Research

On this page: Research in Head and Neck Oncology | Auditory Mechanics | McGill Auditory Sciences Laboratory | Pediatric Basic Science/Clinical Research Centre |  Pediatric Speech and Voice Laboratory | OTL Vestibular Laboratory | Rhinology Research | Otology & Neurotology Research | McGill Cochlear Implant Research Program | Voice Laboratory

Research in Head and Neck Oncology

The Department is active in Head and Neck Cancer research including areas of cancer biology, translational cancer research, novel therapeutics, and clinical trials. Novel therapeutics are offered including immunotherapy, targeted biological treatment, new radiotherapy protocols, and new chemotherapy protocols, not yet available outside the trials.  The department offers Transoral Robotic Surgery  (TORS) at both the Royal Victoria Hospital of MUHC (Glen site) and the Jewish General Hospital with active trials.

Currently there are many trials on head and neck cancer active and accruing patients within the Department and the McGill Head and Neck Cancer Program.  For list of trials on head and neck cancer see https://www.mcgill.ca/rcr-rcn/files/rcr-rcn/head_and_neck_2.pdf

Transotral Robotic Surgery Trials:

ORATOR cooperative  trial with TORS was recently completed accrual.

ORATOR II trial with TORS will be activated soon at MUHC and JGH.

NeCTORS Trial: Neoadjuvant Chemotherapy and Transoral Robotic Surgery

Principal Investigator: Nader Sadeghi

Tel: 514-394-1934 Ext 34978

Co-Investigators: Nathaniel Bouganim, Keith Richardson, Alex Mlynarek, Michael Hier

This novel approach has been pioneered by Dr. Nader Sadeghi and is currently open for accrual in a phase II trial. This is a new concept and novel approach for treatment of advanced oropharyngeal cancer associated with Human Papilloma Virus (HPV).  The approach includes neoadjuvant (upfront) chemotherapy followed by Transoral Robotic Surgery (TORS ) for definitive management of stage 3 and stage 4A oropharyngeal cancers. Surgery is done via TORS and neck dissection.  The trial is designed to start with chemotherapy first.  This provides effective systemic treatment to prevent systemic metastasis while it also down-stages the tumor in the neck and the primary site, allowing less invasive yet effective surgery.  The trial is unique in its concept and approach in that it is surgery based. It is not radiotherapy based unlike standard treatment options and other ongoing trials for oropharyngeal cancer. It is a paradigm shifting approach that allows avoiding radiotherapy, hence avoiding all side effects and chronic sequellae associated with radiotherapy to the head and neck region.

The original publication describing the approach: https://www.ncbi.nlm.nih.gov/pubmed/27299983

Psychosocial Oncology Research Program:

The Psychosocial Research Program of the Department is headed by Dr. Melissa Henry. Dr. Henry’s research program aims to implement and evaluate interventions targeting early determinants of mental health, combining translational research with a major focus on head and neck oncology. Patients with head and neck cancer have been understudied despite presenting higher levels of psychological distress, physical symptom burden, and morbidity, compared to patients in general oncology.  Dr. Henry is mainly interested in preventing long- term psychological distress trajectories and promoting health through thoughtfully planned early interventions, based on sound modeling including translational research combining the fields of psychology, oncology, and most recently genetics. Her innovative and productive research program has and will continue to have an important impact on identifying algorithms for early recognition of head and neck cancer patients at risk of deteriorated mental health, psychological distress, and quality of life compromise during their illness and treatment trajectory. Her research program is already contributing to our better understanding of the biological component to this biopsychosocial vulnerability in a way that has never been previously done, including the underlying contribution of polygenic risk scores, gene-environment interactions, and immunological processes.

Implementing an e-Intervention to Reduce Anxiety Symptoms and Improve Psychosocial Oncology Uptake in Patients Newly Diagnosed with Head and Neck Cancer: Pilot Randomized Controlled Trial

Principal Investigator: Melissa Henri

Co-Investigator: Nader Sadeghi, Michael Hier, Alex Mlynarek, Keith Richardson

Functional Outcome Research on Head and Neck Cancer

Head and Neck Cancer Survivorship: Factors affecting functional outcome in head and neck cancer.

