UNC Otolaryngology/Head and Neck Surgery 2020-2021 Annual Report

2020-2021 REPORT

TABLE OF CONTENTS 2 3

QUICK FACTS

4

LEADERSHIP TEAM

5

RESPONSE TO COVID-19

7

DIVERSITY, EQUITY & INCLUSION

8

DIVISION OF HEAD AND NECK SURGICAL ONCOLOGY

MESSAGE FROM THE CHAIR

11

DIVISION OF PEDIATRIC OTOLARYNGOLOGY

16

DIVISION OF FACIAL PLASTIC & RECONSTRUCTIVE SURGERY

19

DIVISION OF RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY

24

DIVISION OF OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY

27

DIVISION OF GENERAL OTOLARYNGOLOGY

28

DIVISION OF VOICE & SWALLOWING DISORDERS

30

THE COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM

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THE CHILDREN'S COCHLEAR IMPLANT CENTER AT UNC

38 45 51

RESEARCH

52

ADMINISTRATIVE HIGHLIGHTS

EDUCATION CLINICAL HIGHLIGHTS

Page 1

Quick Facts Who We Are

28

12

13

11

48

10

Clinical Faculty

Research Faculty

Adjunct Faculty

APP/Other Providers

7

23

2

16

Fellows

Residents

Postdoctoral Researchers

Research Staff

Clinical Staff

Administrative Staff

Total Research Funding

$3,764,011 Residency Doximity Rankings

#18

Overall Otolaryngology Residency Program

#11

Otolaryngology Residency Research Output

Resident Research Quick Facts

18

43

40

Poster Presentations

Oral Presentations

Publications

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MESSAGE FROM THE CHAIR UNC Otolaryngology/Head and Neck Surgery: Celebrating 70 years of Excellence for the People of North Carolina The Department of Otolaryngology/Head and Neck Surgery is celebrating its 70th year after being founded by Dr. Newton Fischer as the UNC School of Medicine was transitioning to a 4-year medical school. Over this time, the Department’s growth and increased scope has been dramatic. The number of faculty, variety of illnesses, and our understanding of disease processes have remarkably increased. Our educational efforts and academic pursuits have similarly increased as we strive to accomplish our missions of patient care, education, and research. I am extremely proud of our award-winning faculty who have attained national and international prominence for their clinical care, groundbreaking research, and innovative approaches to medical education. During this pandemic year, we have continued to excel as we have revamped our residency, increased our research funding (now ranked 21st in the nation), and continued to expand clinical care for patients in North Carolina, the Southeastern U.S., and the remainder of the nation, as well as internationally. Our staff are the glue that holds us together and are to be congratulated for their dedication to advancing our missions on all fronts - providing critical access and care for our patients as well as supporting education and research. Our learners are exceptional - working in teams to care for complex otolaryngology patients, while excelling in academic productivity. I am truly grateful to lead such an outstanding Department, and hope that you enjoy learning about the leading role that we play within the UNC School of Medicine and UNC Health. In partnership with these entities, we will no doubt continue to provide the highest quality of care to patients while we innovate and advance care through research and education.

Wendell G. Yarbrough, MD, MMHC, FACS Thomas J. Dark Distinguished Professor and Chair

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LEADERSHIP DEPARTMENT CHAIR Wendell G. Yarbrough, MD, MMHC, FACS

VICE CHAIRS OUTPATIENT OPERATIONS & IMPROVEMENT Kevin D. Brown, MD, PhD RESEARCH Emily Buss, PhD

EDUCATION Robert A. Buckmire, MD

FACULTY DEVELOPMENT Amelia F. Drake, MD, FACS

ADMINISTRATION (ACA) Sara Beland, MHA

INPATIENT OPERATIONS & IMPROVEMENT Trevor G. Hackman, MD, FACS ACADEMICS & OUTREACH Brent A. Senior, MD, FACS, FARS

FINANCE Austin S. Rose, MD, MBA, FARS

DIVISION CHIEFS OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY Kevin D. Brown, MD, PhD

VOICE & SWALLOWING DISORDERS Robert A. Buckmire, MD

GENERAL OTOLARYNGOLOGY Christine E. DeMason, MD

FACIAL PLASTIC & RECONSTRUCTIVE SURGERY J. Madison Clark, MD, FACS

HEAD & NECK SURGICAL ONCOLOGY Samip N. Patel, MD, FACS

PEDIATRIC OTOLARYNGOLOGY Carlton J. Zdanski, MD, FAAP, FACS

RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY Brent A. Senior, MD, FACS, FARS

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OUR RESPONSE TO COVID-19 As the world experienced the start of the COVID-19 pandemic in spring of 2020, UNC Otolaryngology/Head and Neck Surgery rapidly mobilized our team of faculty, nursing, audiology, and support personnel to develop and implement evidence-based guidance for our clinical and surgical operations. In the midst of a confusing milieu of rapidly changing information, we put in place strategies to keep our patients and our staff safe while continuing to take care for the people of North Carolina experiencing urgent and emergent head and neck disease needs. As cases in North Carolina continued to rise, faculty and staff were also called on to assist UNC Hospitals with other COVID support activities in the Emergency Department, Respiratory Diagnostic Clinic, as well as other areas where need was greatest. With resumption of normal clinical operations in late spring, multiple new safety features were implemented including reduced seating in waiting areas to encourage social distancing, enhanced cleaning of clinic and waiting rooms, in-car check-in, and HEPA filtration for all clinic rooms--all allowing us to maximize delivery of the safest care in this challenging environment. When the second surge in COVID-19 cases caused by the delta variant hit North Carolina in summer of 2021, we continued many of these same strategies that allowed us to maintain full clinical operations. The commitment, hard work, and resilience of our support staff, nurses, residents and faculty helped us weather rising cases as well as more deployments with only minor disruptions. As a result, UNC Otolaryngology/Head and Neck Surgery has remained and will remain fully available to care for the head and neck needs of all the people of North Carolina, in a safe environment for our patients and our staff.

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DIVERSITY, EQUITY & INCLUSION DEPARTMENT DEI LIAISON Amelia F. Drake, MD, FACS

We now have a strong DEI committee within our department, as well as a section on diversity initiatives at every monthly faculty meeting. We've invited several speakers to discuss the issues of diversity during our Grand Rounds, including David J. Brown, MD, from the University of Michigan and Duane J. Taylor, MD, the Immediate Past President of the American Academy of Otolaryngology-Head and Neck Surgery. In addition, we've started a journal club to launch into discussions of the importance of diversity in the literature, where there has been robust interactions. In addition, we've partnered with the Department of Anesthesiology and many members of the committee participate in their Table Talks to discuss relevant issues. We also now have a Women in Otolaryngology (WIO) group, who has hosted a series of speakers on the topics of interest to women physicians and scientists within our field. We are working well as a group interested in diversity, all within the context of a department who is engaged and with a Chair who is strongly supportive.

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HEAD & NECK SURGICAL ONCOLOGY

Samip N. Patel, MD, FACS Division Chief Associate Professor

Trevor G. Hackman, MD, FACS Fellowship Director Professor

Wendell G. Yarbrough, MD, MMHC, FACS Thomas J. Dark Distinguished Professor

Catherine J. Lumley, MD Assistant Professor

Jeffrey M. Blumberg, MD, FACS Associate Professor

Travis P. Schrank, MD, PhD Assistant Professor

Welcome! Mark C. Weissler, MD, FACS Professor

Catie Voegler, MSPAS, PA-C Inpatient Head & Neck Surgical Oncology APP

Ron Alligood, PhD, ACNP-BC Inpatient Head & Neck Surgical Oncology APP

QUICK FACTS

1,300

1,420

194

New HNO Patient Evaluations

Head & Neck Surgeries

Free Flap Surgeries

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HEAD & NECK SURGICAL ONCOLOGY Advanced Practice Providers Boost Inpatient Care The Department was thrilled to welcome Catie Voegler, MSPAS, PA-C in July 2020 as an Inpatient Head & Neck Surgical Oncology Advanced Practice Provider (APP). We also recently welcomed Ron Alligood, PhD, ACNP-BC as our second Inpatient Head & Neck Surgical Oncology APP. Both have become integral in improving patient care.

Active Lineberger Cancer Center Head & Neck Clinical Trials: LCCC 2044: Prospective observational study to validate circulating HPVDNA and prognostic genomic biomarkers in HPV-associated OPSCC

LCCC 1621: Estimate the pathologic complete response rate (pCRR) after induction chemotherapy with carboplatin, nab-paclitaxel, and durvalumab in previously untreated stage III and IV SCCHN amenable to surgical resection

Head & Neck Cancer NIH SPORE Grant The National Institutes of Health’s Dental and Craniofacial Research Institute awarded UNC Lineberger Comprehensive Cancer Center, Yale Cancer Center and Fox Chase Comprehensive Cancer Center a five-year, $11.7 million Cancer Specialized Program of Research Excellence (SPORE) grant to develop better treatments for head and neck squamous cell carcinoma. Dr. Yarbrough is a clinical co-leader of one of the grant’s three primary projects, a study investigating a new treatment for HPV-associated head and neck squamous cell carcinoma. The clinical trial, based on insights from laboratory studies led by Yarbrough and Natalia Issaeva, PhD are investigating whether there is any clinical benefit in treating patients with a demethylating drug or immunotherapy, or a combination of the two, for approximately two weeks before surgery.

Dr. Schrank Receives NCI K08 Award In July 2020, Dr. Schrank was awarded a NCI K08 award entitled: "Mechanisms Determining Dysregulation of the NRF2 Oxidative Stress Response in Head and Neck Squamous Cell Carcinoma." The proposed research focuses on NRF2, a key regular of oxidative stress, and will explore the proteomic and genomic mechanisms that lead to NRF2 activation, a state associated with the poorer outcome of Head and Neck Squamous Cell Carcinoma (HNSCC). The project has a timeline of five years. This award is one of only 4 head and neck cancer-focused K08s in the US!

