Otolaryngology NewssUMMeR 2015

Message froM the Chair Donald t. Donovan, MD, faCs On behalf of the faculty and staff of The Bobby R. Alford Department of Otolaryngology – Head & Neck surgery, I am pleased to announce the revival of the quarterly newsletter.

In this issue we hope to bring you up to date on some of the many exciting developments that have occurred in the department over the last 18 months. Moving forward we plan to keep you abreast of new services, discoveries, and innovations made by members of our outstanding faculty and staff.

In January 2014 I was appointed the Olga Keith wiess Chair for the department and have been focused on growing our faculty, expanding our clinical sites, and creating substantive additions to our research programs.

A new academic administrative team was assembled in spring 2014. we are fortunate to have Drs. Kenneth Altman and Andrew sikora join Baylor and the department. Dr. Altman is well established internationally in the field of laryngology and is our Vice Chair for Clinical Affairs. He also has established the new Institute for Voice and swallowing at Baylor College of Medicine on the McNair Campus. He brings special expertise in otolaryngology best practices, which will enhance the department’s quality and safety initiatives in the outpatient setting as well as at the Baylor st. Luke’s Medical Center Hospital (BsLMC). Dr. sikora is a funded researcher in head and neck cancer who was named a Baylor College of Medicine Carolyn wiess Law scholar. He is our Vice Chair for Research and will lead our research revitalization program. working with the leadership of Texas Children’s Hospital (TCH), we were able to recruit Dr. ellis Arjmand to succeed Dr. ellen Friedman as Chief of service at TCH.

Dr. K. Kelly Gallagher joined the faculty in August 2013 after completing a residency and fellowship in skull base surgery at the University of Michigan. Dr. N. eddie Liou, a former resident in our program, joined us in July 2014 and has become an integral part of our clinical and educational programs. Most recently Dr. Alex sweeney has returned to Houston to join our faculty after completing a two year fellowship in Otology/Neurotology at Vanderbilt University in Nashville, Tennessee. In addition to their focus on clinical interests, Drs. Gallagher, Liou, and sweeney are very involved in student and resident education. HEALTHCARE

Baylor has continued to move forward with the phased build-out of its new clinical facilities on the McNair Campus just west of the Michael e. DeBakey Veterans Affairs Medical Center. The department has expanded its clinical activity to the McNair Campus.

DONALD T. DONOVAN, MD, FACS

Olga Keith wiess Chair, Otolaryngology – Head & Neck surgery

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we hold a unique position among Baylor clinical departments in that we remain a partner in a joint program serving as the Department of Otolaryngology – Head & Neck surgery across all of our Affiliated Hospital systems (Ben Taub, MeDVAMC, TCH, BsLMC) as well as the academic Department of Otolaryngology – Head & Neck surgery for the Houston Methodist Hospital. we continue to maintain outpatient services in smith Tower and inpatient and outpatient surgery in the Neurosensory Center of Houston for Houston Methodist Hospital. EDUCATION

we had an outstanding group of residents this year with exceptional leadership shown by the chief residents, all of whom pursued fellowships this past July. The residents were extremely productive academically with acceptance of over 100 abstracts, presentations, and manuscripts for publication. The specialty continues to appeal to the best and brightest students in medical school classes both at Baylor and from around the country as evidenced by the applicant pool and our incoming resident class. RESEARCH

we continue to build and strengthen our research program. Dr. sikora brought his laboratory from New York to completely renovated lab space in the Neurosensory Center. Dr. sikora’s focus on translational research in immunological mechanisms in head and neck cancer adds a whole new dimension to the department’s research program. Drs. Brownell and Farrell recently were awarded grants for their ongoing research in biomechanical and electrophysiological properties of hair cells. Dr. Helen Cohen recently received a large grant from the National Institutes of Health that allows her to continue her work on the diagnostic and therapeutic implications of balance disorders after vestibular injury.

we are extremely proud of the progress we have made and feel the future of the department is bright. I am grateful for the dedication, perseverance, and loyalty the faculty and staff have demonstrated. They have worked tirelessly on behalf of our patients, learners, and the community at large to improve the quality of care and advance the science of medicine.

Message from the Chair (continued from cover)

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subspeCialty serviCe lines Kenneth W. altman, MD, phD, faCs It’s a great pleasure to join a department and experienced faculty with such a distinguished history. I look forward to the challenge of balancing academic and research accomplishments with meeting the increasing demands of clinical productivity.