Principal Investigator: Nader Sadeghi

Co-Investigators: Keith Richardson, Alex Mlynarek, Michael Hier, Marco Mascarella

Auditory Mechanics

Research Lab: Auditory Mechanics Laboratory

Site: Dept. of Biomedical Engineering, Lyman Duff Medical Sciences Bldg.

Director: W. Robert J. Funnell, PhD Eng., Assoc. Professor

The overall objectives of the research in this laboratory are improved diagnosis and treatment of hearing disorders based on a quantitative understanding of the mechanical behaviour of the middle ear. Our approach involves the development and analysis of three-dimensional finite-element models, an engineering technique that depends heavily on the use of computers.  The goal is to enhance the non-invasive clinical evaluation of middle-ear and inner-ear function, especially for newborn hearing screening.  The models are also useful for the design of techniques and prostheses for middle-ear surgery.

Our modelling work is done in conjunction with experimental measurements that we make in Dr. Sam Daniel's lab in this department, and also in close collaboration with labs elsewhere in Canada and internationally.  We make use of several types of imaging data produced at McGill (for example, clinical CT scans and state-of-the-art nanoCTscans) as well as data from collaborators elsewhere.

We are also involved in research on using 3-D models in anatomy education and in surgical simulation.

McGill Auditory Sciences Laboratory

Research Lab: McGill Auditory Sciences Laboratory

Site: Montreal Children's Hospital

Director: Dr. Sam J. Daniel

This research unit is equipped with the latest research technology in Laser Doppler Vibrometry, ABR, and OAE measurements. There is a sound-proof room, as well as two animal operating rooms, a computer modeling unit, and four state of the art drilling stations with video recording capacity. The laboratory currently supervises one PhD, two graduate students, and three research fellows. We also have a visiting professorship program.

For a visit to the laboratory or enquiry about projects please contact the lab manager: M Akache at 514-412-4400 ext. 23060.

Past and present areas of research:

  • Ototoxicity
  • Middle-ear mechanics
  • Hearing development
  • Hearing diagnostics
  • Middle ear model as a research project in collaboration with Dr. Robert Funnell, Biomedical Engineering, Lyman Duff Medical Sciences Building.

Pediatric Otolaryngology Research

Site: Montreal Children's Hospital

Supervisors: Dr. S. J. Daniel, Dr. J. Manoukian, Dr. L. Nguyen, Dr. M. D. Schloss, Dr. T. Tewfik

Tel.: 514-412-4304

Fax: 514-934-4342

Responsibilities of the resident:

Prior to the start date of research project, the resident must:

  • choose a research project with the supervisor (clinical and/or basic science research);
  • choose co-supervisors from other departments that will be involved;
  • do literature review to ensure that project is relevant and original;
  • estimate the cost of the project;
  • provide grant proposal and/or request financial support from the OTL Department;
  • choose the location of work and verify the availability of facilities (animal lab, research lab, clinic, OR, etc.);
  • verify and ensure the availability of supervision and/or assistance during research work (coordination of departments involved);
  • think of potential research pitfalls in advance;
  • consider that this research project can be part of a master's degree in Otolaryngology and discuss this with the supervisor.
  • verify that the study can be undertaken and completed in the allocated time period;
  • do a trial run of the research project (when possible);
  • write and submit a research proposal to the hospital's research institute;
  • write and submit a research proposal to the hospital's ethics committee;
  • if applicable, get approval from the animal protection committee as well as the infectious diseases committee;
  • ensure that an epidemiologist and/or biostatistician is involved.

During the research project, the resident must:

  • collect all data and perform data analysis with the biostatistics department;
  • review work and pitfalls with research supervisor and co-supervisor;
  • write up a manuscript;
  • write up and article to be published in an OTL or international journal.

