recent national task force consensus statement on button battery injury and has presented on a button battery hazards expert panel at the U.S. Consumer Product Safety Commission. Dr. Jatana’s work has attracted national attention, including media interviews and consultant and speaker opportunities around the country. He has also helped author educational materials on button battery injury prevention.
Stronger Button Batteries Cause More Severe Injury “The batteries used today are much stronger than batteries in the past. The 3V lithium batteries of 20 millimeters are associated with more severe injuries because they are powerful and large enough to get stuck in the esophagus,” shares Dr. Jatana. Also, button batteries can be inserted in the nasal cavity or ear canal or ingested. Lodgment in the upper esophagus can lead to severe morbidity or mortality. The electrical current generated around the battery when it is in contact with wet tissue causes an alkaline-like tissue burn, which can lead to tissue liquefaction and necrosis. Worse, batteries can erode into the aorta and cause massive hemorrhage and death. “Otherwise healthy children can die from what I consider a preventable hazard. Other patients may develop serious complications, including esophageal perforation, tracheoesophageal fistula, esophageal stricture or vocal cord paralysis,” says Dr. Jatana. “It’s imperative that children who ingest button batteries are transported to appropriate medical facilities without delay. Batteries that are lodged in the esophagus must usually be surgically removed. Afterward, children must be followed for several weeks to months, to ensure no delayed complications occur.” When he was a resident at The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital, Dr. Jatana saw his first cases of button battery ingestion.
“I was surprised by the extent of injury to the esophagus of a four-year-old boy in only two hours,” he says. “While that child recovered well, I have also cared for a young boy who required tracheostomy tube placement for bilateral vocal cord paralysis. I look forward to the day when severe injuries no longer occur.”
Blowgun Dart Aspiration Dr. Jatana has also garnered national media attention for another foreign body topic — accidental aspiration of homemade blowgun darts. He was an author of a paper published in Pediatrics titled, “The Internet, Adolescent Males, and Homemade Blowgun Darts: A Recipe for Foreign Body Aspiration.” Directions on how to make blowgun darts are available on the Internet. If aspirated, the needle-shaped metallic foreign bodies must be removed, but teen patients may be reluctant to reveal the cause of their injury. Withholding the information could lead to complications and death. The Pediatrics paper includes the largest number of cases to date.
Button-battery x-ray
DR. L. ARICK FORREST COLLABORATES ON VOICE MANUAL A laryngologist, a speech and language pathologist and a classically trained singer have combined forces to write The Owner’s Manual to the Voice: A Guide for Singers and Other Professional Voice Users. The book is written in easy-to-understand language and is a practical guide for those who depend on their voice or use it in their work — from a professional singer to a physician who cares for singers, from a C-suite executive to a person who sings at church on weekends. All three authors have ties to The Ohio State University. L. Arick Forrest, MD, professor in Ohio State’s Department of Otolaryngology – Head and Neck Surgery, is medical director of The Ohio State University JamesCare Voice and Swallowing Disorders Clinic and medical director of Ambulatory Services for the OSU Wexner Medical Center. Lead author Rachael Gates, DMA, has a doctorate in musical arts from the university, and co-author Kerrie Obert, MA, CCC/SLP, formerly practiced at Ohio State’s Wexner Medical Center. “I’ve specialized in voice disorders for more than 20 years and have treated touring singers, Broadway actors and other professional voice users,” says Dr. Forrest. “I have known Kerrie for 17 years and Rachael for more than 10 years. We collaborated on this book for more than four years. It represents our accumulated knowledge and experience. Any professional voice user — whether a singer, actor, broadcaster, lawyer, teacher, preacher or politician — can benefit from The Owner’s Manual to the Voice and become empowered to own their instrument and protect their voice.” The book covers anatomy, physiology, common vocal problems, vocal hygiene, age-proofing the vocal cords, questions to ask medical providers, medical treatments for vocal problems, pictures and video links. page I 7