As we move into a broader health system, we are committed to growing and developing our subspecialty service lines, coalescing a critical mass of expert surgeons in each area with the support of ancillary specialties. we are advancing the idea of care teams, featuring nurses and medical assistants to coordinate expedited patient care with attention to the individual patient. Developing a patient “cycle of care” is one way our patients will benefit from our team approach – starting from an initial telephone contact or appointment and continuing through the conclusion of care.

we have added several new service line areas and enhanced our established service lines:

§ Institute for Voice and Swallowing § Facial Plastic and Reconstructive Surgery § Sinus, Rhinology and Skull Base Surgery

There are exciting developments with each of these service lines, including our Head and Neck Cancer program which is part of the Dan L. Duncan Cancer Center, an NCI-designated comprehensive cancer center.

The Center for Hearing and Balance Disorders has been co-located in the Jamail specialty Care Center at the McNair Campus. The 3,200 square foot space brings together three neuro-otologists with our department’s traditional strengths in audiology, balance and hearing rehabilitation. we offer a complete subspecialty service line five days a week and integrate seamlessly with neurosurgeons and neurologists through formal interdisciplinary programs.

we look forward to sharing with you our progress with the other service lines in future editions. LOCATIONS

McNair Campus 7200 Cambridge st., suite 9B Houston, Texas 77030 Appt: 713.798.5900 § Otolaryngology – Head & Neck surgery § Institute for Voice and swallowing § Center for Dysphagia and swallowing Disorders

Jamail Specialty Care Clinic 1977 Butler Blvd., suite e5.100 Houston, Texas 77030 § Otology & Neurotology Appt: 713.798.3200 § Hearing Center Appt: 713.798.4327 (HeAR) § Center for Balance Disorders Appt: 713.798.6336 § Baylor Facial Plastic surgery Center Appt: 713.798.3223 (FACe)

Smith Tower 6550 Fannin st. suite 1701 Houston, Texas 77030 Appt: 713.798.5900 § Otolaryngology – Head & Neck surgery § sinus Center

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KENNETH W. ALTMAN, MD, PHD, FACS

Vice Chair for Clinical Affairs, Otolaryngology – Head and Neck surgery

Director, The Institute for Voice and swallowing

ANDREW H. MURR, MD, FACS

Visiting Professor and Resident

Research symposium

§ Sleep Medicine and Surgery § Head and Neck Cancer Program § Center for Hearing and Balance Disorders

researCh expansion anDreW siKora, MD, phD The Department of Otolaryngology is embarking on an unprecedented expansion of its research, creating new purpose-built laboratory space for basic and translational research in head and neck cancer and neurosensory research. This expansion is a fitting sequel to the department’s decades-long tradition of outstanding contributions to understanding of the fundamental process underpinning the physiology of hearing and balance.

My laboratory recently moved from the Icahn school of Medicine at Mount sinai in New York City to a new 4,400 square foot laboratory space on the 5th floor of the Neurosensory building. The lab focuses on understanding mechanisms by which tumors escape the immune system, and development of new strategies for cancer immunotherapy. In addition to new laboratory benches to house the lab’s postdoctoral fellows, students, and technicians, the facility includes tissue culture and procedure rooms, sophisticated microscopy, and analytic equipment to study cancer in cell culture and mouse models, and to analyze patient biospecimens.

space also has been identified and plans are being finalized for additional square footage on the 3rd floor of the Neurosensory Center to house the research activities of Bill Brownell, PhD, and Brenda Farrell, PhD. Drs. Brownell and Farrell will be studying the physiology and biophysics of hearing at cellular and subcellular levels; Dr. Farrell also studies the biomechanics of cancer cell motility and cytoskeletal structure. The new laboratory space will include purpose-built areas for patch-clamp analysis of cellular voltage potentials, as well as a full-sized sound booth for auditory experiments. The laboratory also will accommodate the optical tweezers, that are capable of immobilizing and moving single living cells in real time.

Additionally, a new 850-square-foot laboratory has been built for Helen Cohen, edD, adjacent to the new neurotology clinical space, which recently opened at the Jamail specialty Care Center. Dr. Cohen performs patient-oriented research on the vestibular (balance) system of patients who experience dizziness. Locating her research space adjacent to the clinical space will streamline patient recruitment and make it convenient for patients to participate in clinical trials.