Upon termination of the research project, the resident must:

  • present the research project at a national or international meeting.

Pediatric Speech and Voice Laboratory

(Gustav Levinschi Laboratory)

Site: Montreal Children's Hospital

Tel.: 514-934-4342

Fax: 514-934-4342

The laboratory is situated at the Montreal Children's Hospital, B-240 (Departmental Clinic). The research deals with pediatric voice and speech problems. This computer-based laboratory is the only pediatric facility in Canada. Equipment includes CSL (Computerized Speech Lab) with its various components: MDVP (Multi-Dimensional Voice Program) and nasometer.

The different types of voice pathology are studied and include:

  • vocal cord nodules and polyps
  • vocal cord paralysis
  • subglottic and glottic stenosis
  • all other congenital and acquired laryngeal problems

Patients with speech defects also benefit from the expertise of the lab. Defects include:

  • velopharyngeal insufficiency
  • cleft palate (including submucous clefts)
  • hyponasality
  • hypernasality

The clinical work is shared by otolaryngologists (fellows, residents, medical students, and staff) and speech therapists, and the patient data base covers the province of Quebec, the Maritime provinces, and various New England states. Different speech pathologists, otolaryngologists, plastic surgeons, gastroenterologists, and respirologists refer their patients to the laboratory.

OTL Vestibular Laboratory

Site: Royal Victoria Hospital

Supervisors: Dr. Tamara Mijovic, Mimi Galiana (PhD)

In the OTL Vestibular Laboratory, under the directorship of Dr. T. Mijovic, the main research thrust is in the function and dysfunction of the vestibular system in humans.  The Laboratory is equipped with state of the art technologies for the assessment of the vestibular function including video Videonystagmography (VNG), Video Head Impulse Test (VHIT), Rotating chair and Vestibular Evoked Myogenic Potentials (VEMPS).

Any project involving human experimentation in the area of the function and dysfunction of the vestibular system can be supported by our facilities.  We have a particular interest in mechanisms of vestibular compensation as well as the use of virtual reality goggles for the assessment of the vestibular system.

Rhinology Research

Site: Royal Victoria Hospital

Supervisors: Dr. M. Tewfik and Dr. S. Frenkiel

2016-2019: Endoscopic Polypectomy performed In Clinic for chronic rhinosinusitis with polyps: The EPIC multicenter randomised controlled trial

Principal Investigator: Kilty, Shaun (Nominated); Fergusson, Dean

This randomized controlled trial seeks to compare endoscopic polypectomy performed in clinic (EPIC) to endoscopic sinus surgery (ESS), the current gold standard surgical treatment for chronic rhinosinusitis with polyps, is normally completed with patients under general anesthetic in a hospital operating room.

2016/10-present: Department of ENT, McGill University, and UQTR Research Chair in Chemosensory Anatomy

The Role of Trigeminal Sensitivity in Chronic Rhinosinusitis

Collaborators: Drs. Johannes Frasnelli, and Maria-Grazia Martinoli

Chronic Rhinosinusitis (CRS) is one of the most common chronic disorders in North America; two very common symptoms described by patients who suffer from this disorder are nasal obstruction (airflow limitation) as well as hyposmia (decreased sense of smell). We hypothesize that the inflammation in the context of a CRS impairs activity and/or density of the TRPM8 receptor, responsible for airflow sensation. We are investigating the association between TRPM8 receptor density and trigeminal sensation in patients with CRS and normal controls.

2015/04-present: Departments of ENT and Materials Engineering, McGill University

Tissue Characterization of Inverted Papillomas using Raman Spectroscopy

Collaborators: Drs. Marta Cerruti

Inverted papillomas (IP) are locally invasive tumors of the nasal cavity with a propensity to recur. More importantly, they have a potential for malignant transformation, with carcinoma found in 10% of cases; they therefore require close surveillance. Until now, this surveillance consisted of serial endoscopic examinations and/or imaging studies, with biopsies of suspicious tissue. The modernization of optical diagnostic tools, including Raman spectroscopy (RS), can potentially identify early tumor recurrence based on the biological fingerprint of normal and neoplastic tissue. If shown to be reliable, in-office or intraoperative probes able to read Raman spectra could be used to diagnose IP or help surgeons confirm negative resection margins in real time during surgery.

