The Division of Laryngology is focused on multidisciplinary treatment of voice, airway and swallowing disorders to improve patients' lives.
Laryngology
The multidisciplinary research team in the Department of Otolaryngology — Head and Neck Surgery's Division of Laryngology includes experts in the following areas:
- Basic science
- Gastroenterology
- Neurology
- Pulmonology
- Speech and language pathology
Airway diseases
Novel treatments for subglottic stenosis
The Mayo Clinic Department of Otolaryngology — Head and Neck Surgery's Division of Laryngology participates in a large multicenter study through the North American Airway Collaborative (NoAAC) that compares airway surgery techniques and their long-term prospective results.
The division's novel approach is to perform CO2 laser wedge excisions and steroid injections without dilation. Preliminary data suggest that this approach results in longer intervals between surgeries, overall improved breathing and improved voice when compared with the traditional endoscopic dilation techniques.
Related publication:
Disease processes
An additional area of airway research interest includes studies of patients with granulomatosis with polyangiitis (GPA, formerly called Wegener's granulomatosis). Specifically, researchers are interested in the causes of idiopathic subglottic stenosis and are exploring this topic through study of biopsies and evaluation of inflammatory markers such as interleukin (IL)-17 and IL-23 proteins. The research goal is to develop a better and more precise medical treatment against inflammatory markers in airway disease.
Swallowing
Surgical techniques for Zenker's diverticulum
The division participates in multicenter prospective studies looking at outcomes of numerous surgical techniques for Zenker's diverticulum. Ongoing retrospective work in this area focuses on comparing recurrence rates and swallowing function after the use of flexible endoscopic technique versus rigid technique.
Related publications:
- Dzeletovic I, Ekbom DC, Baron TH. Flexible endoscopic and surgical management of Zenker's diverticulum. Expert Review of Gastroenterology and Hepatology. 2012; doi:10.1586/egh.12.25.
- Van Abel KM, Tombers NM, Krein KA, Moore EJ, Price DL, Kasperbauer JL, Hinni ML, Lott DG, Ekbom DC. Short-term quality-of-life outcomes following transoral diverticulotomy for Zenker's diverticulum: A prospective single-group study. Otolaryngology — Head and Neck Surgery. 2016; doi:10.1177/0194599815616078.
Disease processes
Inclusion body myositis is another area of research interest. Researchers follow patients after endoscopic cricopharyngeal myotomy surgery to assess outcomes in this inflammatory muscle disease.
Voice
Unilateral vocal fold paralysis
The Division of Laryngology has multiple clinical studies that use large databases to analyze outcomes data on medialization laryngoplasty for treatment of unilateral vocal fold paralysis.
Additionally, the division participates in Mayo Clinic's ear, nose and throat regenerative medicine lab in cooperation with investigators from the United States, United Kingdom and France with the goal of developing a long-lasting biomaterial for injection laryngoplasty.
The multidisciplinary team is studying a novel jellyfish collagen implant for medialization laryngoplasty to treat unilateral vocal fold paralysis. In vitro data show that collagen scaffolding can be combined with autologous adipose derived stem cells and differentiated chondrocytes to create a promising new injectable.
Normal and disordered voice
Division researchers are studying the effects of behavioral interventions using brain-based and motor learning approaches. Investigators use acoustic, aerodynamic and other physiological measures as well as perceptual and visual analysis to understand behavioral responses both in people with normal voices and in those with voice disorders.
Related publications:
- Sara JDS, Maor E, Borlaug B, Lewis BR, Orbelo D, Lerman LO, Lerman A. Non-invasive vocal biomarker is associated with pulmonary hypertension. PLOS One. 2020; doi:10.1371/journal.pone.0231441.
- Youssef S, Bayan S, Ekbom D, Lohse C, Zimmermann T, Pittelko R, Orbelo DM. Breathiness and consensus auditory-perceptual evaluation of voice (CAPE-V) in patients undergoing medialization laryngoplasty with or without arytenoid adduction. Journal of Voice. 2019; doi:10.1016/j.jvoice.2019.08.016.