Total Number of Papers Published Page 9

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HEAD & NECK SURGICAL ONCOLOGY Advanced Surgical Head and Neck Oncology and Microvascular Reconstruction Fellowship The Advanced Surgical Head and Neck Oncology and Microvascular Reconstruction Fellowship continues to thrive. In 2019, we were pleased to have Blair Barton join us. Dr. Barton is now a Surgical Oncologist at Ochsner Health in New Orleans, LA. Our 2020 fellow, Andrew Coniglio now works in the Head & Neck Center at Rochester Regional Health in New York. We're excited to welcome Mia Jusufbegovich as our 2021-2022 fellow, who joins us from Louisville. "UNC is a large, well-respected program with exceptional H&N volume and experience, as well as a collegial environment with mentors invested in the success of both their patients and trainees." Mia Jusufbegovic, MD

Selected Publications

Barton BM, Blumberg JM, Patel SN. Near-total mandibular reconstruction following osteoradionecrosis with double scapula tip free flap: A case report. Microsurgery. 2021 Aug 17. doi: 10.1002/micr.30798. Epub ahead of print. PMID: 34403154. Lenze NR, Farquhar DR, Sheth S, Zevallos JP, Lumley C, Blumberg J, Patel S, Hackman T, Weissler MC, Yarbrough WG, Olshan AF, Zanation AM. Prognostic impact of socioeconomic status compared to overall stage for HPV-negative head and neck squamous cell carcinoma. Oral Oncol. 2021 Aug;119:105377. doi: 10.1016/j.oraloncology.2021.105377. Epub 2021 Jun 20. PMID: 34161897. Schrank, TP, Lenze, N, Landess, LP, Hoyle, A, Parker, J, Lal, A, Sheth, S, Chera, BS, Patel, SN, Hackman, TG, Major, MB, Issaeva, N, Yarbrough, WG. Genomic heterogeneity and copy number variant burden are associated with poor recurrence‐free survival and 11q loss in human papillomavirus‐positive squamous cell carcinoma of the oropharynx. Cancer. 2021 Aug 1;127(15)2788-2800. doi: 10.1002/cncr.33504. Epub 2021 Apr 5. PMID: 33819343; PMCID: PMC8277690. Lenze NR, Farquhar D, Sheth S, Zevallos JP, Blumberg J, Lumley C, Patel S, Hackman T, Weissler MC, Yarbrough WG, Zanation AM, Olshan AF. Socioeconomic Status Drives Racial Disparities in HPV-negative Head and Neck Cancer Outcomes. Laryngoscope. 2021 Jun;131(6):1301-1309. doi: 10.1002/lary.29252. Epub 2020 Nov 10. PMID: 33170518; PMCID: PMC8106650. Wilson JM, Lumley C, Tan X, Shen C, Coniglio A, Weissler M, Yarbrough WG, Hackman T, Blumberg J, Zanation A, Thorp B, Patel SN, Chera BS. Clinical Outcomes of Patients With pT1-T2N0 Oral Tongue Squamous Cell Carcinoma. Am J Clin Oncol. 2021 May 1;44(5):200-205. doi: 10.1097/COC.0000000000000806. PMID: 33710132. Farquhar, D.R., Masood, M.M., Lenze, N.R., Sheth, S., Patel, S.N., Lumley, C., Zanation, A.M., Weissler, M.C., Olshan, A.F. and Hackman, T.G. (2021), Academic Affiliation and Surgical Volume Predict Survival in Head and Neck Cancer Patients Receiving Surgery. The Laryngoscope. 2021 Feb;131(2): E479-E488. https://doi.org/10.1002/lary.28744. Epub 2020 May 25.PMID: 32449832. Lopez EM, Tanner AM, Du E, Patel SN, Weiss J, Weissler MC, Hackman T, Gupta GP, Zevallos J, Elmore S, Betancourt R, Thorne L, Sheth S, Gulley ML. Decline in circulating viral and human tumor markers after resection of head and neck carcinoma. Head Neck. 2021 Jan;43(1):27- 34. doi: 10.1002/hed.26444. Epub 2020 Aug 28. PMID: 32860343.

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PEDIATRIC OTOLARYNGOLOGY

Carlton J. Zdanski, MD, FAAP, FACS Division Chief Herbert H. Thorp & Julian T. Mann Distinguished Professor

Jaime P. Doody, MD Assistant Professor

Amelia F. Drake, MD, FACS Newton D. Fischer Distinguished Professor

Ali Groesser, MSN, RN, CPNP Pediatric Nurse Practitioner

Lauren A. Leeper, MD, FACS Associate Professor Fellowship Director

Austin S. Rose, MD, MBA, FARS Professor

Honors & Awards

Dr. Amelia Drake Guest examiner for the Oral Boards for the AAO-HNS, both in Feb. and Oct. 2021 Dr. Lauren Leeper Promotion to Associate Professor, Aug. 2020 Dr. Austin Rose Judge, UNC Healthcare Case Competition, Center for the Business of Health, Kenan- Flagler Business School, Nov. 7, 2021 Dr. Carlton Zdanski Resident Graduation Invited Visiting Professor, Department of Otolaryngology, UC Davis, June 2021 Resident Research Symposium, Judge, Department of Otolaryngology, UC Davis, June 2021

Total Number of Papers Published Page 11

22

PEDIATRIC OTOLARYNGOLOGY

Our New Raleigh Clinic! The Division of Pediatric Otolaryngology is thrilled to have opened a new clinic near Lake Boone Trail in Raleigh! The clinic follows a pirate theme and is staffed daily with team members that are just as passionate about caring for children as our physicians. The clinic is equipped with the resources to diagnose and treat a wide variety of conditions and diseases. We are thrilled to be able to care for the children of Wake County and beyond and look forward to the clinic's growth.

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PEDIATRIC OTOLARYNGOLOGY Professional Leadership Dr. Jaime Doody: Appointed UNC School of Medicine Well-being Liaison to Department of Otolaryngology; Current Member of Departmental Resident Education Committee; Current Member of Departmental Diversity Committee Dr. Lauren Leeper: Co-Chair, 2022 ACPA PreConference Symposium; Medical Director, Children's Cochlear Implant Center; Public Health Leadership Certificate, Gillings School of Public Health; Faculty Lead for Children's Hospital Morbidity, Mortality & Improvement; Education Committee, ACPA; AOA Faculty Councilor; Board Member, Gigi's Playhouse Raleigh Dr. Austin Rose: Appointed Vice Chair, Finance in the Department, Aug. 2020; Serves on the Department’s Executive Committee, Aug. 2020-present; Serves on the Faculty Council for The University of North Carolina at Chapel Hill, 2020-2023 term Dr. Carlton Zdanski: Associate Surgeon-in-Chief, North Carolina Children's Hospital; Surgical Director, The North Carolina Children's Hospital; Member, Committee for the Complex Pediatric Otolaryngology certifying exam; Guest Examiner for the American Board of Otolaryngology/Head and Neck Surgery Feb. 2021 & Oct. 2021; Member, Committee for the Complex Pediatric Otolaryngology Exam; Member, Pediatric Otolaryngology Education Committee, American Board of Otolaryngology/Head and Neck Surgery

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PEDIATRIC OTOLARYNGOLOGY Select Presentations at National & International Meetings

Dr. Jaime Doody “Overcoming Decannulation Barriers: Suprastomal Collapse and Stenosis”, Round table moderator at ASPO 2021 Panelist at RCSI Virtual Reception, ACS Congress 2020 Dr. Amelia Drake Dr. Lauren Leeper “Voice and Swallowing Dysfunction Associated with Extracorporeal Membrane Oxygenation in Pediatric Patients”; ASPO Annual Meeting (Quickshot poster, presented by E. Ritter) Dr. Austin Rose MC for the Inaugural AAO-HNSF ENTrepreneur Faceoff event. AAO-HNSF Annual Meeting/Research Forum, Los Angeles, CA, October 5, 2019. Dr. Carlton Zdanski Keynote Speaker, European Society of Pediatric Otolaryngology, November, 2021 Invited Panelist, European Society of Pediatric Otolaryngology, November, 2021 Invited Panelist, American Society of Pediatric Otolaryngology, July, 2021 Invited Panelist, Virginia Society of Otolaryngology Meeting. April, 2021

Research and Funding Accomplishments

Dr. Jaime Doody Consultant with NC State Biomedical Engineering student research project Dr. Amelia Drake “The University of North Carolina (UNC) COVID-19 Fund to Retain Clinical Scientists,” will receive a grant totaling $550,000 from the Doris Duke Charitable Foundation thanks to a grant from the John Templeton Foundation. Dr. Austin Rose Served on Clinical Advisory Group for NC FastTraCS - supported through The North Carolina Translational and Clinical Sciences Institute (NC TraCS) NIH CTSA U01 Award, 2020-present Dr. Carlton Zdanski Multi PI: 5-R01-HL123557-01003 9/1/2015-8/31/2021; $1,941,340, NIH National Heart, Lung, and Blood Inst: "Anatomic optical coherence tomography for quantitative bronchoscopy" (5101750) Multi-PI: 1-R01-HL154429-01 9/1/2020-7/31/2025; $3,966,922, NIH National Heart, Lung, and Blood Inst: "Predicting the Need for Surgery in Pediatric Subglottic Stenosis using Airway Elastography derived from Endoscopic OCT and Intraluminal Pressure Measurement" (5119187) Investigator: 10-07742-8060-46 9/1/2020-8/31/2021; $60,000 Physical Sciences, Inc. SBIR: Multimodal Optical Probe for Real-time Assessment of Airway Tissue after Injury Page 14 (5120198)

PEDIATRIC OTOLARYNGOLOGY Mentoring

Dr. Amelia Drake Mentoring across both medical and dental school (4 students, 2 residents, 3 junior faculty members) Dr. Lauren Leeper Mentoring an ENT resident and a medical student Dr. Austin Rose Mentoring of UNC undergraduate students including shadowing, clinical research, and advising on medical school application (Rhea Jain accepted to the UNC SOM, class of 2025) Continued mentoring and advising of residents on Personal Finance and Investing Dr. Carlton Zdanski Served on advisory committee for Doctoral student in Applied Physics and Mathematics; Thesis successfully defended Mentoring 2 students in Zdanski lab who have successfully applied and been admitted to medical school Mentoring an undergraduate student who will be working in the lab next year and applying to medical school

Pediatric Otolaryngology Fellowship The Division of Pediatric Otolaryngology is excited to welcome Darrin Bann, MD, PhD as the the 2021-2022 Pediatric Otolaryngology fellow. A New Jersey native, Dr. Bann earned his MD and PhD from Penn State University College of Medicine and completed his residency at Penn State Health Milton S. Hershey Medical Center. He represents our first fellow with the entire fellowship fully ACGME-accredited. "The Pediatric Otolaryngology Fellowship at UNC offers world-class training and mentorship in a supportive and collaborative environment nestled within a welcoming, family-friendly community." Darrin Bann, MD, PhD

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FACIAL PLASTIC & RECONSTRUCTIVE SURGERY

Welcome! J. Madison Clark, MD, FACS Division Chief Professor

Matthew Q. Miller, MD Director, UNC Facial Nerve Center Assistant Professor

William W. Shockley, MD, FACS Professor (Retired)

Honors & Awards Drs. Clark and Shockley were Carolina Care Excellence Award winners 2015-2021 Dr. Clark Promoted to W. Paul Biggers Distinguished Professor of OHNS Named a Castle Connolly Top Doctor 2021 Dr. Shockley: 2021 Teaching Award for Dept OHNS Dr. Miller was successfully recruited to UNC to lead the UNC Facial Nerve Center. He started in August 2021 and has already seen over 100 new facial paralysis patients.

Professional Leadership Dr. Clark: Experienced Examiner ABOHNS (Year 2/3) Vice Chair AAFPRS Fellowship Committee Dr. Shockley: Journal reviewer for FPSAM, PRS and OPRS Dr. Menapace (Fellow)-AAFPRS Fellow Curriculum Subcommittee

Research & Funding Accomplishments NIH 1F32DE029964-01, Gene Delivery to Injured Peripheral Nerves, July 1, 2020-June 30, 2021. PI: Matthew Q. Miller. Awarded funds $74,450. 100% effort.