These new laboratories not only directly support the scientific efforts of the department’s four NIH-funded investigators and one NAsA-funded investigator, but also create new opportunities for residents, fellows, and medical students to participate in research. As more investigators are recruited, the otolaryngology research footprint will continue to grow.

ANDREW SIKORA, MD, PHD

Vice Chair for Research Co-Director Head & Neck Cancer Program Caroline wiess Law Translational Research scholar

reCently aWarDeD researCh funDingpi projeCt title Donor

william Brownell, PhDBrenda Farrell, PhD

Intracochlear electro-Chemical Gradients

NIDCD (National Institute of Deafness and other Communication Disorders)

Helen Cohen, eDDR01: epidemiological Research on screening for Vestibular and Balance Disorders

National Institute on Deafness and other Communication Disorders (NIDCD)

Jeffrey T. Vrabec, MD Gift-in-Kind 4 stryker Otology Drills stryker Instruments

Andrew G. sikora, MD, PhDValidation of novel monoclonal antibodies targeting HPV-associated cancers

DLDCC Pilot Project Grants

Andrew G. sikora, MD, PhDInitial ex-vivo clinical validation of a dentritic cell-targeting therapeutic HPV vaccine for HIV-posstiive patients with HPV-related cancers

Collaborative Faculty Research Investment Program

Julina Ongkasuwan, MDTreatment Alternatives in Adult Rare Disease; Assessment of options in idiopathic subglottic stenosis: NOAAC PR-02 study

Patient-Centered Outcomes Research Institute (PCORI)

Andrew G. sikora, MD, PhD

Cancer Research Institute Clinical strategy Team Grant: Targeting Tumor Microenvironment to enhance immune-stimulating effects of chemoradiotherapy.

Cancer Research Institute

seleCt publiCations § Altman Kw, Banoff KM, Downes M, “Medical economic impact of tracheotomy on a hospital system,” J Med Econ. 18:258-62, 2015.

§ Altman Kw, Noordzij JP, Rosen CA, Cohen s, sulica L, “Neurogenic cough,” Laryngoscope, 125: 1675-81, 2015.

§ B.A. Miles, A. Patsias, T. Quang, A.D. Polyorides, R. Richards-Kortum, A.G. sikora. Operative margin control with high-resolution optical microendoscopy for head and neck squamous cell carcinoma. (in press – Laryngoscope)

§ B.R. Keeley, F. Islami, J. Pak, e.M. Genden, P. Boffetta, R. Malekzadeh, A.G. sikora. Prediagnostic serum Levels of Inflammatory Biomarkers are Correlated with Future Development of Lung and esophageeal Cancer. Cancer Scinece, 2014; 105(9); 1205-11. doi: 10.111/cas12485.

§ C. Levovitz, , D. Chen, e. Ivansson, U. Gyllensten, J. Finnigan, s. Alshawish, w. Zhang, e. schadt, M. Posner, J. McKay, P. Brennan, P. Boffetta, A.G. sikora. TGFBR1: an immune susceptibility gene for HPV-related head and neck cancer. Cancer Research, 2014; 74(23): 6833-44/ doi 10.115/0008-5472.CA-14-0602-T.

§ Chen Dw, Young A, Donovan DT, Ongkasuwan J. Routine computed tomography (CT) in the evaluation of vocal fold movement impairment (IVFMI) without an apparent cause. Otolaryngol Head Neck Surg. 2015 Feb;152(2):308-13.

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§ Chiang D and Cuthbertson D, Ruiz F, Li N, Pereira, F. A coreculatory network of NR2F1 and microRNA-140. PLoS ONE. 2014; 8: e83358. doi:10.1371/journal.pone.0083358.

§ Cuthbertson Dw, Caceres K, Hicks J, Friedman eM. A cooperative approach to diagnosis of rare diseases: primitive myxoid mesenchymal tumor of infancy. Ann Clin Lab Sci. 2014 summer;44(3):310-6.

§ Cuthbertson D, Raol N, Hicks J, Green L, Parke R. Minor salivary Gland Basal Cell Adenocarcinoma: A systematic review and report of a new case. JAMA – Head and Neck Surgery. 2015; 141:276-283.

