Department: Otolaryngology (Head and Neck Surgery)

Inner ear microendoscopy -- Developing techniques for minimally-invasive imaging of inner ear microanatomy and neural pysiology. Applications include improved cochlear implant development, inner ear regenerative techniques, inner ear surgery, and auditory physiology. Microsurgical robotics -- Developing scalable microsurgical instrumentation and robotic techniques for use in head and neck surgery. Surgical Simulation -- Immersive environment for temporal bone surgical simulation.

Pre-operative evaluation and selection of potential candidates for OSA Surgery. Sleep MRI. Innovative approaches for management of OSA.

http://med.stanford.edu/ohns/research/labs_chang.html

Active Wnt signaling maintains somatic stem cells in many organ systems. Using Wnt target genes as markers, we have characterized distinct cell populations with stem cell behavior in the inner ear, an organ thought to be terminally differentiated. Ongoing work focuses on delineating the developing significance of these putative stem/progenitor cells and their behavior after damage.

Multi- modality treatment of Head and Neck Cancer Phase 1 clinical trials

Advanced MRI imaging for laryngeal cancer and swallowing disorders; applications of robotics in microlaryngeal surgery; high speed digital imaging of vocal fold vibration; the effects of hormones and anabolic steroids on vocal function.

- Visuohaptic virtual environments for interactive planning tools for preoperative surgery simulation in Cranio-Maxillofacial Surgery, Maxillofacial Trauma and Dental Implantology - Molecular basis of maxillo-mandibular bone regeneration and oral mucosal changes - Excellence and Diversity in Academic Medicine and Medical Education

Middle ear mechanics, correction of hearing loss, development and evaluation of middle ear prosthesis; creative strategies for correcting various types of hearing loss using surgery in temporal bone models and humans. Research in new methods to surgically correct tongue collapse in sleep apnea. Research to improve facial muscle movement following facial nerve injury using surgical techniques.

Microsurgical treatment of tumors of the brain, spinal cord, pituitary gland and skull base; Radiosurgery of tumors; Molecular biology of brain tumors.

Most types of congenital and acquired hearing loss arise from damage to, or loss of hair cells, the sensory cells of the inner ear. Our work focuses on generating mouse and human inner ear cell types from stem cells and we are interested in signaling pathways that control hair cell (re-)generation in vitro and in vivo. In a second line of research, we are working on the identification and the molceular characterization of proteins that are important for hair cell function.

- Characterization of ion transport activity in sinonasal epithelium - Optimization of mucosal wound healing in a rabbit model of sinus surgery - Clinical outcomes in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery - Effect of intraoperative local anesthetic use on post operative pain in patients undergoing endoscopic sinus surgery

Development of innovative surgical methods, via the cranial base, to expose inaccessible intracranial disease. Surgical simulation and robotics. Evidence based outcomes analysis in acoustic neuroma and other tumors of the cerebellopontine angle. History of tobacco advertising with false reassurance of healthfulness (see tobacco.stanford.edu). Medical history - especially the history of otology, neurosurgery, deafness, and quackery.

1) New therapeutic approaches for head and neck cancer, including immune stimulation possibilities (IRX-2 protocol), integration of biological modifiers, and, eventually, genetic approaches. 2) Head and neck cancer stem cells: identification, characterization, control--in conjunction with the Irv Weissman and Michael Clarke labs in the Stem Cell Institute 3) Development of innovative surgical methods at the anterior cranial base

1 - Airway and swallow evaluation of infants with micrognathia. 2 - Investigating the vascular anatomy of the post cricoid region. 3 - Conducting a long term follow-up of children who have had powered intracapsular tonsillectomy

My laboratory research interest focuses on the identification of biomarkers for prognosis in patients with head & neck or lung cancers. I am also conducting a number of clinical trials specifically in patients with head & neck cancers.

Surgical Simulation Biorobotics

--CMV Associated Hearing Loss --Newborn Hearing Screening --Sensorineural Hearing loss --Postoperative tonsillectomy care --Ankyloglossia --Steroids in otolaryngology --vocal cord paralysis --diagnosis of gastropharyngeal reflux

1. Evidence-based medicine in Facial Plastic Surgery The primary goal of this research program is to develop a higher standard of care for facial plastic surgery patients. One example of this is the evelopment of prospective studies that examine the efficacy of new or existing surgical techniques in facial plastic surgery. One clinical problem we have already begun to examine is nasal obstruction. 2. Examination of facial nerve injury and biological correlates of functional recovery.

Hearing is one of the most sensitive functions controlled by thyroid hormone (TH). TH is required for the timely coordination of a complex set of differentiation events in the maturing cochlea. Hypothyroidism retards the differentiation of the cochlea, including synaptogenesis, neurogenesis and myelinogenesis. The mechanisms that prompt the progression of these developmental events are poorly understood. Our preliminary data shows that many genes are differentially regulated by thyroid hormone ..

Kari Nadeau, MD, PhD, Allergy, Immunology and Asthma Our research interests in the laboratory focus on the role of human T cells, specifically natural regulatory T cells (Treg, in immunological diseases. We aim to differentiate the mechanisms of action of regulatory T cell suppressive function. We study how pollution, such as diesel exhause, disrupt Treg suppressive function and how chemokines, like lymphotactin, enhance Treg suppressive function. We also study Treg function in tolerance.

Nasal Mucosal Regeneration Intranasal Vaccination

Hearing loss can begin at any age and tends to progress. Ultimately, this may lead to deafness. Our research team seeks to understand the mechanisms of progressive hearing loss, to develop better techniques of diagnosing the cause of hearing loss in individual patients, and to optimize outcomes after cochlear implantation. We perform translational research using animal models of hearing loss and clinical research in both adult and pediatric patients to accomplish our goals.

Stem cell-based research on the inner ear

Clinical Interests: general oncology, head and neck cancer Research Interests: chemoprevention trials and combined modality approaches to head and neck cancer

Understanding and accurately measuring auditory function for high-frequency signals in both humans and small mammals. Understanding toxic effects of hyperbilirubinemia on auditory function in the developing human neonate.

The auditory sensory cell, the hair cell, detects mechanical stimulation at the atomic level and conveys information regarding frequency and intensity to the brain with high fidelity. Our interests are in identifying specializations associated with mechanotransduction and synaptic transmission leading to the amazing sensitivities of the auditory system. We are also interested in the developmental process, particularly in how development gives insight into repair and regenerative mechanisms.

Innovation of devices to improve the quality of life of patients with advanced head and neck cancers, Microvascular free flap reconstruction of large head and neck defects to restore cosmesis and function (speech, swallowing), stem cell recovery of radiation induced salivary damage, and salivary gland cancer biology

Laryngology Otolaryngology Professional voice

My laboratory is focused on two primary areas of research: (1) the immune response to head and neck cancer and to a tumorigenic population of cells within these malignancies called cancer stem cells; (2) the developmental programs of a special lymphocyte population involved in innate immunity called natural killer (NK) cells.