ACTIVE RESEARCH FUNDING 2013 Susan Nittrouer, PhD
7/1/1994 – 2/29/2016
NIH/NIDCD
R01DC000633
NIH/NIDCD
R01DC006237
OSUCCC Viral Oncology Program (VOP) Research Award / OSUCCC
The Ontogeny of Segmental Speech Organization
Susan Nittrouer, PhD
9/1/2003 – 2/28/2015
Early Development of Children With Hearing Loss
Matthew Old, MD
1/1/2013 – Present
VOP ProgramEnhancement of Oncolytic Herpes Virus (34.5ENVE) Activity in Head and Neck Squamous Cell Carcinoma With Bortezomib
Quintin Pan, PhD & Co-Investigator Theodoros Teknos, MD 8/1/2008 – 5/31/2014 NIH/NCI
R01CA135096
Role of PKC in Oral Cancer
Tony Shahin, PhD
7/1/2009 – 6/30/2014
NIH/NIDCD
R03DC11168
8/1/2011 – Present
Seed grant, OSU Center for Cognitive Science
2/5/2010 – 2014
National Comprehensive Cancer Network
Development of Electrophysiological Auditory Response to Speech
Tony Shahin, PhD
Neural Mechanisms of Speech Segmentation
Theodoros Teknos, MD
Phase I Clinical Trial to Determine the Efficacy of Vorinostat in Oropharyngeal Cancer
Theodoros Teknos, MD & Quintin Pan, PhD James Lang, PhD 3/1/2011 – 4/30/2013
CCC RISE Award
Molecular Characterization of Invasive and Metastatic Head and Neck Cancer
Hua Hua Tong, MD
07/1/2008 – Present
Complement in S. Pneumoniae Otitis Media
D. Bradley Welling, MD, PhD
7/1/2013 – 6/30/2016
U.S. Department of Health and Human Services
Congressionally Directed Medical Research Program / Department of Defense
Exploratory Evaluation of AR-42 Histone Deacetylase Inhibitor in the Treatment of Vestibular Schwannoma and Meningioma
D. Bradley Welling, MD, PhD
9/30/2012 – 9/29/2016
Congressionally Directed Medical Research Program / Department of Defense
Fibroblast Growth Factor Regeneration of Tympanic Membrane Perforations
D. Bradley Welling, MD, PhD
8/1/2012 – 7/31/2013
AR-42-Induced Cell Cycle Arrest in Schwannoma and Meningioma Cells page I 8
NF Midwest
D. Bradley Welling, MD, PhD
12/1/2011 – 11/30/2013
Children’s Tumor Foundation
Development Fund
Novel Treatments for NF2-Associated Schwannomas and Meningiomas
D. Bradley Welling, MD, PhD
2/24/2011 – 1/23/2013
Advocure, Neurofibromatosis NF2 Research
Gregory Wiet, MD & Co-Investigator: D. Bradley Welling, MD, PhD
8/5/2011 – 07/31/2016
Development Fund
Virtual Temporal Bone Surgery: Defining and Translating Standardized Metrics
NOVEL RESEARCH IDENTIFIES POSSIBLE THERAPY FOR HEAD AND NECK CANCERS Novel research led by scientist Mozaffarul Islam, PhD, in the Head and Neck Oncology Program at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), has determined that the drug atorvastatin significantly reduces head and neck metastasis by inhibiting RhoC activity. This study, published in Oral Oncology (M. Islam et al., 2013. Atorvastatin inhibits RhoC function and limits head and neck cancer metastasis.), is the first to establish the potential role of this statin in head and neck cancer therapy, leading researchers to believe atorvastatin may be a low-risk adjuvant therapy to minimize metastases in aggressive forms of this cancer. This is a particularly important finding given the high mortality associated with head and neck cancers. As a next step, Dr. Islam and his colleagues in the Head and Neck Oncology Program at the OSUCCC – James will conduct an epidemiology study to assess the prognosis of patients with head and neck cancer who also are taking statins. “Our results strongly support RhoC as a major player in controlling cancer cell motility and the transition of a tumor cell from noninvasive to invasive cell type,” says Dr. Islam.
A Side Benefit to Research — Enabling Other Researchers In his research, Dr. Islam used various techniques to measure active RhoC in head and neck cancers, including a small G-protein assay — G-LISA kit — from Cytoskeleton, Inc., which has been used to measure the RhoA-GTP. Using a RhoC primary antibody, Dr. Islam easily modified the G-LISA kit to enable it to measure RhoC-GTP.
