We are investigating many important clinical problems that face neonates and children, including projects concerning hearing, cochlear implantation, swallowing, sleep disturbances and vocal fold mobility.
Clinical (Patient-Centered) Research
Outcomes research in atresia repair, chronic ear surgery and skull base tumor resection
While the decision-making process and treatment strategy for each patient is individualized, our goal is to use the latest technologies available to provide the best possible outcomes. Because of the complexity of the diseases in many of the patients referred to the Hearing Center, we strive to convey these findings to other physicians around the world by publishing in the medical literature.Our data on treatment outcomes track recurrence rates, postoperative hearing results and various other measures that can help to guide physicians in treatment decisions.
Outcomes of a coordinated educational program after pediatric cochlear implantation
We are making a dedicated effort to design the best possible schooling, speech therapy and counseling programs for our young patients who have undergone cochlear implants. We believe that this wholistic process may provide an educational advantage for our patients. We are measuring long-term outcomes in our patients to test this hypothesis and refine our recommendations for future patients.
Hearing preservation after cochlear implantation
We are careful to preserve whatever acoustical hearing a child has going into a cochlear implantation. We use a minimally invasive technique so as to reduce cochlear trauma during placement of the electrode, and every patient with any acoustical hearing is followed with serial hearing tests after cochlear implantation. Many children retain some or all of their acoustical hearing after implantation, which may improve their long-term outcomes.
Speech outcomes after pediatric cochlear implantation
In order to test speech outcomes in all patients who have undergone cochlear implantation, children have a sample of their speech recorded digitally preoperatively, and at routine intervals postoperatively. These are analyzed using a special algorithm to quantify several important speech characteristics that are often affected in deaf children. As the children use their cochlear implants more and more, their ability to produce specific sounds improves. We are striving to determine what type of speech therapy and/or cochlear implant programming strategies could allow this process to occur more quickly.
Correlation of chronic intermittent hypoxemia on brain MRI in children with obstructive sleep apnea
We hypothesize that the hypoxemia associated with obstructive sleep apnea (OSA) in children will alter brain morphology and cognitive function; these changes might be more pronounced in patients with severe OSA. We plan further study in this area to help evaluate the risks of OSA and benefits of treatment.
Basic Science (Laboratory-Based) Research
We have several research laboratories at Baylor College of Medicine and Rice University interacting closely with The Hearing Center at Texas Children's Hospital. Through our collaborations, we remain on the cutting edge of research and patient care for children with otolaryngological problems.
- The Cochlear Biophysics Laboratory, directed by William E. Brownell, PhD, Baylor College of Medicine
Our researchers are studying the biophysics of hearing in order to better derive treatments for those with hearing issues. The remarkable sensitivity of mammalian hearing results from the ability of inner ear sensory receptor cells (the outer hair cells) to generate mechanical force in response to small electric fields. The mechanism responsible for this electromotility is a membrane-based motor that resides in the cell's lateral wall. The Cochlear Biophysics Laboratory is dedicated to understanding how electromotility is generated.
- The Interdepartmental Program in Cell and Molecular Biology Laboratory, directed by Fred A. Pereira, PhD, Baylor College of Medicine
The Interdepartmental Program in Cell and Molecular Biology Lab uses mice with mutations involving deficits in hearing and/or balance generated by random insertion mutagenesis or by homologous recombination to study the signaling pathways important for functional hearing and balance. We are also performing a structure-function mutagenesis analysis of the novel outer hair cell membrane protein prestin. These studies will help us to better understand and treat hearing and balance problems.
- The Molecular Genetics Laboratory, directed by Raye Lynn Alford PhD, Baylor College of Medicine
Early intervention and effective treatment of childhood hearing loss is crucial to a child's speech, language development, and ability to learn. This lab follows children with sensorineural hearing loss over time, gathering data on their responses to standard therapies for hearing loss. Through these studies, we expect to evaluate the success of different treatments for hearing loss, including hearing aids and cochlear implants, in children with particular genetic mutations. These data will assist in the development of new guidelines for the treatment of early childhood hearing loss that take into account genetic information.
- The Anvari Lab, directed by Bahman Anvari, PhD, Rice University
The Anvari Lab uses laser technologies to improve our understanding of cochlear outer hair cell and basilar membranes, which are crucial to hearing. These studies should help to generate new knowledge that may lead to better treatments for children with hearing impairment.
- The Raphael Lab, directed by Robert Raphael, PhD, Rice University
The focus of the Raphael Lab includes electromechanical transduction in cochlear outer hair cells and the study of aspirin-like molecules and membrane mechanics. We approach scientific problems in a multidisciplinary spirit, employing both theory and experimental data to understand biologic processes at a fundamental level and apply this knowledge for the benefit of human health.