2014/09-present: Departments of ENT and Biomedical Engineering, McGill University

Development and validation of 3D-printed rhinology surgical training models

Collaborators: Drs. Lily Nguyen, Luc Mongeau, Robert Funnel

With this research, we attempt to answer whether surgical training can be standardized by creating a specific training curriculum that utilizes 3-D printed anatomical models produced at a low-cost allowing trainees to acquire skills at a rate that is comfortable for them. We are hoping to demonstrate that a low cost medium fidelity surgical task trainer designed by our group will allow trainees to practice the surgical skills deemed important in nasal and sinus surgery, and to improve their skills at a rate that is the same or better as traditional learning techniques.

2012/01-present: Department of ENT, McGill University Health Centre

Differences in innate immunity gene expression and response between chronic rhinosinusitis (CRS) patients with gram-positive and gram-negative infection

Collaborator: Dr. Simon Rousseau 

Oral and topical glucocorticoids are the current mainstay of therapy, however response to the medications is variable among CRS patients. This research seeks to identify biological markers that may contribute to CRS recalcitrance and resistance to glucocorticoids therapy, as well as to evaluate the effect of medical treatment on the sinonasal microbiome.

Otology & Neurotology Research

Location: SMBD — Jewish General Hospital

Supervisors: Dr. Jamie Rappaport and Dr. Tamara Mijovic

Opportunities are available for basic science and/or clinical Neurotology research.  Close collaboration with the Audiology Department offers many resources including computerized systems for audiometry, auditory brainstem responses (ABR), and distortion product oto-acoustic emission (DPOAE) measurements.  Vestibular evaluation is available with ocular and cervical vestibular-evoked myogenic potential (VEMP) testing, as well as, computerized electronystagmography (ENG) laboratory.

The Jewish General Hospital is a major center for acoustic neuroma management in Quebec.  Drs. Jamie Rappaport and Tamara Mijovic collaborate with Dr. Sal DiMaio from Neurosurgery for treatment of these and other skull base pathologies.  Previous projects have examined hearing preservation and vestibular findings in this patient population.  Our current research efforts focus on mechanisms of vestibular compensation.

Dr. Rappaport has a busy clinical practice in Otology, with a major focus on stapes surgery to treat Otosclerosis.  Other potential areas of interest include sudden sensorineural hearing loss, noise-induced hearing loss, tinnitus, chronic ear disease, and vestibular rehabilitation (in collaboration with the Jewish Rehabilitation Hospital in Laval, QC).

Location: Royal Victoria Hospital

Supervisors: Dr. Tamara Mijovic and Dr. Anthony Zeitouni

The vestibular laboratory, located at the Royal Victoria Hospital, is both a clinical and a research facility under the directorship of Dr. Mijovic.  State of the art technology is available for the assessment of the vestibular systems.  The research initiatives are in collaboration with the McGill departments of Biomedical Engineering and Physiology (See Vestibular lab section for details).

Location: McGill University - Mendelsohn Temporal Bone Laboratory

Supervisors: Dr. Tamara Mijovic and Dr. Melanie Duval

The Temporal Bone laboratory located at the Strthcona Anatomy Building on the McGill University campus is a surgical training facility for otologic procedures simulated on cadaveric specimens.  The laboratory can support research in anatomy of the ear and medical education.

Location: Montreal Neurological Hospital

Supervisors: Dr. Anthony Zeitouni and Dr. Marc Tewfik

The Montreal Neurological Hospital is a designated Supraregional Center for Skull Base Surgery including acoustic neuromas and pituitary tumors.  Through clinical and research collaborations over several decades with established labs and researchers a number of research opportunities exist in imaging, surgical education, patient reported outcomes, cognitive issues related to hearing loss and survivorship in skull base surgery patients.