This successful outcome has made it possible to study RhoC function in a wider range of research applications, helping the scientific community — particularly those who are working on this pro-metastatic oncogene in their cancer research.” His research published in Oral Oncology referenced this assay modification. When the manufacturer, Cytoskeleton, became aware of Dr. Islam’s alteration of its kit, the company revised its marketing materials to mention Dr. Islam’s work and instruct other researchers in using the G-LISA kit to quickly and accurately measure RhoC activity. “This is a well-documented study of the effect of atorvastatin on head and neck cancer,” says Dr. Islam. “I am pleased that after the modification of the G-LISA kit, it became possible to measure active RhoC in research samples. This successful outcome has made it possible to study RhoC function in a wider range of research applications, helping the scientific community — particularly those who are working on this pro-metastatic oncogene in their cancer research.” Dr. Islam’s research was supported by Ohio State’s Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, and the Slomin Family Foundation (Florida). page I 9
HIGHLIGHTED PUBLICATIONS Chiang T, Marcinow AM, deSilva BW, Ence N, Lindsey SE, Forrest LA. “Exercise-Induced Paradoxical Vocal Fold Motion Disorder: Diagnosis and Management.” Laryngoscope 2013; 123(3):727-31. Walz P, Scholes M, Merz M, Elmaraghy C, Jatana K. The Internet, Adolescent Males and Homemade Blowgun Darts. Pediatrics. 132 (2): e519-21. Jatana KR, Silverman J, Mets M, Thomas D, Weber L, Young NM. Usher’s syndrome: characteristics and outcomes of cochlear implant recipients. Otology & Neurotology, 2013 April;34(3):484-489. Dziegielewski PT, Teknos TN, Durmus K, Old M, Agrawal A, Kakarala K, Marcinow A, Ozer E. Transoral Robotic Surgery for Oropharyngeal Cancer: Long-term Quality of Life and Functional Outcomes. JAMA Otolaryngol Head Neck Surg. 2013 Apr 10:1-9. [Epub ahead of print] Nittrouer, S. & Lowenstein, J.H. (2013). Perceptual organization of speech signals by children with and without dyslexia. Research in Developmental Disabilities., 34, 2304-2325. DOI: 10.1016/j.ridd.2013.04.018 Nittrouer, S. & Lowenstein, J.H.. (ahead of print). Separating the effects of acoustic and phonetic factors in linguistic processing by adults and children. Applied Psycholinguistics. DOI:10.1017/S0142716412000410 Kaka AS, Kumar B, Kumar P, Wakely PE Jr, Kirsch CM, Old MO, Ozer E, Agrawal A, Carrau RE, Schuller DE, Siddiqui F, Teknos TN. (2013). Highly aggressive human papillomavirus-related oropharyngeal cancer: clinical, radiologic, and pathologic characteristics. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. Vol. 116. Issue 3: 327-335. Abstract Thongrong C, Kasemsiri P, Carrau RL, Bergese SD. (2013). Control of bleeding in endoscopic skull base surgery: current concepts to improve hemostasis. ISRN Surgery. 2013: 191543. Abstract McLaughlin N, Carrau RL, Kelly DF, Prevedello DM, Kassam AB. (2013). Teamwork in skull base surgery: An avenue for improvement in patient care. Surgical Neurology International. Vol. 4: 36. Abstract Spear SA, Burns SS, Oblinger JL, Ren Y, Pan L, Kinghorn AD, Welling DB, Chang LS. (2013). Natural Compounds as Potential Treatments of NF2-Deficient Schwannoma and Meningioma: Cucurbitacin D and Goyazensolide. Otology Neurotology. Vol. 34. Issue 8: 1519-1527. Abstract Durmus K, Kakarala K, Old MO, Teknos TN, Ozer E. (2013). Anterolateral thigh butterfly free flap reconstruction for peristomal recurrence following laryngectomy: Our experience in six patients. Clinical Otolaryngology. Vol. 38. Issue 4: 339-342. Welling DB, Stewart MG. (2013). Minimal reporting standard for reporting hearing outcomes. Laryngoscope. Vol. 123. Issue 2: 303. [no abstract available] Das S, Rosas LE, Jurcisek JA, Novotny LA, Green KB, Bakaletz LO. (2013). Improving patient care via development of a protein-based diagnostic test for microbe-specific detection of chronic rhinosinusitis. Laryngoscope. [Epub ahead of print] Abstract
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HIGHLIGHTED CLINICAL TRIALS Amit Agrawal, MD Head and Neck Oncology A Phase lb Pilot Study Evaluating Oral Administration of Freeze-Dried Black Raspberries in Post-Surgical Appalachian Oral Cancer Patients Amit Agrawal, MD Head and Neck Oncology currently recruiting Food-Based Modulation of Biomarkers in Human Tissues at High-Risk for Oral Cancer Subinoy Das, MD Otolaryngology Improving Patient Care Via ProteomicsBased, Microbe-Specific Detection of Chronic Rhinosinusitis Enver Ozer, MD Head and Neck Oncology currently recruiting A Pilot Study Assessing Transoral Robotic Surgery (TORS) for Oral and Laryngopharyngeal Benign and Malignant Lesions Using the DaVinci Robotic Surgical System Theodoros Teknos, MD Head and Neck Oncology currently recruiting A Phase I Trial of Vorinostat in the Treatment of Advanced Laryngeal, Hypopharyngeal, Nasopharyngeal and Oropharyngeal Squamous Cell Carcinoma of the Head and Neck Gregory Wiet, MD Pediatric Otolaryngology Virtual Temporal Bone Surgery: Defining and Translating Metrics
