The Caruso Department of Otolaryngology – Head and Neck Surgery has the tenth largest National Institutes of Health (NIH) funding targeted to clinical otolaryngology departments in the nation, and our research is led by world experts in their fields with an unrelenting passion for discovery. Our clinical research is well positioned to be on the leading edge of understanding of pathologies and disorders affecting the head and neck.
Our clinical research goes hand-in-hand with our academic mission to train the next generation of leaders in international specialty medicine. Our research is designed to go from bench to bedside, so trainees experience a large volume case load with a spectrum of pathologies that can inform their research. Trainees have access to the latest technologies, particularly with respect to imaging, robotic surgery and diagnostic capabilities.
Of babies born in the United States, 2 to 3 of every 1,000 have a detectable hearing loss in at least one ear and 1 out of 500 newborns suffers from significant hearing impairment. Congenital hearing loss (hearing loss present at birth) can include hereditary hearing loss or hearing loss due to other factors present either in the womb during pregnancy or at the time of birth.
When a child is born, their ear is hard-wired for sound, but the brain has to learn how to perceive sound and speech from the information coming up the hearing pathway. Children can be born with damage to auditory hair cells, abnormalities in the hearing organ (the cochlea), or they can be born without auditory nerves carrying the hearing information. Without intervention, hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier children with hearing loss receive an intervention, the more likely they are to reach their full potential. Otologists can intervene with hearing aids, cochlear implants, and auditory brain stem implants.
Clinicians and researchers in the Caruso department are working with the world-renown USC Institute for Neuroimaging and Informatics looking at the development of the auditory pathway and the effects of various types of hearing loss on brain patterning.
A team of multidisciplinary researchers is currently leading a breakthrough (NIH)-funded clinical trial that attempts to prove that young children born without a hearing nerve can safely undergo an auditory brainstem implant (ABI) surgery. The study also allows our researchers to study how the brain develops over time and how it learns to hear sound and develop speech.
A separate NIH-funded study examines the effects of cochlear implantation on language, behavioral, and societal outcomes in children.
Cancer Head and Neck
Description: work in progress
In the instance of serious conditions such as facial paralysis or disfigurement, reconstructive surgery helps patients overcome physical limitations that drastically impact quality of life. Our team places great emphasis on research in order to design new approaches for treatment, especially when it comes to facial nerve and paralysis. They working to harness the power of induced stem cells to create nerve grafts generated from a patient’s skin. This opens the door to stem cell therapy and tissue engineering that does not rely on fetal or bone marrow tissue.
Hearing and Balance
Hearing loss is the third most common health problem in the United States and affects all ages including newborn babies to elderly adults. About 48 million Americans (1 out of 8 people) have lost some hearing. Of babies born in the U.S., 2 to 3 of every 1,000 have a detectable hearing loss in at least one ear and 1 out of 500 newborns suffers from significant hearing impairment. 1 out of 3 adults aged 65-74 have disabling hearing loss, and that number increases to 1 out of 2 adults over the age of 75.
Causes of hearing loss can include aging, ototoxic drugs, noise exposure, head trauma, infection, genetic conditions. Once mechanosensory hair cells in the inner ear are damaged and lost by any of a variety of reasons they never regenerate. A majority of sensorineural hearing loss is permanent and significantly affects the patient’s quality of life. Research indicates that people with hearing loss have higher rates of depression, social isolation and cognitive decline.
Researchers and clinicians in the Caruso Department are leading a unique interdisciplinary effort which uses the latest technology in genetics, stem cell medicine, neuroscience, neuroimaging, and biomedical engineering to approach otology research. Our Aim is to restore hearing through a variety of methods including cochlear implantation, auditory brain stem implants, bone conductive hearing devices, and to explore the future of restoring hair cells through regeneration. Building on recent stem cell research, our department is working on the possibility of regenerating hair cells in humans. By determining the mechanisms of cell regulation, scientists hope to develop a biological, curative approach that will trigger natural replacement of those hair cells in order to allow the inner ear to respond with substantive improvement in hearing.
Research at Keck Medicine of USC in the field of laryngology is focused on clinical outcomes studies and clinical trials to improve voice, swallowing and airway for people who have experienced loss of these crucial functions due to conditions affecting the larynx (voice box) and throat.
Leveraging their unique interprofessional approach and clinical excellence, faculty in the division of laryngology/USC Voice Center are uniquely positioned to advance knowledge and treatment of voice, swallowing and airway disorders. Active research is underway to restore voice loss associated with aging, vocal fold paralysis, vocal fold paresis, scar and dystonia using novel behavioral, medical and procedural interventions.
Clinical trials are underway to investigate novel office-based minimally invasive laryngeal injectable therapeutics, including intralesional injection of corticosteroids for subglottic and tracheal stenosis, platelet-rich plasma injections to rejuvenate vocal fold tissue loss in scar and aging, and novel bio-compatible materials to restore voice in vocal fold paralysis and paresis. Novel voice therapy techniques are being developed, studied, and applied by the team of scholarly speech-language pathologists in the division.
Faculty in the Division of Laryngology and the USC Voice Center are actively engaged in and lead multi institutional research and are members of the North American Airway Collaborative, the Vocal Cord Paralysis Experience (COPE) study, and multi institutional research in treatment outcomes for patients with Zenker’s diverticula
Michael Johns, III, MD
Chronic rhinosinusitis is an inflammatory disorder of the paranasal sinuses and the lining of the nasal passages, affecting about 10% of the US population. Treatment of chronic sinusitis, as well as tumors of the nasal cavity and sinuses, involve complex surgeries close to both the brain and the eye. The surgeries require cutting edge endoscopic technology as well as novel technologies, such as new surgical dressings, to improve outcomes.
With a number of both clinical and scientific research studies currently underway, the physicians in the Caruso Department are working towards making the surgeries safer and ensuring that new technologies are efficient and cost effective. Along with the Neurosurgery Department, the Division has pioneered and researched a model to train surgeons for intra-operative complications. This type of simulation technology has been proven to increase physician response times and surgical skills during rare emergencies. The Division has also researched the effectiveness of new technology, such as balloon catheter dilation, and the way the utilization of new technology affects the health system. The Division is also actively engaged in studies to better monitor the quality of life outcomes of both medical and surgical interventions, especially for some of the most vulnerable patient populations such as the homeless and children with cystic fibrosis.
Elisabeth Ferenece MD, MPH
Sleep Medicine and Surgery
The surgical evaluation and treatment of obstructive sleep apnea and snoring is a relatively new subspecialty, and our research at Keck Medicine of USC has contributed to many important scientific advances in this field.
Drug-induced sleep endoscopy is an evaluation for sleep apnea patients considering surgery. We have conducted many studies in this area, including leading two international, multicenter studies showing how drug-induced sleep endoscopy can help select procedures and improve results with tailored, effective treatment plans.
We participate in major studies examining the benefits of innovative treatments like Inspire Medical’s Upper Airway Stimulation®.
Collaborations with experts in magnetic resonance imaging and biomedical engineering here at USC is enabling examination of neurologic changes that occur in obstructive sleep apnea and the improvements that can occur with treatment. Additional work with colleagues at other institutions will shed new light on the causes of sleep apnea and the potential combination of surgery and medications to improve outcomes.
Eric Kezirian MD, MPH