McGill Cochlear Implant Research Program

Program Director: Dr. Anthony Zeitouni, MD

Program Lead Researcher: Alexandre Lehmann, PhD

Lay Abstract:

Cochlear implants can restore audition in deaf individuals; however, successful use of the implant varies widely among individuals.  Recovery of function is limited and the responsible mechanisms are unknown.  A better understanding of the factors that limit outcomes is critical to maximizing functional recovery and improving rehabilitation strategies.

McGill's CI research program combines clinical and basic hearing research to accomplish three specific objectives:  (1) to characterize the brain mechanisms associated with hearing loss and hearing restoration throughout the lifespan; (2) to identify individual factors that impact adaptation and can predict specific outcomes; (3) to develop new strategies that boost the brain's capacity to adapt and improve outcomes.  The ultimate goal is to improve outcomes of implantation and rehabilitation programs and to fully understand the factors that promote or inhibit recovery of function.

Our team combines expertise in Otolaryngology, Audiology, and Cognitive Neuroscience with state-of-the-art brain imaging in order to carry out this innovative research successfully.  A close collaboration between researchers, clinicians, and knowledge users facilitates the translation of research results into new clinical applications.  Significant progress over the past four years demonstrated the feasibility of the program and generated novel knowledge.  Seed funding, keynote invitations to international conferences and peer-reviewed scientific communications demonstrate the recognition of our program's excellence by the scientific and medical communities.

 Research Projects:

  • "Systematic analysis of factors predicting implantation outcomes".  Aim: systematically review the surgical and genetic factors that limit cochlear implantation outcomes.
  • "Neural mechanisms underlying sensory integration in cochlear implant users".  Aim: understand how implant users' brain combine what they see with what they hear, in order to maximize their outcomes.
  • "Brain activity during music perception in cochlear implant patients" (in collaboration with Stanford University).  Aim: assess the capacity of implant users to perceive rhythm and melody and overcome limitations.
  • "Processing of Musical and Vocal Emotions through Cochlear Implants" (GRAMMY funded project).  Aim: understand the brain mechanisms that impede cochlear implant users to understand emotions in voice (i.e happy, angry, sarcastic) and in music.
  • "Linking objective measures to cochlear implant patients; outcomes" (in collaboration with Sao Paulo's Faculty of Medicine Implant Program).  Aim: to connect laboratory measures with real-life difficulties of implantees in order to improve outcomes.
  • Determining the impact of previous visual and auditory sensory experience on the emergence and quality of auditory cortex processing following cochlear implantation (in collaboration with Montreal Neurological Institute).  Aim: to understand how the auditory brain re-organized with hearing loss and subsequent restoration.
  • "Stimulus-specific adaptation from cochlea, to brainstem and cortex" (in collaboration with Salamanca's Neuroscience Institute).  Aim: to contrast animal and human models to understand the effect of hearing loss on the brain.
  • "Objective Measures of cognitive load in cochlear implant patients".  Aim: to measure and reduce the brain fatigue created by using implants.

Collaborating with:

  • Centre for Interdisciplinary Research on Rehabilitation, Montreal
  • Institut Raymond Dewar, Montreal
  • MAB Mackay Rehabilitation Center, Montreal
  • Ear Specialist Center, King Saud University, Saudi Arabia
  • Cochlear Implant Group, University of Sao Paolo, Brazil

Voice Laboratory

Dr. M. Black, Dr. F. Chagnon, Dr. K. Kost

The Voice Laboratory, situated at the Montreal General Hospital (Room C2.125) is a clinical and research unit for voice and laryngeal disorders. Technology available includes video-laryngostroboscopy and spectrography.

The Voice Lab supports multi-disciplinary endeavours between laryngologists, speech-language pathologists, voice scientists, and vocal pedagogues.

Tags: