Department of Otolaryngology—Head and Neck Surgery Works

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    Eliciting and Characterizing Porcine Vocalizations: When Pigs Fly
    (Elsevier, 2022-04-30) Zhang, Lujuan; Fujiki, Robert Brinton; Brookes, Sarah; Calcagno, Haley; Awonusi, Oluwaseyi; Kluender, Keith; Berry, Kevin; Venkatraman, Anumitha; Maulden, Amanda; Sivasankar, M. Preeti; Voytik-Harbin, Sherry; Halum, Stacey; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background/Objectives: While voice-related therapeutic interventions are often researched preclinically in the porcine model, there are no well-established methods to induce porcine glottic phonation. Described approaches such as training animals to phonate for positive reinforcement are time-consuming and plagued by inherent variability in the type of phonation produced and contamination of background noise. Thus, a reliable method of assessing glottic phonation in the porcine model is needed. Methods: In this study, we have created a novel pulley-based apparatus with harness for “pig-lifting” with surrounding acoustic insulation and high-directional microphone with digital recorder for recording phonation. Praat and Matlab were used to analyze all porcine vocalizations for fundamental frequency (F0), intensity, duration of phonation and cepstral peak prominence (CPP). Glottic phonation was detected using F0 (≥ 2000 hz), duration (≥.3 seconds) and researcher perceptual judgment. Partial-glottic phonations were also analyzed. Reliability between researcher judgment and acoustic measures for glottic phonation detection was high. Results: Acoustic analysis demonstrated that glottic and partial-glottic phonation was consistently elicited, with no formal training of the minipigs required. Glottic vocalizations increased with multiple lifts. Glottic phonation continued to be elicited after multiple days but became less frequent. Glottic and partial-glottic phonations had similar CPP values over the 6 experimental days. Conclusion: Our cost-effective, reliable method of inducing and recording glottic phonation in the porcine model may provide a cost effective, preclinical tool in voice research.
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    A single-cell level comparison of human inner ear organoids with the human cochlea and vestibular organs
    (Cell Press, 2023) van der Valk, Wouter H.; van Beelen, Edward S. A.; Steinhart, Matthew R.; Nist-Lund, Carl; Osorio, Daniel; de Groot, John C. M. J.; Sun, Liang; van Benthem, Peter Paul G.; Koehler, Karl R.; Locher, Heiko; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Inner ear disorders are among the most common congenital abnormalities; however, current tissue culture models lack the cell type diversity to study these disorders and normal otic development. Here, we demonstrate the robustness of human pluripotent stem cell-derived inner ear organoids (IEOs) and evaluate cell type heterogeneity by single-cell transcriptomics. To validate our findings, we construct a single-cell atlas of human fetal and adult inner ear tissue. Our study identifies various cell types in the IEOs including periotic mesenchyme, type I and type II vestibular hair cells, and developing vestibular and cochlear epithelium. Many genes linked to congenital inner ear dysfunction are confirmed to be expressed in these cell types. Additional cell-cell communication analysis within IEOs and fetal tissue highlights the role of endothelial cells on the developing sensory epithelium. These findings provide insights into this organoid model and its potential applications in studying inner ear development and disorders.
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    Long-Term Neck and Shoulder Function Among Survivors of Oropharyngeal Squamous Cell Carcinoma Treated with Chemoradiation as Assessed with the Neck Dissection Impairment Index (NDII)
    (Wiley, 2021) Burgin, Sarah J. M.; Spector, Matthew E.; Pearson, Alexander T.; Bellile, Emily; Vainshtein, Jeffrey M.; Rosko, Andrew; Mclean, Scott A.; Bradford, Carol R.; Wolf, Gregory T.; Prince, Mark E. P.; Worden, Francis P.; Eisbruch, Avraham; Chepeha, Douglas B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background: Of interest is the long-term neck and shoulder impairment of patients treated with primary chemoradiotherapy (CRT). This is important for counseling patients regarding treatment decisions when discussing primary CRT. Methods: A cross-sectional study to identify factors that contribute to neck and shoulder dysfunction in patients treated with primary CRT. We utilized the neck dissection impairment index (NDII). Eighty-seven patients treated between 2003 and 2010, who were free of disease, responded; 24 of these 87 underwent post-CRT neck dissection. Mean interval since completion of CRT was over 5 years (62.7 months). Mean age, 63.5 years, male:female 75:12. Results: Mean NDII score was 87.4 (SD 22.1, range 5-100). Multiple linear regression revealed worse NDII scores for patients with larger pre-CRT gross tumor nodal volume (GTVnodal), controlled for age, sex, body mass index (BMI), and the presence of neck dissection (p = 0.02). There were significant associations with increasing GTVnodal and "low" scores for components of the NDII that assessed neck pain (p = 0.02), neck stiffness (p = 0.01), lifting heavy objects (p = 0.02), reaching overhead (p = 0.02), and ability to do work (p = 0.02). Physical therapy (PT) was evaluated as an "anchor" but it was prescribed "as needed." Regression revealed participation in PT was associated with higher GTVnodal, lower BMI, presence of neck dissection, and female sex (p = 0.00007). Conclusion: GTVnodal was an independent predictor of neck and shoulder impairment. High GTVnodal was associated with increased pain and stiffness, and increased difficulty lifting heavy objects, reaching overhead, overall ability to perform work-related tasks and was associated with participation in post-treatment PT.