Mentoring

The Division mentored three different medical students and residents in research projects resulting in presentations and/or publications. We also hosted one MS 1/2 UNC medical summer student as part of the Carolina Medical Student Research Program (CMSRP)-Cartilage Analysis (Sulgi Kim). Page 16

FACIAL PLASTIC & RECONSTRUCTIVE SURGERY Textbook Chapters Menapace D, Shockley WW. Master Techniques Rhinoplasty: Chapter – Septoplasty Basicsto-Advanced (in-press) Menapace D, Clark JM. Baileys: Chapter –Soft Tissue Trauma of the Face (in-press) Menapace D. Rhinoplasty Collective (submitted) Menapace D. Hollinshead’s Anatomy for Surgeons: The Head and Neck. 4e – Face Chapter (in illustrations) Mims MM, Clark JM. The Butterfly Graft in Rhinoplasty Archives Mims MM, Clark JM. Baileys: Chapter – Periorbital Reconstruction (in-press)

Presentations

Miller MQ, Shockley WW, Lindsay RW, Clark JM. Challenges in Facial Plastic and Reconstructive Surgery. Newton D. Fischer Society Annual Meeting. June 2021. Chapel Hill, NC Shockley WW: Grand Rounds for OMFS and Plastic Surgery Clark JM: Invited Keynote Speaker in Paris (on Rhinoplasty) and Madrid (on Eyelid Surgery)

Facial Plastic & Reconstructive Surgery Fellowship

The fellowship continues to grow, both in reputation and in size. The addition of Dr. Matthew Miller, Director of the Facial Nerve Center, will significantly expand the breadth of clinical and research exposure for our fellowship. Despite the retirement of Dr. Shockley from clinical work, he will be integrally involved in the education and mentorship of our fellows. The program is recognized across the country for its emphasis on training fellows who intend to pursue an academic career. All of our graduates are full-time faculty members, and several have won faculty teaching awards. Dr. Deanna Menapace, will begin her career at Creighton University Medical Center, her medical school alma mater, upon completion of her fellowship.

We look forward to welcoming Kristy Truong, MD as the next Facial Plastic and Reconstructive Surgery Fellow in July 2021. Dr. Truong received her MD from Georgetown University School of Medicine and completed her residency at the University of Iowa Hospitals and Clinics. "Strong academic program, great mentors, excellent reputation, comprehensive top-tiered facial plastic surgery program." -Kristy Truong, MD

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FACIAL PLASTIC & RECONSTRUCTIVE SURGERY Selected Peer-Reviewed Publications Miller MQ, Jowett N, Hadlock TA. Lessons from Gracilis Free Tissue Transfer for Facial Paralysis: Now versus 10 Years Ago. Facial Plast Surg Clin North Am. 2021 Aug;29(3):415-422. doi: 10.1016/j.fsc.2021.03.001. PMID: 34217444. Malka R*, Miller MQ*, Fullerton Z, Hadlock TA, Banks C. Reliability Between In-Person and Still Photograph Assessment of Facial Function in Facial Paralysis Using the eFACE Facial Grading System. Facial Plast Surg Aesthet Med. Epub ahead of print. PMID: 33325774. Miller MQ, Hadlock TA, Fortier E, Guarin DL. The Auto-eFACE: Machine Learning-Enhanced Program Yields Automated Facial Palsy Assessment Tool. Plast Reconstr Surg. 2021 Feb 1;147(2):467-474. doi: 10.1097/PRS.0000000000007572. PMID: 33235050. Miller MQ, Hadlock TA. Deep Dive into Denervation: Institutional Experience with Selective Denervation in Nonflaccid Facial Palsy. Facial Plast Surg Aesthet Med. 2020 Oct 29. doi: 10.1089/fpsam.2020.0325. Online ahead of print. Miller MQ, Hadlock TA. Improving Outcomes Tracking in Facial Plastic and Reconstructive Surgery. Facial Plast Surg Aesthet Med. October 2020. 22(5); 319-320. PMID 32498557. Mecham JC, Menapace D, Bowe SN, Carlson ML; Recruitment and Networking with Social Media for the Otolaryngology Match in the COVID 19 Pandemic; Otolaryngol Head Neck Surg. 2020 Sept. Menapace D, Carlson KD, Dragomir-Daescu Dan, Matsumoto J, Hamilton GS III; Finite Element Analysis of the Septal Cartilage L-Strut”; Facial Plastic Surgery & Aesthetic Medicine. 2020 July. Ghodke A, Mims M, Shockley W, Clark JM. Suture Knot Externalization Modification of the Fasanella‐Servat Technique for Involutional Ptosis. Laryngoscope. 2020 December 10. doi: 10.1002/lary.29294. Ghodke A, Mims M, Shah R, Clark JM. A complication of Mycobacterium chelonae infection following orbital floor fracture repair. Journal of Craniofacial Surgery. 2020 Dec 3. SCS-2001904.

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RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY

Brent A. Senior, MD, FACS, FARS Division Chief Nathaniel & Sheila Harris Distinguished Professor

Charles S. Ebert, Jr., MD, MPH, FARS, FAAOA, FACS Professor Medical Director of Allergy

Adam J. Kimple, MD, PhD, FACS, FARS Assistant Professor

Brian D. Thorp, MD, FACS, FARS Associate Professor

Honors & Awards

Dr. Kimple was awarded the UNC Academy of Educators Mentorship award. Dr. Ebert promoted to Professor in August of 2020. Dr. Senior: Received the 2021 American College of Surgeons/Pfizer Award for International Volunteerism Named Castle Connolly Top Doctor 2021 Named Best Doctor 2021

Professional Leadership

Dr. Thorp: Established and was elected Chair the Section of Skull Base and Orbital Surgery (SBOS) within the American Rhinologic Society. The section has 201 members as of last count. Dr. Ebert: Elected information officer and chair of Information and Communication Committee for SBOS Named Associate Editor of upcoming ICAR: Allergic Rhinitis 2023 Is Treasurer of American Academy of Otolaryngic Allergy Foundation Named to Rhinology Training Council of the American Rhinologic Society, the Committee that oversees fellowship training in advance rhinology and skull base surgery. Dr. Kimple: Named Research Officer and Chair of Research Committee. Dr. Senior serves as: Academic At-Large Director and on the Executive Committee of the American Academy of Otolaryngology/Head and Neck Surgery Foundation Vice President for Development and Strategy for the ARS President of the International Rhinologic Society Drs. Senior and Kimple served as Co-Chairs of the ENT Guidelines Committee of the Cystic Page 19 Fibrosis Foundation

RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY Select Presentations at National and International Meetings:

Dr. Senior: “Covid Nose-No Limits”. Meeting of the Philippine Society of Otolaryngology-Head and Neck Surgery and the Philippine Academy of Rhinology. July 19, 2020 “Primary and Secondary Rhinosinusitis” Third IndoRhino Meeting, Jakarta, Indonesia. November 1, 2020 “Visiting Professor” Tanta University, Tanta, Egypt. February 5, 2021 “Understanding New Classifications of CRS” and “Frontal Sinus Surgery” at RhinoEgypt, Cairo. March 4-6, 2021. “Minimally Invasive Pituitary Surgery” and “Cryoablation of the PNN for Rhinitis” at 11th Emirates Otorhinololaryngology Audiology and Communication Disorders Congress 2021. April 8-10, 2021 Dr. Ebert: “New Frontiers in Advanced Navigation Technology – Live Discussion”. Invited Panelist. American Academy of Otolaryngology Virtual Meeting. October 17, 2020. Oral Presentation. Virtual Surgeon Lounge: Discussion of Central Compartment Atopic Disease, Migraine, and Sleep & Allergy”. Invited Panelist. American Academy of Otolaryngic Allergy Annual Virtual Meeting. October 27, 2020. Oral Presentation. “Revision Sinus Surgery”. Invited Panelist. 9th American Rhinologic Society Summer Sinus Symposium Virtual Meeting. November 14, 2020. Oral Presentation.

Research and Funding Accomplishments:

Dr. Adam Kimple has continued his work with the Genetics Disorders of Mucociliary Clearance (GDMCC) funded by the National Heart Lung Blood Institute (U54HL096458). Dr. Kimple was recently awarded a Chan Zuckerberg Initiative grant for “Mapping the Pediatric Inhalation Interface: Nose, Mouth, and Airways.” This international project led out of UNC, aims to create transcriptome, proteome, and epigenome reference data from birth to pre-adolescence in diverse and inclusive manner from the mouth and nose to the alveoli. Drs. Senior and Kimple serve as co-Investigators for “Assessment of CFTR Modulators and Sinus Disease in CF” 450,000, Anna Zemke, PI, University of Pittsburgh This is a multi-center study with the University of Pittsburgh understanding the effects of the newly release modulator therapy for patients with cystic fibrosis. This therapy has demonstrated amazing pulmonary results for patient with CF but it is unknown how this life change medication improves sinus disease. The study team is working on finalizing the analysis and submitting this study for publication. Dr. Senior was named Global PI, Lyr-220 Phase 2 Trial sponsored by Lyra Pharmaceuticals

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RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY NeuroRhinology-Advanced Rhinology and Endoscopic Skull Base Surgery Fellowship While 2020 and 2021 have been difficult years for everyone, the NeuroRhinology- Advanced Rhinology and Endoscopic Skull Base Surgery Fellowship at the University of North Carolina celebrated a significant milestone: we celebrated the 10th year of our fellowship! Our training of fellows in the medical and surgical management of sinonasal inflammatory disease, anterior and central skull base lesions (utilizing both endoscopic and/or open techniques), allergic disease, and orbital pathology began in 2011 with our first fellow, Mitch Gore (a former UNC resident). In 2014, we expanded the fellowship to include two fellows per year. Dr. Del Signore and our own Dr. Thorp were the first pair of fellows. Since 2011, we have enjoyed being a part of the development of a group of outstanding neurorhinologists and endoscopic skull base surgeons. We are extremely proud of all their accomplishments and the care they are able to provide to patients all over the country. Our 2020-2021 fellows, Craig Miller, MD and Justin Morse, MD, are now practicing in Rhinology-Skull Base Surgery at Virginia Mason in Seattle, WA and Rhinology at Associates in ENT in Chattanooga, TN, respectively. We're excited to welcome Mark Chaskes, MD, MBA and Keonho (Albert) Kong, MD as our 2021-2022 fellows. Dr. Chaskes earned his MD from Albany Medical College and completed his residency at Thomas Jefferson University Hospital. Dr. Kong earned his MD from Drexel University College of Medicine and completed his residency at Louisiana State University – New Orleans.

"As someone interested in both endoscopic and open skull base surgery, this is the best Rhinology fellowship training program in the country without question." -Mark Chaskes, MD

"The pathology and breadth of rhinology/skull base practice here is unparalleled. That coupled with stellar mentorship amongst faculty makes this an excellent training environment." -Keonho (Albert) Kong, MD

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RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY Mentoring Division Mentored 12 different students and residents in research projects resulting in presentations and/or publications Hosted two MS1/2 UNC medical summer students are part of the Carolina Medical Student Research Program (CMSRP). Mentored Daniel Bacon and Alexander Murr both rising UNC 4th year medical students who were in the Howard Holderness Distinguished Medical Scholars Program

Other Mentoring Highlights

Daniel Bacon published a first author paper looking at the effects of starting triple modulator therapy on olfaction in patients with cystic fibrosis and had a second 1st author paper on a clinical study he performed understanding the effects of COVID-19 on ambulatory patients. Both of Daniel's studies were also accepted for podium talks at national meetings. The COVID-19 pandemic has particularly affected otolaryngologists due to our routine work in the nose and throat. Alexander Murr worked in our division to help better understand what type of procedures generate aerosols in the clinic as well as in the operating room. Additionally, he completed a study looking at a novel device to reduce aerosol generation intraoperatively. His work on aerosols has resulted in three, first author publications and multiple podium presentations at national meetings. Alexander also received a student scholarship for the CI2021 Cochlear Implants in Children and Adults Conference. Abdullah Zeauton joined our division and has been working on starting a clinical trial looking at the effects of TXA on visualization and bleeding in pituitary surgery.

Total Number of Papers Published Book Chapter Published: Senior BA and Gelpi M “Extraocular muscle injury” in Lessons Learned from Rhinologic Procedure Complications. Rakesh Chandra and Kevin Welch, eds. Springer Nature Switzerland 2021. Ebert Jr. CS. “Chapter 10: Case 2: Rhinitis.” In Aleman M and Ortega P, eds. “Spanish and the Medical Interview: Clinical Cases and Exam Review.” Edited by Aleman M and Ortega P. Elsevier. January 2021. Total pages typed: 12. Page 22

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RHINOLOGY, ALLERGY & ENDOSCOPIC SKULL BASE SURGERY Selected Peer-Reviewed Publications Chronic Rhinosinusitis and Allergy

Management of CRS with Nasal Polyps in the Era of Biologics. Morse J, Miller C, Senior B. J Asthma Allergy 2021 July 12;14: 873-882 Contemporary classification of chronic rhinosinusitis beyond polyps vs no polyps: a review. Grayson JW, Hopkins C, Mori E, Senior B, Harvey RJ. JAMA Otolaryngology;2021 Subcutaneous Versus Sublingual Immunotherapy for Adults with Allergic Rhinitis: A Systematic Review with Meta-Analyses. Tie K, Miller C, Zanation AM, Ebert CS Jr. Laryngoscope. 2021 Apr 30. doi: 10.1002/lary.29586. Online ahead of print. PMID: 33929726 Review. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M Jr, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang Y, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. Int Forum Allergy Rhinol. 2021 Mar;11(3):213-739. doi: 10.1002/alr.22741. PMID: 33236525 Review. Intranasal Corticosteroids: Patient Administration Angles and Impact of Education. Treat S, Ebert CS Jr, Farzal Z, Basu S, Zanation AM, Thorp BD, Kimbell JS, Senior BA, Kimple AJ. Rhinol Online. 2020;3:160-166. doi: 10.4193/rhinol/20.070. Epub 2020 Nov 8. PMID: 34263161 Free PMC article.

COVID-19 Pharmacokinetic-based failure of a detergent virucidal for SARS-COV-2 nasal infections. Esther CR, Kimura KS, Mikami Y, Edwards CE, Das SR, Freeman MH, Strickland BA, Brown HM, Wessinger BC, Gupta VC, Von Wahlde K, Sheng Q, Huang LC, Bacon DR, Kimple AJ, Ceppe AS, Kato T, Pickles RJ, Randell SH, Baric RS, Turner JH, Boucher RC. Res Sq. 2021 May 14:rs.3.rs-500168. doi: 10.21203/rs.3.rs-500168/v1. Preprint. PMID: 34013253 Free PMC article. Quantification of Aerosol Concentrations During Endonasal Instrumentation in the Clinic Setting. Murr AT, Lenze NR, Gelpi MW, Brown WC, Ebert CS Jr, Senior BA, Thorp BD, Kimple AJ, Zanation AM. Laryngoscope. 2021 May;131(5):E1415-E1421. doi: 10.1002/lary.29122. Epub 2020 Oct 5. PMID: 33017067 Free PMC article. Quantification of Aerosol Particle Concentrations During Endoscopic Sinonasal Surgery in the Operating Room. Murr A, Lenze NR, Brown WC, Gelpi MW, Ebert CS Jr, Senior BA, Thorp BD, Zanation AM, Kimple AJ. Am J Rhinol Allergy. 2021 Jul;35(4):426-431. doi: 10.1177/1945892420962335. Epub 2020 Oct 4. PMID: 33012174

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OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY Otology, Neurotology & Lateral Skull Base Surgery Fellowship Dr. Selleck, who recently joined as an assistant professor, was the Otology, Neurotology & Lateral Skull Base Surgery fellow for 2019-2021. During her fellowship and residency at UNC, she fell in love with all things ears and restoration of hearing. She has a particular research interest in cochlear implant and patient outcomes utilizing non-invasive imaging techniques. Dr. Selleck has demonstrated herself to be an outstanding surgeon, clinician, humanitarian, and researcher, and we're thrilled she officially joined our team.

Nick Thompson, MD will join us as our 2021-2022 Otology, Neurotology & Lateral Skull Base Surgery fellow. Dr. Thompson worked closely with our team during his residency with UNC. An Iowa native, he earned his MD from the University of Iowa and his undergraduate degree in Kinesiology and Health, Iowa State University.

Total Number of Papers Published

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OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY

Welcome!

Kevin D. Brown, MD, PhD Division Chief Associate Professor

Matthew M. Dedmon, MD, PhD Medical Director of Audiology Assistant Professor

A. Morgan Selleck, MD Assistant Professor

Kayla Wilkerson, DNP, FNPBC, RN Otology Nurse Practitioner

Individual Accomplishments Dr. Selleck: Was named the co-fellowship director of the Otology, Neurotology & Lateral Skull Base Surgery fellowship. Serves on the Equilibrium Committee and the Imaging Committee of the Academy of Otolaryngology – Head and Neck Surgery. Dr. Dedmon: Accepted a position as director of the Temporal Bone Course at UNC. Received the Committee on Faculty Research and Scholarly Leave – Jr. Faculty Development Award of $10,000 for 2021 Received a departmental internal research grant. Dr. Brown: Inducted as a fellow in the Triological Society and was awarded the Harris P. Mosher award for his Triological Thesis: “Benefits of Cochlear Implantation in Childhood Unilateral Hearing Loss (CUHL Trial).” Serves on the Hearing and Implantable Hearing Devices Committees of the Academy of Otolaryngology. He has served on the board of the American Cochlear Implant Alliance and was recently named treasurer. He is on the program committee for the 2022 Combined Sections Meeting in San Diego. Serves on the Editorial Board of Otology and Neurotology and is the Assistant Editor of Cochlear Implants International. Co-authored a position statement by the Academy of Otolaryngology on minimum test batteries for pediatric patients with bilateral sensory hearing loss. Acts as principal or co-investigator on 3 NIH grants studying outcomes of cochlear Quickimplantation Facts in adults and children.

24

100

>400

280

Presentations in 2021

Skull Base Cases Performed

Chronic Ear Cases Performed

Cochlear Implants (Adults + Children) Performed

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OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY Selected Publications

Selleck AM, Brown KD, Park LR. Cochlear Implantation for Unilateral Hearing Loss. Otolaryngol Clin North Am. 2021 Dec;54(6):1193-1203. doi: 10.1016/j.otc.2021.07.002. Epub 2021 Sep 15. PMID: 34535281. Schwartz N, Brown KD, Sasaki-Adams D, Morgan SA, Zanation AM, Thorp BD, O'Connell BP. Multifocal Skull Base Defects With Associated Spontaneous Cerebrospinal Fluid Leaks. Otol Neurotol. 2021 Jun 1;42(5):e624-e628. doi: 10.1097/MAO.0000000000003048. PMID: 33416298. King K, Dillon MT, O'Connell BP, Brown KD, Park LR. Spatial Release From Masking in Bimodal and Bilateral Pediatric Cochlear Implant Recipients. Am J Audiol. 2021 Mar 10;30(1):67-75. doi: 10.1044/2020_AJA-20-00051. Epub 2020 Dec 1. PMID: 33259722. Canfarotta MW, Dillon MT, Buchman CA, Buss E, O'Connell BP, Rooth MA, King ER, Pillsbury HC, Adunka OF, Brown KD. Long-Term Influence of Electrode Array Length on Speech Recognition in Cochlear Implant Users. Laryngoscope. 2021 Apr;131(4):892-897. doi: 10.1002/lary.28949. Epub 2020 Aug 1. PMID: 32738069; PMCID: PMC7855603. Eskridge HR, Park LR, Brown KD. The impact of unilateral, simultaneous, or sequential cochlear implantation on pediatric language outcomes. Cochlear Implants Int. 2021 Jul;22(4):187-194. doi: 10.1080/14670100.2020.1871267. Epub 2021 Jan 12. PMID: 33430719. Selleck AM, Rodriguez JD, Brown KD. Predicting Hearing Outcomes in Conservatively Managed Vestibular Schwannoma Patients Utilizing Magnetic Resonance Imaging. Otol Neurotol. 2021 Feb 1;42(2):306-311. doi: 10.1097/MAO.0000000000002923. PMID: 33290358. Selleck AM, Rodriguez JD, Brown KD. Vestibular Schwannoma Measurements-Is Volumetric Analysis Clinically Necessary? Otol Neurotol. 2021 Jul 1;42(6):906-911. doi: 10.1097/MAO.0000000000003055. PMID: 33577243. Selleck AM, Hodge SE, Brown KD. Cerebrospinal Fluid Leak Following Translabyrinthine Vestibular Schwannoma Surgery-Is Mesh Cranioplasty Necessary for Prevention? Otol Neurotol. 2021 Jun 1;42(5):e593-e597. doi: 10.1097/MAO.0000000000003038. PMID: 33443978. Selleck AM, Dillon M, Perkins E, Brown KD. Cochlear Implantation in the Setting of Menière's Disease After Labyrinthectomy: A Meta-Analysis. Otol Neurotol. 2021 Sep 1;42(8):e973-e979. doi: 10.1097/MAO.0000000000003200. PMID: 34049331. Brown KD, Dillon MT, Park LR. Benefits of Cochlear Implantation in Childhood Unilateral Hearing Loss (CUHL Trial). Laryngoscope. 2021 Sep 20. doi: 10.1002/lary.29853. Epub ahead of print. PMID: 34542181. Park LR, Preston E, Eskridge H, King ER, Brown KD. Sound Opportunities: Factors That Impact Referral for Pediatric Cochlear Implant Evaluation. Laryngoscope. 2021 Dec;131(12):E2904-E2910. doi: 10.1002/lary.29686. Epub 2021 Jun 15. PMID: 34132401. Hodge SE, Thompson NJ, Park LR, Brown KD. Enlarged Vestibular Aqueduct: Hearing Progression and Cochlear Implant Candidacy in Pediatric Patients. Otol Neurotol. 2021 Jan;42(1):203-206. doi: 10.1097/MAO.0000000000003034. PMID: 33885268.

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OTOLOGY/NEUROTOLOGY & LATERAL SKULL BASE SURGERY Park LR, Dillon MT, Buss E, O'Connell BP, Brown KD. Spatial Release From Masking in Pediatric Cochlear Implant Recipients With Single-Sided Deafness. Am J Audiol. 2021 Jun 14;30(2):443451. doi: 10.1044/2020_AJA-20-00119. Epub 2021 Mar 26. PMID: 33769866. Canfarotta MW, Dillon MT, Brown KD, Pillsbury HC, Dedmon MM, O'Connell BP. Incidence of Complete Insertion in Cochlear Implant Recipients of Long Lateral Wall Arrays. Otolaryngol Head Neck Surg. 2021 Oct;165(4):571-577. doi: 10.1177/0194599820987456. Epub 2021 Feb 16. PMID: 33588627. Murr AT, Canfarotta MW, O'Connell BP, Buss E, King ER, Bucker AL, Dillon SA, Rooth MA, Dedmon MM, Brown KD, Dillon MT. Speech Recognition as a Function of Age and Listening Experience in Adult Cochlear Implant Users. Laryngoscope. 2021 Sep;131(9):2106-2111. doi: 10.1002/lary.29663. Epub 2021 May 27. PMID: 34043247; PMCID: PMC8363561. Gagnon EB, Eskridge H, Brown KD, Park LR. The Impact of Cumulative Cochlear Implant Wear Time on Spoken Language Outcomes at Age 3 Years. J Speech Lang Hear Res. 2021 Apr 14;64(4):1369-1375. doi: 10.1044/2020_JSLHR-20-00567. Epub 2021 Mar 30. PMID: 33784469. Lopez EM, Dillon MT, Park LR, Rooth MA, Richter ME, Thompson NJ, O'Connell BP, Pillsbury HC, Brown KD. Influence of Cochlear Implant Use on Perceived Listening Effort in Adult and Pediatric Cases of Unilateral and Asymmetric Hearing Loss. Otol Neurotol. 2021 Oct 1;42(9):e1234-e1241. doi: 10.1097/MAO.0000000000003261. PMID: 34224547; PMCID: PMC8448920. Canfarotta MW, Dillon MT, Brown KD, Pillsbury HC, Dedmon MM, O'Connell BP. Insertion Depth and Cochlear Implant Speech Recognition Outcomes: A Comparative Study of 28- and 31.5-mm Lateral Wall Arrays. Otol Neurotol. 2021 Nov 11. doi: 10.1097/MAO.0000000000003416. Epub ahead of print. PMID: 34772886. Selleck AM, Dedmon MM. Accuracy and patient perceived difficulty of utilizing ototopical antibiotic therapy. Am J Otolaryngol. 2021 Sep-Oct;42(5):103130. doi: 10.1016/j.amjoto.2021.103130. Epub 2021 Jun 19. PMID: 34242952. Hollis ES, Canfarotta MW, Dillon MT, Rooth MA, Bucker AL, Dillon SA, Young A, Quinones K, Pillsbury HC, Dedmon MM, O'Connell BP, Brown KD. Initial Hearing Preservation Is Correlated With Cochlear Duct Length in Fully-inserted Long Flexible Lateral Wall Arrays. Otol Neurotol. 2021 Sep 1;42(8):1149-1155. doi: 10.1097/MAO.0000000000003181. PMID: 33859134; PMCID: PMC8373638. Tittman SM, Yawn RJ, Manzoor N, Dedmon MM, Haynes DS, Rivas A. No Shortage of Decibels in Music City: Evaluation of Noise Exposure in Urban Music Venues. Laryngoscope. 2021 Jan;131(1):25-27. doi: 10.1002/lary.28556. Epub 2020 Feb 10. PMID: 32040200.

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GENERAL OTOLARYNGOLOGY

Christine E. DeMason, MD Division Chief Assistant Professor

Doris Lin, MD Assistant Professor

Andrea Jarchow, MD Assistant Professor

The general division has growing over the last few years. It consists of Dr. Christine DeMason, Dr. Andrea Jarchow and Dr. Doris Lin, who joined the Department in 2020 after being in private practice in the area for many years. The general division has continued to serve both the Orange and Chatham county communities, and has expanded to daily coverage at Chatham county over the last year. Dr. Lin has been expanding office procedures at our Chatham clinic, such has offering nasal vestibular repair surgeries to her patients in clinic. Dr. DeMason continues to focus on sleep surgery and, along with Dr. Trevor Hackman, have now done over 50 hypoglossal nerve implants at UNC. The General Division is also very active in both resident and medical student education. Dr. DeMason became the Director of Medical Student Affairs for Otolaryngology this past year. Drs. DeMason and Lin are active in teaching clinically, as well as giving lectures to medical students. Expanding patient care and increasing student and resident exposure to General Otolaryngology will continue to be major focuses of the general division over the next few years.

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VOICE & SWALLOWING DISORDERS

Robert A. Buckmire, MD Division Chief Professor

Rupali (Pali) N. Shah, MD Associate Professor UNC SOM College Advisor

Our Multidisciplinary Clinic The UNC Voice Center offers a multidisciplinary voice clinic that includes 2 fellowship trained laryngologists, Drs. Buckmire and Shah, along with two voice specialized speech language pathologists: Heather Davis, MA, CCC-SLP and Joe Hall, CCC-SLP. We offer diagnosis and treatment of the full spectrum of voice, swallowing, and airway disorders. We perform over 400 operative cases (endoscopic and open approaches) and over 300 office based laryngology procedures annually (vocal fold augmentation, laser treatments, botox, and more).

Fostering Collaboration

We are proud to have strong, collaborative working relationships with interventional pulmonology, gastroenterology, and thoracic surgery often performing joint cases such as complicated airway treatments, rendezvous procedures, and laryngotracheal reconstructions. We are part of the North American Airway Collaborative (NoAAC), a regional voluntary consortium founded to provide information about the management of adult airway disorders in North America and Europe. With this group, we have participated in and published multiple research projects. During the COVID-19 pandemic, we led institutional airway procedure protocols including tracheostomies in COVID-positive patients and participated in multidisciplinary care of these complicated patients.

Total Number of Papers Published

18

Research Highlights Dr. Shah was awarded the UNC Otolaryngology/Head & Neck Surgery Small Research Grant for an amount of $16,364. She was also awarded the American Laryngological Association's Seymour R. Cohen, MD Research Grant for an amount of $10,000. With the UNC Voice Center, the project was initiated as: Encore: remotely tracking patient reported outcomes in real-time through a mobile application platform. The goal was to design a functioning, user friendly smartphone application platform that effectively and efficiently collects validated survey responses and voice recordings in real-time following intervention. The app is now developed and tested and is currently in enrollment phase.

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VOICE & SWALLOWING DISORDERS The Phase II RRP-001 is an open label, multi-center phase II clinical trial sponsored by Inovio Pharmaceuticals. The UNC Voice Center and Lineberger Cancer Center was chosen to be a study site for patients with recurrent respiratory papillomatosis. Enrolled patients with RRP will receive INO-3017 with electroporation in subjects with HPV 6 or HPV 11 associated RRP. The study will evaluate INO-3017’s ability to generate T cell responses against HPV 6 and 11 with the goal of decreasing or complete regression of RRP lesions. Our group initiated a second novel arm to this study investigating quantification of pre-treatment and on-treatment plasma-based circulating cell free HPV DNA (cfHPVDNA) to correlate levels with clinical response to INO-3017. In addition, Dr. Buckmire is hosting a one-year international research fellow, Dr. Changmyeon Song, MD, within the division.

Professional Leadership

Dr. Buckmire: Program Director, Residency Program, UNC Department of Otolaryngology/Head & Neck Surgery Vice Chair of Education, UNC Department of Otolaryngology/Head & Neck Surgery ALA Program Chair, ALA Meeting 2022 SUO Diversity Committee Fall Voice 2021 Program Committee Dr. Shah: Associate Program Director, UNC Department of Otolaryngology/Head & Neck Surgery Academic Advisor, UNC School of Medicine

Selected Presentations

Dr. Buckmire was selected to be a moderator for: "Surgical Management of Voice disorders" (scientific session). Fall Voice Course, Miami, FL. October 22, 2021. Dr. Buckmire was selected to be a panelist for: " Navigating Relationships in a Laryngology Practice." Early Career Laryngology Section: Fall Voice Course, Miami, FL. October 22, 2021.

Selected Publications

Dorismond C, Shah RN, Ebert CS Jr, Buckmire RA. Impact of medical student research fellowships on otolaryngology match outcomes. Laryngoscope. 2021 Sep;131(9):E2506-E2510. Ghodke A, Tracy LF, Hollis A, Adams K, Shah RN, Buckmire RA. Combined transverse cordotomy – anteromedial arytenoidectomy for isolated glottic stenosis. Laryngoscope. 2021 Oct;131(10):2305-2311. Ghodke A, Mims MM, Shah RN, Clark JM. A complication of mycobacterium chelonae infection following orbital floor fracture repair. J Craniofac Surg. 2021 Jun 1;32(4):1494-1495. Berger MH, Weiland D, Tierney WS, Bryson PC, Weissbrod PA, Shah PV, Shah RN, Buckmire RA, Verna SP. Surgical management of recurrent Zenker’s diverticulum: A multi-institutional cohort study. Am J Otolaryngol. 2021 JanFeb; 42(1):102755. Bick E, Dumberger LD, Farquhar DR, Davis H, Ramsey E, BuckmireRA, Shah RN. Does voice therapy improve vocal outcomes in vocal fold atrophy? Ann Otol Rhinol Laryngol. 2021 Jun; 130(6):602-608. Lenze NR, Ghodke A, Shah RN, Buckmire RA. Predictors of increased surgical drain output following type I thyroplasty for glottic insufficiency. Laryngoscope. 2021 Jul;131(7)1447-1560. Dorismond C, Farzal Z, Shah, RN, Ebert CS, Buckmire RA. “Effect of Applicant Screening Methods on Racial/Ethnic Diversity in Otolaryngology.” Oral presentation for annual AAOHNSF meeting. Oct 3-5, 2021. Ghodke A, Shah RN, Buckmire RA. "Development & Validation of The Shaky Voice Index (SVI-9) for Vocal Tremor and Spasmodic Dysphonia." Oral presentation for annual ALA meeting at COSM May 2021. Trainee received travel grant scholarship from the National Spasmodic Dysphonia Association.

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COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM The UNC Cochlear Implant Clinical Research Program—part of the Division of Auditory Research— is directed by Margaret Dillon, AuD. Research faculty include Lisa Park, AuD, Margaret “Gretta” Richter, AuD, and Meredith Rooth, AuD. Team members include Michelle Bocanegra and Alia Cousar (clinical research coordinators) and Kelly Anderson, Shannon Culbertson, Amanda Davis, and Victoria Sweeney (graduate research assistants). The faculty mentor Department of Otolaryngology/Head & Neck Surgery residents and neurotology fellows, Department of Allied Health Sciences graduate students, and UNC medical students on clinical research projects.

The team has dedicated lab space proximal to the adult cochlear implant clinical program and ENT clinic at Carolina Crossing and to the Children’s Cochlear Implant Center at UNC, which improves the accessibility for adult and pediatric cochlear implant patients to participate in clinical research and allows for rapid application of new evidence-based procedures into the clinical treatment and care of these patients. The current research focuses on outcomes for cochlear implantation in pediatric and adult patients with residual hearing and unilateral hearing loss, procedures for optimizing the mapping of cochlear implant and electric-acoustic stimulation devices, and effects of age at implantation on outcomes. Most investigations are multidisciplinary collaborations with neurotologists, otologists, audiologists, speech-language pathologists, and auditory researchers within UNC School of Medicine and UNC Health. These multidisciplinary collaborations ensure the development of novel approaches for the treatment and care of pediatric and adult cochlear implant patients and resulted in 22 peerreviewed publications and 37 presentations at state, national, and international meetings this year.

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COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM In response to the COVID-19 pandemic, members of the UNC Cochlear Implant Clinical Research Program evaluated methods to improve efficiency of data collection. When UNC Research restricted all in-person research activities in the spring of 2019, the UNC Cochlear Implant Clinical Research team remained productive by initiating virtual meetings and establishing new procedures to collect subjective data from study participants electronically. Team members continued these procedures when in-person research activities resumed, which increased the efficiency of data collection and streamlined in-person visits. Also, team members worked to increase the dissemination of research findings by sharing updates on social media and sending quarterly research updates in a mailer to referring clinicians, study participants, and colleagues. Dr. Park discussed research that expanded pediatric candidacy criteria for cochlear implantation for the On the Ear Podcast. The UNC Cochlear Implant Clinical Research Program celebrated multiple achievements of their team members and colleagues this year. Program funding expanded to include an R21 grant awarded to CoPrincipal Investigators Drs. Dillon and Brown from the NIH NIDCD for their project titled Place-Based Mapping in Electric-Acoustic Stimulation Listeners. This project investigates the effectiveness of a new procedure that combines the surgeon’s expertise in cochlear anatomy and the audiologist’s expertise in device mapping on the performance of cochlear implant patients with hearing preservation who listen with the combination of electric and acoustic stimulation in the same ear.

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COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM Selected Presentations Park, L., Gagnon, E., Dillon, M. (2021). Outcomes of children with cochlear implants and preoperative residual hearing: Electric only and electric-acoustic stimulation. British Cochlear Implant Group Virtual Meeting 2021. May 11-12th, 2021. Virtual. Oral presentation. [Best Presentation Award] Richter, M., Rooth, M., Bucker, A., Dillon, S., Thompson, N., Lopez, E., Pillsbury, H., Brown, K., Dillon, M. (2021). Two year subjective and objective outcomes for cochlear implant recipients with asymmetric hearing loss. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Poster presentation. Dillon, M., Canfarotta, M., Buss, E., Rooth, M., Richter, M., Bucker, A., Quinones, K., Young, A., Roth, N., Raymond, J., Dillon, S., Pearson, A., Dedmon, M., Brown, K., O’Connell, B. (2021). Frequency-to-place mismatch in electric-acoustic stimulation users: Effects on word and vowel recognition. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Oral presentation. [Best Abstract Award] Davis, A. Bucker, A., Roth, N., Dillon, M., Brown, K., Dedmon, M. (2021). Cochlear implant candidate referrals and recipient follow-up patterns as a function of socioeconomic status and geographic region. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Poster presentation. Rooth, M.A., Dillon, M., Buss, E., Richter, M., Pillsbury, H., Brown, K (2021). Spatial release from masking for cochlear implant recipients with unilateral hearing loss. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Poster presentation. Noxon, A., Dillon, M., Preston, E., Park, L. (2021). Assessing speech recognition in the implanted ear alone for pediatric cochlear implant recipients with single-sided deafness: a comparison of test methods. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Poster presentation. [Runner-Up Poster Award] Park, L.R., Gagnon, E.B., Dillon, M.T. (2021). Outcomes in children with cochlear implants and preoperative residual hearing: Electric only and electric-acoustic stimulation. CI2021 Virtual Symposium: Cochlear Implants in Children and Adults, April 28th – May 1st 2021, Virtual. Oral presentation. Anderson, K., Murr, A., Canfarotta, M., Buss, E., Bucker, A., Rooth, M., Dedmon, M., Brown, K., Dillon, M. (2021). Long-term speech recognition in younger and older adult cochlear implant users. American Academy of Audiology (AAA) 2021 Virtual, April 14-16th 2021. Poster presentation, abstract published online. Dillon, M. (2021). Single-Sided Deafness: Influence on speech recognition and quality of life for children and adults. International Otology and Neurotology Symposium: Sharing skills and care across boarders, Virtual conference for csurgeries.com, April 24, 2021. Oral presentation. [Invited Speaker] Dillon, M. (2020). Frequency-to-place mismatch and initial speech recognition of electric-acoustic stimulation device users. Virtual Midwest Conference on Cochlear Implants (CI CRASH) and Mid-Atlantic Symposium on Hearing (MASH) Joint Meeting, Virtual. October 16th - 17th 2020. Oral presentation. Muzio, S., Dillon, M., Park, L., Rooth, M., Brown, K., Lopez, E. (2020). Improved listening effort in adult and pediatric cochlear implant recipients with unilateral and asymmetric hearing loss. North Carolina Audiology Association 2020 Virtual Mini-Conference, Virtual. September 26th 2020. Poster presentation.

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COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM Sweeney, V., Rooth, M., Park, L., Dillon, M. (2020). Benefits of electric-acoustic stimulation (EAS) device use in a pediatric cochlear implant recipient with unilateral hearing loss. North Carolina Audiology Association 2020 Virtual Mini-Conference, Virtual. September 26th 2020. Poster presentation. Anderson, K., Rooth, M., Young, A., Dillon, M. (2020). Long-term hearing preservation and speech recognition benefit in a bilateral electric-acoustic stimulation (EAS) device user. North Carolina Audiology Association 2020 Virtual Mini-Conference, Virtual. September 26th 2020. Poster presentation. Davis, A., Rooth, M., Dillon, M. (2020). Initial spatial hearing abilities of an electric-acoustic stimulation device user with asymmetric hearing loss. North Carolina Audiology Association 2020 Virtual MiniConference, Virtual. September 26th 2020. Poster presentation. Gagnon EB, Park LR, Eskridge H. 2021 The impact of full time use in pediatric cochlear implant users. Poster for the Early Hearing Detection and Intervention Virtual Conference. March 2 – 5, 2021.

Selected Publications Lopez, E.M., Dillon, M.T., Park, L., Rooth, M.A., Richter, M.E., Thompson, N.J., O’Connell, B.P., Pillsbury, H.C., Brown, K.D. (2021). Influence of cochlear implant use on listening effort in adult and pediatric cases of unilateral and asymmetric hearing loss. Otology & Neurotology, 42(9):e1234-e1241. doi: 10.1097/MAO.0000000000003261 Selleck, A.M., Dillon, M., Perkins, E., Brown, K.D. (2021). Cochlear implantation in the setting of Meniere’s disease after labyrinthectomy: A meta-analysis. Otology & Neurotology, 42(8):e973-e979. doi: 10.1097/MAO.0000000000003200 Park LR, Preston E, Eskridge H, King ER, Brown KD. 2021. Sound opportunities: Factors that impact referral for pediatric cochlear implant evaluation. Laryngoscope. 131(12): E2904-E2910. DOI: 10.1002/lary.29686.

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COCHLEAR IMPLANT CLINICAL RESEARCH PROGRAM Murr, A., Canfarotta, M.W., O’Connell, B.P., Buss, E., King, E.R., Bucker, A.L., Dillon, S.A., Rooth, M.A., Dedmon, M.M., Brown, K.D., Dillon, M.T. (2021). Speech recognition as a function of age and listening experience in adult cochlear implant users. Laryngoscope, 131(9):2106-2111. doi: 10.1002/lary.29663 Hollis, E., Canfarotta, M.W., Dillon, M.T., Rooth, M.A., Bucker, A.L., Dillon, S.A., Young, A., Quinones, K., Pillsbury, H.C., Dedmon, M.M., O’Connell, B.P., Brown, K.D. (2021). Initial hearing preservation is correlated with cochlear duct length in fully-inserted long flexible lateral wall arrays. Otology & Neurotology, 42(8):1149-1155. doi: 10.1097/MAO.0000000000003181 Park. L.R., Noxon, A., Preston, E., Dillon, M.T. (2021). Comparison of test methods to assess the implanted ear alone for pediatric cochlear implant recipients with single-sided deafness. Cochlear Implants International, 22(5):283-290. doi: 10.1080/14670100.2021.1903715 Park, L.R., Dillon, M.T., Buss, E., O’Connell, B.P., Brown, K.D. (2021). Spatial release from masking in pediatric cochlear implant recipients with single-sided deafness. American Journal of Audiology, 30(2):443-451. doi: 10.1044/2020_AJA-20-00119 Park LR, Perkins E, Woodard J, Brown KD. 2020. Delaying cochlear implantation impacts post-operative speech perception of non-traditional pediatric candidates. Audiol Neurotol. 36(3): 1825-187 Dillon, M.T., Canfarotta, M.W., Buss, E., O’Connell, B.P. (2021). Comparison of speech recognition with an organ of Corti versus spiral ganglion frequency-to-place function in place-based mapping of cochlear implant and electric-acoustic stimulation devices. Otology & Neurotology, 42(5):721-725. doi: 10.1097/MAO.0000000000003070 Eskridge H, Park LR, Brown KD. 2021. Pediatric language outcomes following simultaneous, sequential, and unilateral cochlear implantation. Cochlear Implants Int. [Published Online Ahead of Print]. DOI: 10.1080/14670100.2020.1871267. Vos, T.G., Dillon, M.T., Buss, E., Rooth, M.A., Bucker, A.L., Dillon, S., Pearson, A., Quinones, K., Richter, M.E., Roth, N., Young, A., Dedmon, M.M. (2021). Influence of protective face coverings on the speech recognition of cochlear implant patients. Laryngoscope, 131(6):E2038-E2043. doi: 10.1002/lary.29447 Canfarotta, M.W., Dillon, M.T., Brown, K.D., Pillsbury, H.C., Dedmon, M.M., O’Connell, B.P. (2021). Incidence of complete insertion in cochlear implant recipients of long lateral wall arrays. Otolaryngology Head and Neck Surgery [online ahead of print]. doi: 10.1177/0194599820987456 Dillon, M.T., Canfarotta, M.W., Buss, E., Hopfinger, J., O’Connell, B.P. (2021). Effectiveness of place-based mapping in electric-acoustic stimulation devices. Otology & Neurotology, 42(1):197-202. doi: 10.1097/MAO.0000000000002965 [Invited Submission: Proceedings from the ACIA 16th Symposium on Cochlear Implants in Children Special Issue]. King, K., Dillon, M.T., O’Connell, B.P., Brown, K.D., Park, L.R. (2020). Spatial release from masking in bilateral and bimodal pediatric cochlear implant recipients. American Journal of Audiology, 30(1):67-75. doi: 10.1044/2020_AJA-20-00051 Dillon, M.T., Buss, E., Rooth, M.A., King, E.R., McCarthy, S.A., Bucker, A.L., Deres, E.J., Richter, M.E., Thompson, N.J., Canfarotta, M.W., O’Connell, B.P., Pillsbury, H.C., Brown, K.D. (2020). Cochlear implantation in cases of asymmetric hearing loss: subjective benefit, word recognition, and spatial hearing. Trends in Hearing, 24:1-20. doi: 10.1177/2331216520945524. Gagnon EB, Eskridge H, Brown KD, Park LR. 2021. The impact of cumulative cochlear implant wear time on spoken language outcomes at age 3 years. J Speech Lang Hear R. 64(4): 1369-1375.

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THE CHILDREN’S COCHLEAR IMPLANT CENTER AT UNC

Our mission at the CCIC is to help children maximize hearing access to optimize communication potential by: Providing quality audiology & speech-language services to children and their families regardless of their ability to pay Coaching professionals in the skills and knowledge to serve children who are deaf or hard of hearing Empowering parents and families to be primary teachers and advocates Improving outcomes in pediatric cochlear implantation through research and cutting edge science

Quality Care

This past year, the pediatric cochlear implant team performed 140 cochlear implants, our 3rd highest number ever. They continued to expand virtual health care options. Our audiologists saw 101 patients virtually and our speech language pathologists continue to provide care to 50% of our therapy patients remotely. In collaboration with the adult cochlear implant program we created a mailing for all NC ENTs which included current guidelines for cochlear implant candidacy; how to refer to our team; and our research studies currently recruiting.

Education & Coaching Our speech team held our first completely virtual Carolina Summer Institute (CSI) to train speech language pathologists and teachers of the deaf in NC and around the country in developing listening and spoken language for children who are deaf or hard of hearing. We’ve been hosting CSI for over 25 years. We also coached professionals towards certification in Listening and Spoken Language. We were grateful to have audiology and speech pathology graduate students back in clinic for internships as well.

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THE CHILDREN’S COCHLEAR IMPLANT CENTER AT UNC Empower Patients In collaboration with the Care Project, we developed a web-based app to connect parents of children who are deaf or hard of hearing with Care Coaches. Care Coaches are parents who have received training and agreed to support other parents on their child’s journey with hearing loss. We continued our work to improve access identified from our Parent Task Force with a focus on bilingual materials for parent handouts and clinic signage. We also hosted a 9 session remote training in collaboration with Early Hearing Detection and Intervention called Parents as Collaborative Leaders (PACL).

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THE CHILDREN’S COCHLEAR IMPLANT CENTER AT UNC CCCDP Financial Assistance Program The W. Paul Biggers Children’s Communication Disorders Program (CCCDP) continued to provide financial assistance to children and families across North Carolina for hearing technology and services. Financial assistance is provided for qualifying children from birth to age 21. This year 30 new patients were enrolled in the grant and 204 patients were served.

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RESEARCH Otolaryngology has a vibrant and diverse research portfolio. In addition to the work conducted by our dedicated research faculty, most of our clinical faculty, medical residents, and fellows are actively engaged in scholarly research related to their clinical interests. Much of our research includes highly skilled research staff, as well as undergraduate, graduate, and medical students. We cover a wide range of topics, including basic and applied research in hearing, rhinology, airway, voice, and head and neck cancer. Across all these endeavors, our faculty have published 110 papers in Emily Buss, PhD peer-review journals in the past year and have garnered nearly $4 million Vice Chair of Research in research funding. Even more important than these milestones, we have found creative ways to continue making headway on our research projects and research training missions despite the changing landscape of COVID restrictions.

Total Number of Papers Published

110 Total Research Funding

$3,764,011 Major Funding Contributors

$432,515

$491,407

$2.3 Million

Department of Defense

MED-EL Corporation

National Institutes of Health

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RESEARCH FACULTY

Emily Buss, PhD Professor Chief, Division of Auditory Research

Meredith Anderson Rooth, AuD Assistant Professor

Margaret T. Dillon, AuD Douglas C. Fitzpatrick, PhD Associate Professor Associate Professor Director, UNC Cochlear Implant Clinical Research Lab

Kendall A. Hutson, PhD Assistant Professor

Natalia Isaeva, PhD Assistant Professor

Andrew F. Olshan, PhD Professor

Lisa Park, AuD Assistant Professor

Michael Kasten, PhD Assistant Professor

Margaret Richter, AuD Research Instructor

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John H. Grose, PhD Professor

Paul B. Manis, PhD Professor Chief, Research Training & Education

Tessa-Jonne Ropp, PhD Assistant Professor

2020-2021 Grants Federal Funding

Emily Buss Developing Evidence-Based Clinical Tools for Managing Mild Hearing Loss in Children (R01, Boys Town, Father Flanagan's Boys' Home) Susceptibility to and Release from Masking in Infancy and Childhood (R01, Boys Town National Research Hospital) A test of children's English/Spanish speech perception in noise or speech maskers (R01, Boys Town National Research Hospital) Factors influencing the behavioral assessment of hearing during infancy and childhood (RO1, NIH) Margaret T. Dillon Place-Based Mapping in Electric-Acoustic Stimulation Listeners. Co-PI: Kevin Brown, MD, PhD (R21, NIH) Douglas C. Fitzpatrick Measurements of Cochlear Synaptopathy Using Electrocochleography (DOD) Mechanisms and Effects of Hearing Loss After Cochlear Implantation (RO1, Oregon Health and Science University) Physiological studies of the precedence effect (RO1, University of Massachusetts at Amherst) Natalia Isaeva, PhD Exploring mechanisms of therapeutic demethylation effects in HPV-associated head and neck cancer (R01, NIDCR) Observational study to validate HPV DNA genotyping and prognostic genomic biomarkers for diagnosis and treatment of HPV-associated HNSCC (U01, NIDCR) Yale SPORE in HN Cancer (NIH) Paul B. Manis Cellular Mechanisms of Auditory Information Processing (R01, NIDCD) Research Training in Otolaryngology (T32, NIDCD) The Nanoscale Connectome of the Cochlear Nucleus in Health and after NIHL (R01, University of South Florida Tampa) Travis P. Schrank Mechanisms Determining Dysregulation of the NRF2 Oxidative Stress Response in Head and Neck Squamous Cell Carcinoma (K08, NIDCR) Investigating Double-Strand Break Repair Deficiency as a Driver of Genomic Copy Number Heterogeneity in HPV Associated Head and Neck Squamous Cell Carcinoma (Yale University) Wendell G. Yarbrough Exploring mechanisms of therapeutic demethylation effects in HPV-associated head and neck cancer (R01, NIDCR) Observational study to validate HPV DNA genotyping and prognostic genomic biomarkers for diagnosis and treatment of HPV-associated HNSCC (U01, NIDCR) Yale SPORE in HN Cancer (NIH)

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Non-Federal Funding Kevin D. Brown Cochlear Implantation in Pediatric Cases of Unilateral Hearing Loss (MED-EL Corporation) Single-Sided Deafness and Asymmetric Hearing Loss Post-Approval Study (MED-EL Corporation) Margaret T. Dillon Cochlear Implantation in Cases of Single-Sided Deafness (MED-EL Corporation) Med-El Collaboration Master Agreement (MED-EL Corporation) Subjective and Objective Performance with the SONNET2EAS (MED-EL Corporation) Douglas C. Fitzpatrick The Optimization of Electrocochleography (ECochG) for Intra-Operative Monitoring and Post-Operative Management (Advanced Bionics Corporation) Adam J. Kimple TRACS Internal (Internal) Lisa Park Outcomes in Children with Cochlear Implants and Pre-Operative Residual Hearing: Electric Only and Electric-Acoustic Stimulation (MED-EL Corporation) Expanded Indications in the MED-EL Pediatric Cochlear Implant Population (MED-EL Corporation) Tessa-Jonne Felicia Ropp Communication deficits in autism linked to central auditory axonal dysfunction (Autism Speaks) Rupali N. Shah UNC Encore: Remotely Tracking Patient Voice Outcomes in Real-Time Through a Mobile Application Platform (American Laryngological Association) Carlton J. Zdanski A Phase 4, Open-Label, Single-Dose, Parallel-Group Study to Evaluate the Safety of 1 g Cefazolin in Pediatric Subjects with a Weight of at Least 25 kg but Less than 60 kg Scheduled for Surgery and the Safety of 2 g of Cefazolin in Pediatric Subjects with a Weight of at Least 60 kg Scheduled for Surgery (B. Braun Medical Inc.) Austin Rose Partial FTE support through The North Carolina Translational and Clinical Sciences Institute (NC TraCS) NIH CTSA U01 Award

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RESEARCH HIGHLIGHTS Auditory Research The Hearing Research Laboratories, led by Drs. John Grose and Emily Buss, are excited to be launching a new 5-year project entitled ‘Binaural Processing and Spatial Hearing: Effects of Age and Hearing Loss’ funded by the National Institute on Deafness and other Communication Disorders (NIDCD). The purpose of this project is to obtain a comprehensive characterization of the spatial hearing abilities of adults across a wide age range, with a particular emphasis on differentiating effects of age and hearing loss. A new intramural grant is funding a collaboration with Dr. Matt Dedmon aimed at synchronous measurement of the electrically-evoked compound action potential and the ABR in adults implanted with MED-EL devices. In the area of pediatric hearing research, our team is wrapping up a 5-year multi-center clinical trial evaluating methods for testing Spanish/English bilingual children. We are excited to release the resulting clinical instrument in the coming year. The Auditory Physiology and Anatomy Research Lab, led by Dr. Fitzpatrick, has been utilizing state of the art 3-D imaging methods combined with electrocochleography (ECochG) to probe the structure and function of the gerbil cochlea. For example, Ken Hutson has developed methods for rapidly imaging the cochlear using light sheet fluorescence miscroscopy. This approach provides 3D images with micrometer resolution, which in turn support modelling and data complementary to other physiological measurements.

This work was recently featured as a cover article in the Journal of Comparative Neurology (Hutson et al, 2020). In addition to animal studies, the lab continues to use ECochG measurements in human subjects taken before, during and after cochlear implantation to better understand the role of cochlear health in outcomes of cochlear implant users.

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RESEARCH HIGHLIGHTS Head and Neck Oncology Research Dr. Natalia Isaeva and Dr. Travis Schrank were selected as guest editors for a Special Issue entitled "Head and Neck Cancers" in the journal Cancers. All articles can be accessed freely online. The Head and Neck Oncology Lab, including Drs. Yarbrough and Isaeva, received a Head and Neck Spore (Yale) Development Research Pilot Award to determine molecular characteristics and prognostic significance of constitutively active NF-κB in the HPV-positive head and neck squamous cell carcinoma (HNSCC). A pressing goal in head and neck oncology is to decrease the morbidity of therapy for HPV+ HNSCC through treatment de-escalation. However, molecular biomarkers that identify HPV+ patients with good prognosis who may be appropriate for de-escalation therapy are lacking. Current work builds on our previous data showing genetic defects in NF-κB regulators are associated with activation of NF-κB signaling that correlates with survival. We have also shown that HPV-positive head and neck tumors exhibiting activated NF-κB have downregulated expression of oxidative stress response NRF2 targets, which may contribute to their increased sensitivity to radiation.