HEAD AND NECK ONCOLOGY LAB CHOSEN AS NCI TISSUE SOURCE SITE The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) has a reputation for having one of the largest head and neck tumor banks in the United States. For that reason, its Head and Neck Oncology Lab has been selected by the National Cancer Institute a tissue source site (TSS) for The Cancer Genome Atlas (TCGA) project. Only a small number of head and neck oncology labs around the world have been chosen to participate. The goal of the $275-million TCGA project is to sequence the genome of about 10,000 tumors from the 20 major cancers to identify the gene mutations that contribute to each cancer type. By comparing DNA from a cancer specimen and normal DNA from the same person, researchers can identify mutations in the genes. The results will help scientists develop gene-targeted therapies to more effectively treat cancer. This is the first time a lab at Ohio State has been chosen a TSS for the TCGA project, which began in 2005. “Our selection for participation in TCGA showcases the importance of our head and neck tumor bank and our strong history of collection, analysis of specimens and publication,” says James (Jas) Lang, PhD, associate professor in the Department of Otolaryngology – Head and Neck Surgery at OSUCCC – James. “Ohio State has been collecting head and neck cancer specimens since 1994.”
the cancer site but will also be based on the exact mutation involved. The most promising example of such a drug today is imatinib (Gleevec®), a gene-targeted therapy used to treat chronic myeloid leukemia with great success, according to Dr. Lang. At this point in the collection process, TCGA is focused on collecting head and neck specimens only from underrepresented minority patients to allow increased representation from these population groups in the study. Head and neck cancer is highly correlated with smoking, alcohol consumption and the human papillomavirus (HPV) — lifestyle factors that may be the driving forces for the development of head and neck cancer. The results of the TCGA study will allow future investigation of the links between such lifestyle factors and gene mutations. Ohio State’s contract with the NCI began in March 2013 and will run through 2014. “We’re pleased to be part of TCGA. Every day, more than 1,500 Americans die from cancer — that’s one person every minute. That is the impetus behind this project,” says Dr. Lang.
Ohio State will provide clinical information for each specimen, which will allow scientists to link raw data with coded clinical information and attempt to determine if certain mutations are related to certain patient outcomes. Approximately 500 head and neck cancer specimens (tissue, cells or blood) will be collected by TCGA from the participating tissue source sites. “TCGA is part of an important shift in the way we look at cancer,” says Dr. Lang. “In the future, cancer will also be defined by the type of genetic mutation rather than only the organ of origin. For example, some mutations of head and neck cancer may also occur in other types of cancer, such as breast or lung.” Identifying cancer by the type of genetic mutation that causes it is paving the way for more targeted therapies. A patient’s treatment will no longer be dictated solely by
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OTITIS MEDIA RESEARCH FOCUSES ON LITTLE-STUDIED COMPLEMENT SYSTEM Otitis media — a middle ear infection — drives many parents with young children to physicians’ offices. Because of the condition’s prevalence, researchers strive to determine causal factors and strategies for therapies. Hua Hua Tong, MD, a research assistant professor at the Department of Otolaryngology − Head and Neck Surgery at The Ohio State University Wexner Medical Center, has conducted research on one of the least-studied areas involved in inflammation — the complement system. The complement system is designed to destroy invading bacteria, viruses and damaged cells. Middle ear infection activates the complement system to begin this healing process. Persistent presence of bacteria, however, continues to stimulate ongoing complement activation and results in overactivating the complement system. Targeting the complement components released from the excessive activation might help resolve middle ear infection, according to Dr. Tong.
“We sought to determine if the complement system could be manipulated to prevent otitis media, prevent damage that occurs during the inflammatory process,” says Dr. Tong. “This could involve enhancing its function to fight infection in some situations or inhibit in other situations with persistent inflammation. “We designed an experiment to understand how the complement system works in children with recurrent acute middle ear infection. We identified certain active components in middle ear effusions from patients with recurrent acute otitis media and learned they could be new targets for treating otitis media. The study was preliminary but sheds light on the activity of the complement system during the disease course and helps us understand how the specific complement pathway might be targeted to decrease the inflammatory process involved with infection.” The results of this work were published in the International Journal of Pediatric Otorhinolaryngology (Vol. 77, 911-917.2013) and presented at the 7th Extraordinary International Symposium on Recent Advances in Otitis Media in Stockholm, Sweden, in June 2013. Greg Wiet, MD, an otolaryngologist at Nationwide Children’s Hospital in Columbus and professor in the Department of Otolaryngology − Head and Neck Surgery at Ohio State, co-authored the study with Dr. Tong. “This is a fairly novel approach to the pathogenesis of otitis media,” he says. “Through Ohio State’s collaboration with Nationwide Children’s and our ENT clinic, we have access to a real-life population of children with recurrent ear infections. This ready availability of clinical specimens combined with Ohio State’s research infrastructure was appealing to the National Institutes of Health, which supported this research project.”
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NEW HOUSE STAFF: RESIDENTS AND FELLOWS Pediatric Otolaryngology Fellow
Otolaryngology PGY-1 Residents
Ben Feldman, MD
Christian Francom, MD
Hometown: Cottonwood, Arizona Undergraduate Education: University of California at Berkeley – BA in Integrative Biology and in Anthropology Medical School: University of Arizona, College of Medicine, Tucson Residency: Otolaryngology – Head and Neck Surgery, University of Wisconsin Hospitals & Clinics Madison Hobbies/Personal Interests: Gardening, running, hiking and bicycling
Hometown: Ogden, Utah Undergrad: Weber State University – BS in Zoology Medical School: University of Virginia School of Medicine Hobbies/Personal Interests: Hiking, camping, skiing, snowboarding, boating, fly fishing, football, volleyball, basketball and national/international volunteering
Otology, Neurotology, Cranial Base Surgery Fellow
Hometown: Miami, Florida Undergrad: Emerson College – BA in Theater Studies; The City College of New York – Premedical Studies Medical School: University of Miami Leonard M. Miller School of Medicine Hobbies/Personal Interests: Basketball, traveling, cooking and film
Jason Beyea, MD, PhD Hometown: Saint John, New Brunswick, Canada Undergrad: University of New Brunswick – BSC in Biology/Psychology Medical School: Queens University Residency: Western University Hobbies/Personal Interests: Photography and travel
Head and Neck Surgery Fellow Jon Chan, MD Hometown: New York City, New York Undergrad: Saint John’s University – BS in Biology Medical School: Mount Sinai School of Medicine Residency: University of Pittsburgh Hobbies/Personal Interests: Cooking, bicycling and martial arts
Facial Plastic and Reconstructive Surgery Fellow Yalon Dolev, MD Hometown: Montreal, Quebec, Canada Undergrad: McGill University – BS in Physiology Medical School: McGill University Residency: Otolaryngology – Head and Neck Surgery, McGill University Hobbies/Personal Interests: Montreal Men’s Hockey League (2008 - present), Montreal Industrial Soccer League (2007 - present), skiing, snowboarding, tennis, squash, hockey, soccer, drawing, painting and sculpture
Brian Garnet, MD
Nolan Seim, MD Hometown: Salina, Kansas Undergrad: University of Kansas – BA in Human Biology Medical School: University of Kansas School of Medicine Hobbies/Personal Interests: Golfing, home maintenance and improvement, exercise, all sporting events, casual reading and gardening
Scott Smith, MD Hometown: Columbus, Ohio Undergrad: University of Virginia – BA in Biology Medical School: The Ohio State University College of Medicine Hobbies/Personal Interests: Family, sports (wrestling, squash, rugby), painting, outdoor activities (skiing, hiking, sailing) and traveling
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THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
ENT HIGHLIGHTS - CELEBRATING 100 YEARS September 1914
1988
The OSU Department of Otolaryngology was established, under the direction of John Edwin Brown, MD
Andrew Migletts, MD, becomes the first physician in central Ohio to perform a cochlear implant surgery in an adult patient
1928
1988
First bronchoscopy clinic west of the Alleghenies
That same day, D. Bradley Welling, MD, PhD, and Howard Lowrey, MD, become the first physicians in central Ohio to place a cochlear implant in a pediatric patient
1929 Ophthalmology splits from Otolaryngology to form its own specialty
1988 The Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute opens under the direction of David Schuller, MD
1937 2-year combined Otolaryngology and Ophthalmology residency program approved
1993
1947 Otolaryngology approves a separate 3-year residency program
Voice and Swallowing Disorders Clinic opens under the direction of L. Arick Forrest, MD, and Michael Trudeau, PhD
1952
2007
Residency program gains Accreditation Council for Graduate Medical Education status
Communication Sciences Research Department added, with appointment of Susan Nittrouer, PhD
1961
2008
William H. Saunders, MD, becomes the first physician to perform a septal dermoplasty surgery
Theodoros Teknos, MD, is named director of the Head and Neck Oncology Program
June 2009
1964
Eye and Ear Institute opens
Otologic Research Labs open, initiated by Michael Paparella, MD
2010 Enver Ozer, MD, becomes the first otolaryngologist in central Ohio to perform a robotic thyroidectomy
1977 The Head and Neck Oncology program is established under the direction of David Schuller, MD
2014
Only ENT group ranked in central Ohio by U.S.News & World Report Innovating since 1914
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years
2014
Department Turns 100!