§ Cohen Hs, Mulavara AP, Peters BT, sangi-Haghpeykar H, Bloomberg JJ. standing balance tests for screening people with vestibular impairments. Laryngoscope 2014: 124;545-550. PMC3841227

§ Cohen Hs, sangi-Haghpeykar, Ricci NA, Kampangkaew J, williamson RA. Utility of stepping, walking, and Head Impulses for screening Patients for Vestibular Impairments. Otolaryngology Head Neck Surg 2014:151;131-136. NIHMs##574999

§ Cohen Hs. Use of the Vestibular Disorders Activities of Daily Living scale to describe functional limitations in patients with vestibular disorders. J Vestib Res 2014:24;33-38.

§ Cohen Hs, Mulavara AP, sangi-Haghpeykar s, Peters BT, Bloomberg JJ, Pavlik VN. screening people in the waiting room for vestibular impairments. Southern Med J 2014; 107:549-553. PMC4156111

§ F. Parikh, A. Clark, A. Patsias, P. Jayaraman, A. Yerasi, s. Kim-schulze, K. Misiukiewicz, M. Bonomi, e. Genden, D. Deluc, s. Oh, M. Posner, A.G. sikora. Cisplatin-based concurrent chemoradiotherapy antagonizes pre-existing anti-tumor immunity in patients with HPV-positive head and neck cancer. Cancer Research, 2014; 74: 626. doi: 10.1158/1538-7445.AM2014-626.

§ Gelbard A, sandulache V, Francis DO, simmons JC, Donovan DT, Ongkasuwan J. Laryngotracheal stenosis as a Common Clinical endpoint of Multiple Upper Airway Injury Mechanisms. Laryngoscope. 2015 May;125(5):1137-43.

§ Guy wM, Pattisapu P, Ongkasuwan J, Brissett A. Creation of a Head and Neck Keloid Quality of Life Questionnaire. Laryngoscope. Accepted. In press.

§ G. Lu, R. Zhang, s. Geng, L. Peng, P. Jayaraman, C. Chen, J. Yang, Q. Li, H. Zheng, K. shen, J. wang, X., Liu, w. wang, C. Qi, F. Xu, J. C. He, K. Liu, s.A. Lira, A.G. sikora, L. Li, H. Xiong. Myeloid cell-derived inducible nitric oxide synthase promotes M1 macrophage dedifferentiation. (in press – Nature Communications)

§ H.Lee, D. Ruane, Y. Ho, s. Govindaraj, K. Law, A.G. sikora, C. Cheong, B. Chen, s. Mehandru. Phenotype and function of nasal dendritic cells. (in press – Mucosal Immunology)

§ M. Moskalenko, M. Pan, Y. Fu, e.H. de Moll, D. Hashimoto, A. Mortha, M. Leboeuf, P. Jayaraman, A.G. sikora, J. wolchok, N. Bhardwaj, M. Merad, Y. saenger. Requirement for innate immunity and NK1.1-CD90+ lymphocytes to treat established melanoma with chemo-immunotherapy. Cancer Immunology Research, 2015. pii: canimm.0120.2014.

§ Ongkasuwan J. Voice – The Original social Media. Otolaryngol Head Neck Surg Bulletin. 2015 Mar: 12-14.

§ Reschke MF, Cohen Hs, Cerisano J, Clayton J, Cromwell R, Danielson R, Hwang e, Tingen C, Allen J, Tomko D. Neuroscience in space: differences based on sex and gender in NAsA’s spaceflight program. Journal of Women’s Health 2014;23:959-962.

§ Rettig e, wentz A, Posner M, Gross N, Haddad R, Gillison M, Fakhry C, Quon H, sikora AG, stott w, Lorch J, Gourin C, Guo Y, Xiao w, Miles B, Richmon J, Anderson P, Misiukiewicz K, Chung C, Gerber J, Rajan s, D’souza G. Prognostic Implication of Persistent Human Papillomavirus 16 DNA Detection in Oral Rinses for Human Papillomavirus-Related Oropharyngeal Carcinoma. (in press - JAMA Oncology)

select publications (continued from page 5)

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N. Eddie Liou, MD

Assistant Professor

In the tradition of the Bobby R. Alford Department of Otolaryngology – Head & Neck surgery, our residents continue to excel in their academic and postgraduate pursuits. Their productivity in basic and clinical research has resulted in numerous publications and presentations at the local and national level. Additionally, their dedication to academic medicine has led them to prestigious fellowship opportunities and academic faculty appointments. At this year’s Combined Otolaryngology spring Meeting, our department had one of the highest selection rates in recent years. Nine trainees traveled to Boston and gave six poster and five oral presentations addressing topics in otology, rhinology, laryngology, head and neck surgery, and sleep medicine.

The residents in the graduating class of 2015 all have decided to pursue fellowships across the country: 1 Benjamin Anthony, MD – Laryngology, emory University (Atlanta, GA) 2 Katherine Dunsky, MD – Pediatric Otolaryngology, Texas Children’s Hospital (Houston, TX) 3 Zhen Jane Huang, MD, MBA – Pediatric Otolaryngology, Children’s National Medical Center (washington D.C.) 4 Paul Kwak, MD, MM, MSc – Laryngology and Laryngeal surgery, Massachusetts General Hospital (Boston, MA) 5 Vlad Sandulache, MD, PhD – Head and Neck surgery, MD Anderson Cancer Center (Houston, TX).

Recent graduates who are now completing fellowship training have accepted faculty appointments in the following academic institutions: § Alexander Gelbard, MD – Laryngology, Vanderbilt University (Nashville, TN) § Alex Sweeney, MD – Neurotology and skull Base surgery, Baylor College of Medicine (Houston, TX) § William Yao, MD – Rhinology, University of Texas Health science Center at Houston (Houston, TX)

On the local level, we are proud to announce that Ashley wenaas, MD, has won this year’s Houston society of Otolaryngology resident research competition with her project on the prognostic significance of P16 cellular localization in head and neck squamous cell carcinoma. Three of the four runner-ups chosen to present at the event also were Baylor College of Medicine residents. In celebration of world Voice Day, one of our residents, Paul Kwak, MD, MM, Msc, increased local awareness of vocal health by convening a multidisciplinary panel of voice experts at Rice University, which included voice coaches, professional opera singers, and laryngologists.

we are delighted to share with you the continued excellence of the residents of the Bobby R. Alford Department of Otolaryngology – Head and Neck surgery. Their commitment to surgical training and academic medicine embodies Baylor College of Medicine’s missions of education, patient care, and research. we look forward to updating you with the many achievements and opportunities that lie ahead of them.

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§ Ricci NA, Aratani MC, Caovilla HH, Cohen Hs, Gananca FF. evaluation of properties of the Vestibular Disorders Activities of Daily Living scale (Brazilian version) in an elderly population. Braz J Phys Ther 2014; 18:174-182

§ Richards AN, sugumaran M, Aviv J, woo P, Altman Kw, “The Utility of Office-based Biopsy for Laryngopharyngeal Lesions: Comparison with surgical evaluation,” Laryngoscope, 125: 909-12, 2015.Richter A, Chen Dw, Ongkasuwan J. surveillance Direct Laryngoscopy and Bronchoscopy in Children with Tracheostomies. Laryngoscope. 2015 Mar 17.

§ R. L. Alford, K.s. Arnos, M. Fox, J.w. Lin, C.G. Palmer, A. Pandya, H.L. Rehm, N.H. Robin, D.A. scott, C. Yoshinaga-Itano. American College of Medical Genetics and Genomics Guideline for the Clinical evaluation and etiologic Diagnosis of Hearing Loss. Genetics in Medicine 2014;16(4):347-355. doi:10.1038/gim.2014.2

§ Todai JK, Congdon sL, sangi-Haghpeykar H, Cohen Hs. Ocular vestibular evoked myogenic potentials in response to three test positions and two frequencies. Laryngoscope 2014;124:e237-240 PMC4007378.

§ U. Megawalu, A.G. sikora. survival Outcomes in Advanced Laryngeal Cancer. JAMA Otolaryngology – Head & Neck Surgery 201;: 140(9): 855-60. doi: 10.1001/jamaoto.2014.1671.

§ Vertigan Ae, Murad MH, Pringsheim T, Feinstein A, Chang AB, Newcombe PA, Rubin BK, McGarvey LP, weir K, Altman Kw, weinberger M, Irwin Rs; CHesT expert Cough Panel, “somatic Cough syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHesT Guideline and expert Panel Report, Chest 148: 24-31, 2015.

§ Victores A, Hamblin J, Gilbert J, switzer C, Takashima M. Usefulness of sleep endoscopy in Predicting Positional Obstructive sleep Apnea. Otolaryngology Head Neck Surg 2013;150:487-93.

§ wenaas Ae, Tran B, Ongkasuwan J. The Progression of Thyroid Cartilage Calcification as it Relates to the Utilization of Laryngeal Ultrasound. Laryngoscope. Accepted. In press.

select publications (continued from page 6)

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2015 FACULTY AND RESIDENTS