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EDUCATION Program Leadership

Robert A. Buckmire, MD Residency Program Director

Rupali (Pali) N. Shah, MD Associate Program Director

Charles Ebert, Jr. MD, MPH Associate Program Director

Ellen Doutt Program Administrator

Ombudspeople We recently implemented residency representatives to department leadership. For the last two years, Dr. Kelly Dean and Dr. Joseph Conduff served in this role representing and advocating for the interests of their peers. Some of their accomplishments include: Creating streamlined order sets with the ED to improve consult workflow Improving access to ENT equipment and supplies in the ED Improving the workflow around disposable flexible scope use Implementing periodic evaluation of new curriculum updates

COVID-19 Pandemic

Our Residency Program remained strong and productive during the COVID-19 pandemic. While following extreme safety measures, our residents played a crucial role in treating patients during the pandemic, including those that were COVID positive. Despite being unable to travel, our residents attended and presented at several virtual conferences. They also still participated in high level of research and became thought-leaders in COVID-19 related research. We're very impressed with their resilience in these difficult times. Residents are returning to an in-person temporal bone lab—a three month hands-on skills lab — this year. Interviews remain virtual for next year's recruitment.

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Education Restructure The Residency Program underwent a complete education restructuring using resident feedback. The new program emphasizes flexibility and has been adjusted to best meet educational needs. A few highlights include: PGY2 year: New one month rotation on head and neck surgery service, and one month elective on audiology, neuroradiology, and speech/language pathology PGY3 year: Elective one month rotations added to give residents more flexibility to learn more about subspecialties of interest earlier; incorporated earlier facial plastics rotation PGY4 year: Incorporated earlier facial plastics rotation PGY5 year: Introduced a new role of “Academic” chief responsible for didactics and residency curriculum-related matters

Doximity Rankings

#18

Overall Otolaryngology Residency Program

#11

Otolaryngology Residency Research Output

Resident Research Quick Facts

18

43

40

Poster Presentations

Oral Presentations

Publications

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Resident Spotlights Joseph Conduff, MD (PGY4) AAO-HNS SRF Program Representative AAO-HNS Board of Governors (BOG) Governance and Society Committee Ombudsman for UNC ENT Residency

Zainab Farzal, MD, MPH (PGY6, T-32 Research Track) AAO-HNS Served as the 2020-2021 Chair of the Section for Residents and Fellows Section (SRF) Served as the Resident/Fellow representative to the Board of Directors and sat on biannual Board of Directors meetings representing the interests of trainees around the country Completed a term on the Humanitarian Efforts Committee and started a term on the Imaging Committee Led two online webinars for medical student applicants for National Medical Student Forum Featured in the “Why Oto?” video at the 2021 Meeting Opening Ceremony American College of Surgeons Started term as the Resident and Associate Liaison Representative to the Advisory Council on Otolaryngology Started term on the Resident and Associate Section Advocacy and Issues Committee

Andrew Prince, MD (PGY4, T-32 Research Track) Chief Executive Officer and Co-Founder of LiRA (Lip Reading Assistant Technology), a start-up company that partners with patients and health systems to provide lip-reading technology to empower individuals without a voice Top 3 Finalist at AAO-HNS Forum Entrepeneur Face-Off Winner of over $170K in grant funding for his start-up LiRA Featured in multiple print and online media for LiRA innovation

Sarah Russel, MD (PGY2, T-32 Research Track) Advisory Task Force of the AAMC Clinical Skills Assessment and Standardization (CLASS) Member, which was created to determine how to assess clinical skills after the cancellation of Step 2 CS Co-Founder of SPECTRUM, the UNC Graduate Medical Education LGBTQ+ group

Honors and Awards Wesley Stepp: Top Basic Science Abstract, American Rhinologic Society Meeting 2021 Ameer Ghodke: National Spasmodic Dysphonia Association Grant 2021 awarded for recognition of oral presentation selected at COSM 2020

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PGY3 Wesley Stepp, MD, PhD (left) and PGY1 Ameer Ghodke, MD (right)

2020-2021 CHIEF RESIDENTS

Mohammed Mamdani, MD, PhD

Parth V. Shah, MD

Nicholas J. Thompson, MD

NEW RESIDENCY CLASS

Ameer Ghodke, MD Medical School: UNC-Chapel Hill

Habib Khoury, MD Medical School: UCLA

Kayla (Hicks) White, MD Medical School: Case Western

Selected Publications

Cameron Worden, MD Medical School: Virginia Tech Carilion

Canfarotta MW, O'Connell BP, Giardina CK, Buss E, Brown KD, Dillon MT, Rooth MA, Pillsbury HC, Buchman CA, Adunka OF, Fitzpatrick DC. Relationship Between Electrocochleography, Angular Insertion Depth, and Cochlear Implant Speech Perception Outcomes. Ear Hear. 2021 Jul-Aug 01;42(4):941-948. doi: 10.1097/AUD.0000000000000985. PMID: 33369942; PMCID: PMC8217403. Dean K, Grose JH. The Binaural Interaction Component of the Auditory Brainstem Response Under Precedence Effect Conditions. Trends Hear. 2020 Jan-Dec;24:2331216520946133. doi: 10.1177/2331216520946133. PMID: 32808860; PMCID: PMC7436800. Farquhar DR, Lenze NR, Masood MM, et al. Access to preventive care services and stage at diagnosis in head and neck cancer. Head Neck. 2020;10.1002/hed.26326. doi:10.1002/hed.26326 Lopez EM, Dillon MT, Park LR, et al. Influence of Cochlear Implant Use on Perceived Listening Effort in Adult and Pediatric Cases of Unilateral and Asymmetric Hearing Loss. Otol Neurotol. 2021;42(9):e1234-e1241. doi:10.1097/MAO.0000000000003261 Stepp WH, Farzal Z, Kimple AJ, Ebert CS Jr, Senior BA, Zanation AM, Thorp BD. HPV in the malignant transformation of sinonasal inverted papillomas: A meta-analysis. Int Forum Allergy Rhinol. 2021 Oct, 11(10):1461-1471. doi: 10.1002/alr.22810. Epub 2021 May 6. PMID: 33956402 Russel S, Geraghty J, Renaldy H, et al. Training for Professional Uncertainty: Socialization of Medical Students Through the Residency Application Process, Academic Medicine: November 2021 - Volume 96 - Issue 11S - p S144-S150 doi: 10.1097/ACM.0000000000004303 Vos TG, Dillon MT, Buss E, Rooth MA, Bucker AL, Dillon S, Pearson A, Quinones K, Richter ME, Roth N, Young A, Dedmon MM. Influence of Protective Face Coverings on the Speech Recognition of Cochlear Implant Patients. Laryngoscope. 2021 Feb 16:10.1002/lary.29447.

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MEDICAL STUDENT EDUCATION Despite COVID-19, UNC Otolaryngology has continued to be very active in medical student education. The department is extremely proud that five UNC medical students successfully matched into Otolaryngology this past spring, continuing this tradition over the last decade. We are also fortunate that the department was allowed to resume medical student away rotators this past summer, which was deferred last year due to COVID.

Rupali (Pali) N. Shah, MD Co-Director, Medical Education for Otolaryngology

Christine E. DeMason, MD Co-Director, Medical Education for Otolaryngology

Dr. Rupali Shah was selected for the extremely sought-after role of UNC SOM College Advisor, advising 60-70 students throughout their four years of medical school. This past year, Dr. Christine DeMason became the Director of Medical Student Affairs for Otolaryngology and serves as the Otolaryngology Curriculum Course Director for the UNC School of Medicine. Drs. Shah and DeMason jointly act as career goal advisor for ENT. The department continues to be involved in many preclinical student courses—such as the Respiratory and Neuroscience courses—and is constantly one of the most popular specialty surgery rotations for third year students during their surgery block. The department always has students involved in active research projects and consistently has students completing a dedicated research year with the department during medical school. UNC Otolaryngology understands the importance of medical school education and is lucky to work with such wonderful students year after year here at UNC.

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CLINICAL HIGHLIGHTS Promotions Michelle Solano promoted to Admin Support Supervisor Sherena Rudd promoted to CMA Dani Hamlett promoted to CMA

New Services Opened new Pediatric Raleigh Clinic New COVID-19 processes and procedures implemented Became pilot for outpatient COVID-19 vaccines Implemented utilization of medical scribes in outpatient clinics

Team Building Lunch and Learn team building activities for clinic support technicians Implemented daily clinic huddles

News Ashton Fields Named Outpatient Medical Assistant Personnel of the Year for the UNC Medical Center Diane Burden retired

Carolina Care Excellence Awards We are proud to have eight doctors named as Carolina Care Award Recipients this year, including: Dr. Robert Buckmire Dr. Madison Clark Dr. Matthew Dedmon Dr. Harold Pillsbury Dr. Brent Senior Dr. William Shockley Dr. Brian Thorp Dr. Mark Weissler

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FACULTY DEVELOPMENT The following faculty received much-deserved promotions this year: Dr. Ebert was promoted to Professor in July 2020 Dr. Leeper was promoted to Associate Professor in August 2020 Elizabeth Preston, AuD, CCC-A was promoted to Assistant Professor in October 2020 Dr. Thorp was promoted to Associate Professor in January 2021 Dr. Clark was promoted to Professor in July 2021 Dr. Thorp recently completed the Academic Career Leadership Academy in Medicine (ACCLAIM) program and Dr. Patel is in the current cohort of developing leaders.

ADMINISTRATIVE HIGHLIGHTS We had two valuable team members retire after years of service: administrative coordinator Donna Woodard and HR business representative Cheryl Goodrich. We also hired three new team members. Heather Moffitt and Karen Rhodes have both join our administrative team. The department's website is getting revamped and we're devoting effort to build our social media presence. We also implemented two new software systems to streamline processes. Concur is our new travel system and Qgenda is our new scheduling software to automate creation of the physicians' callschedules.

COMMUNICATIONS

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Let's be honest--It's what we all want to do! COVID-19 has impacted us all in seemingly never-ending fashion. Despite this, UNC Otolaryngology/Head and Neck Surgery has continued to move forward and will over this next year as well. We are growing our program, moving forward our care for all the people of North Carolina, while continuing our tradition to be the best providers of specialty otolaryngology/head and neck surgery in the state. Whether it is children or adults suffering from ear infections, hearing loss, sinusitis, allergy, voice disorders, or tumors of the head, neck, and skull base, our team of dedicated providers offer world-leading, cutting-edge care, right here in your own back yard. While our innovative research, education, and outreach in these areas continues to move forward care for North Carolinians as well as patients around the globe. We are proud to be the University of North Carolina Department of Otolaryngology/Head and Neck Surgery, moving forward in 2022 for the people of North Carolina.

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