OSU DEPARTMENT OF OTOLARYNGOLOGY I WINTER 2014
DEPARTMENT CHAIRS 1914 - 2014
John Edwin Brown, MD 1914-1923
Hugh Gibson Beatty, MD 1923-1951
William H. Saunders, MD 1963-1984
Russell G. Means, MD 1951-1952
David E. Schuller, MD 1985-2005
Edwin W. Harris, MD 1952-1963
D. Bradley Welling, MD, PhD 2005-2014
AWARDS AND RECOGNITION Ricardo Carrau, MD AAO-HNS Foundation Distinguished Service Award American Academy of Otolaryngology — Head and Neck Surgery
Subinoy Das, MD Edmund Prince Fowler Award for Excellence in Scientific Research Triological Society Thesis: “Improving Patient Care Via a Proteomics-Based Diagnostic Test for Microbe-Specific Detection of Chronic Rhinosinusitis” Charles Elmaraghy, MD, Kris Jatana, MD Timothy McEvoy, MD 2nd Place Clinical Research Award American Society of Pediatric Otolaryngology “Wound Prevention Regimen After Pediatric Tracheotomy: A Team-Based Approach” Candace Hrelec, MD CORE AwardAAO-HNS “For Research Prevention of Cisplatin-Induced Ototoxicity by Intratympanic Dexamethasone” Matthew Old, MD , Enver Ozer, MD Theodoros Teknos, MD Best Scientific Paper Award Combined Otolaryngological Spring Meetings “Transoral Robotic Surgery for Oropharyngeal Cancer: Long-Term Quality of Life and Functional Outcomes”
Enver Ozer, MD, Theodoros Teknos, MD Best Poster Award COSM “Surgical Management of Oropharyngeal Squamous Cell Carcinoma: Survival and Functional Outcomes” Sanjeet Rangarajan, MD Elected Delegate to the American Medical Association AAO-HNS Section for Residents and Fellows David Schuller, MD Distinguished Professor Award Ohio State College of Medicine Theodoros Teknos, MD Awardee, Sommer Memorial Lecture Series D. Bradley Welling, MD, PhD Vice Presidential Citation, Southern Section of the Triological Society Triological Society American Neurotologic Society Trainee Award American Neurotologic Society William F. House Lecturer American Neurotologic Society Gregory Wiet, MD Innovation Excellence Award Ohio State College of Medicine page I 15
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
NEW JAMES CANCER HOSPITAL Opening in 2014 Leveraging our incomparable academic depth and breadth, The Ohio State University is transforming the way cancer is prevented, detected, treated and cured by creating the 21st century cancer hospital. Opening in late 2014, the new James Cancer Hospital and Solove Research Institute combines the discoveries of more than 300 cancer researchers from 12 of the University’s 14 colleges, and the expertise of more than 200 cancer super-subspecialists, to deliver the most effective ways to prevent and treat individual cancers. Ohio State has demonstrated that there is no routine cancer and that every cancer is unique, driven by molecules and markers in each person that enable his or her cancer to survive, move and grow. The new James promises and promotes the discovery and delivery of the world’s most targeted cancer preventions and treatments, leading to more options, faster responses, fewer side effects and improved outcomes. Large photo: An artist’s rendering depicts rooftop green spaces at the Ohio State University Wexner Medical Center’s New James Cancer Hospital and Solove Research Institue and critical care center. ©2014 The Ohio State University Wexner Medical Center CORP20130438
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