Ear, Nose and Throat Surgery

About Ear, Nose and Throat (ENT) Surgery Research

Can a Coblation Tonsillectomy (the combination of gentle radio frequency energy with natural saline to quickly remove tonsils) be an effective treatment for children with obstructive sleep apnoea syndrome? How do we ensure chronic ENT infections/over operated sinuses/exposed bones in the nose and ear don't become chronic and untreatable bacteria biofilms.

This is just a taste of the research currently being carried out by the Ear, Nose and Throat Surgery Research team.

If you are thinking of a career in surgical research, the School of  Clinical Sciences is a great place to start. We are located at Monash  Medical Centre (MMC) Clayton within easy walking distance of both Monash  University Clayton Campus and the Clayton Shopping District.

BMedSc(Hons) projects

Ear Nose and Throat, Head and Neck Surgery: Hearing Preservation after Cochlear Implantation

Supervisors: Professor  Stephen O’Leary (Royal Victorian Eye and Ear Hospital, Melbourne University department of Otolaryngology) and Dr Debbie Phyland (Monash Health)

Aim: The study of hearing preservation and inflammation associated with cochlear implantation to improve cochlear implant outcomes.

Background: Melbourne is one of the world’s leading centres for cochlear implant research. The multichannel Bionic ear was pioneered in this city. The study of hearing loss and its management is complex and the bionic ear and its successful use worldwide has been a result of a cooperative approach involving: scientists, surgeons, engineers, audiologists, speech pathologists, paediatricians and early intervention educators.
Areas of research: This field is ever expanding and there are a variety of projects which may involve laboratory and clinical research. Basic science research and laboratory techniques will be applied to implantation technology in the animal model (rats, guinea pigs) and cochlear implant patients. There will be an opportunity to attend clinics and see cutting edge translational research in action.

Location: Royal Victorian Eye and Ear Hospital – laboratory and clinical

Please contact Dr Debbie Phyland on Debra.Phyland@monashhealth.org if  you wish for more information about any of these projects.

Quality of life for persons with Hereditary Haemorrhagic Telangiectasias (Osler-Weber-Rendu Sydrome)

Supervisor: Dr Debbie Phyland
Principal ENT Consultant Researcher: Dr Joanne Rimmer

Background: Hereditary haemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant vascular disease with an incidence of approximately 1:5000 and characterized by mucocutaneous telangiectasia and visceral arteriovenous malformations, with recurrent epistaxis being the predominant symptom for most patients. The genetic abnormality, of which there are various, leads to inappropriate maturation of blood vessels in response to angiogenic stimuli. Fragile vessel walls make the nasal lesions prone to haemorrhage, even in response to minor trauma such as nasal airflow, and a lack of elastic fibres in vessel walls leads to prolonged bleeding as they are unable to undergo vasoconstriction. Epistaxis varies in severity and frequency but is often moderate to severe and significantly affects patients’ quality of life. Treatment is therefore aimed at reducing the frequency and severity of bleeding. (Rimmer, J., & Lund, V. J. (2014). A modified technique for septodermoplasty in hereditary haemorrhagic telangiectasia. Laryngoscope, 124(1), 67-69).

Project-This project would involve the evaluation of outcomes pre and post ENT intervention using validated Quality of Life measures.

The Development and Use of 3D printed prototype Temporal Bones in Surgical Training

Supervisor: Dr Debbie Phyland
Principal ENT Consultant Researcher: Dr Paul Paddle

Background: The usefulness of 3D prototypes in medicine is well accepted. Surgical trainees need multiple attempts to learn essential procedures. The use of models for surgical-training simulation allows trainees to practice these procedures repetitively in a safe environment until they can master it. This would theoretically shorten the learning curve while standardizing teaching and assessment techniques of these trainees.

Project-This project would involve a review of the literature regarding the usefulness of 3D printing of anatomical models for the purposes of training, the design and development of models and part validation of the role of temporal bone models in skill development for ENT training.

Serial Intra-Lesional Steroid (SILSI) injections for Subglottic Stenosis using a new Steroid Polymer
Supervisor: Dr Debbie Phyland
Principal ENT Consultant Researcher: Mr Paul Paddle

Background: Idiopathic subglottic stenosis (ISS) is a complex problem for which the ideal solution has yet to be developed. Surgical management typically consists of laryngeal dilation, laryngotracheoplasty or laryngotracheal resection with primary anastomosis. Often, surgical management requires multiple interventions due to recurrence of stenosis. In addition, there are the surgical risks of recurrent laryngeal nerve injury, vocal fold scarring and dehiscence of anastomosis. No proven medical alternative for ISS is available but there is emerging evidence for improved outcomes with serial intra-lesional steroid injections (Franco, R. & Paddle, P. 2015 AAOHNS).

Project- This project would involve evaluation of airway outcomes pre and post SILSI trials using a recently developed steroid polymer.  

Microbacterial profiling of vocal fold process granulomas

Supervisor: Dr Debbie Phyland                             
Principal ENT Consultant Researchers: Mr Neil Vallance & Mr Paul Paddle

Contact granulomas and contact ulcers of the larynx are benign lesions of the posterior glottis most commonly located/arising at the tips of the cartilaginous vocal processes. Typically they cause symptoms of hoarseness, throat discomfort, chronic throat clearing and frequently a sharp stabbing pain radiating into the ear. Surgical intervention is frequently required for symptomatic management but there is a high rate of recurrence. Vocal process granulomas are considered to develop from mechanical and/or inflammatory injury to the posterior glottis. Although bacterial, viral and fungal infections have been implicated in their development, their microbiota has not been studied to date.

Project- This project will involve the characterisation of bacterial communities in biopsies of granulomas using a methodology used in a similar study in the US. (Hanshew, A. S., Jetté, M. E., & Thibeault, S. L. (2014). Characterization and comparison of bacterial communities in benign vocal fold lesions. Microbiome, 2(1), 1.)

There is also potential for involvement in other ongoing Departmental projects which include:

  • Quality of life in children before and after adeno-tonsillectomy with or without Obstructive Sleep Apnoea
  • Inflammatory factors in
  • chronic sinusitis (Joanne Rimmer)
  • benign laryngeal lesions (Neil Vallance & Debbie Phyland)
  • subglottic stenosis (Paul Paddle & Neil Vallance)