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    Early Wnt Signaling Activation Promotes Inner Ear Differentiation via Cell Caudalization in Mouse Stem Cell-Derived Organoids
    (Oxford University Press, 2023) Tang, Pei-Ciao; Chen, Li; Singh, Sunita; Groves, Andrew K.; Koehler, Karl R.; Liu, Xue Zhong; Nelson, Rick F.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The inner ear is derived from the otic placode, one of the numerous cranial sensory placodes that emerges from the pre-placodal ectoderm (PPE) along its anterior-posterior axis. However, the molecular dynamics underlying how the PPE is regionalized are poorly resolved. We used stem cell-derived organoids to investigate the effects of Wnt signaling on early PPE differentiation and found that modulating Wnt signaling significantly increased inner ear organoid induction efficiency and reproducibility. Alongside single-cell RNA sequencing, our data reveal that the canonical Wnt signaling pathway leads to PPE regionalization and, more specifically, medium Wnt levels during the early stage induce (1) expansion of the caudal neural plate border (NPB), which serves as a precursor for the posterior PPE, and (2) a caudal microenvironment that is required for otic specification. Our data further demonstrate Wnt-mediated induction of rostral and caudal cells in organoids and more broadly suggest that Wnt signaling is critical for anterior-posterior patterning in the PPE.
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    Function‐Preserving Tailored Open Partial Laryngectomy for Chondrosarcoma of the Thyroid Ala: A Case Report
    (Sage, 2023-09-05) Farlow, Janice L.; Hogikyan, Norman D.; Morrison, Robert J.; Otolaryngology -- Head and Neck Surgery, School of Medicine
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    Photo-click hydrogels for 3D in situ differentiation of pancreatic progenitors from induced pluripotent stem cells
    (BMC, 2023-08-30) Arkenberg, Matthew R.; Ueda, Yoshitomo; Hashino, Eri; Lin, Chien‑Chi; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background: Induced pluripotent stem cells (iPSC) can be differentiated to cells in all three germ layers, as well as cells in the extraembryonic tissues. Efforts in iPSC differentiation into pancreatic progenitors in vitro have largely been focused on optimizing soluble growth cues in conventional two-dimensional (2D) culture, whereas the impact of three-dimensional (3D) matrix properties on the morphogenesis of iPSC remains elusive. Methods: In this work, we employ gelatin-based thiol-norbornene photo-click hydrogels for in situ 3D differentiation of human iPSCs into pancreatic progenitors (PP). Molecular analysis and single-cell RNA-sequencing were utilized to elucidate on the distinct identities of subpopulations within the 2D and 3D differentiated cells. Results: We found that, while established soluble cues led to predominately PP cells in 2D culture, differentiation of iPSCs using the same soluble factors led to prominent branching morphogenesis, ductal network formation, and generation of diverse endoderm populations. Through single-cell RNA-sequencing, we found that 3D differentiation resulted in enrichments of pan-endodermal cells and ductal cells. We further noted the emergence of a group of extraembryonic cells in 3D, which was absent in 2D differentiation. The unexpected emergence of extraembryonic cells in 3D was found to be associated with enrichment of Wnt and BMP signaling pathways, which may have contributed to the emergence of diverse cell populations. The expressions of PP signature genes PDX1 and NKX6.1 were restored through inhibition of Wnt signaling at the beginning of the posterior foregut stage. Conclusions: To our knowledge, this work established the first 3D hydrogel system for in situ differentiation of human iPSCs into PPs.
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    RIPOR2-mediated autophagy dysfunction is critical for aminoglycoside-induced hearing loss
    (Elsevier, 2022) Li, Jinan; Liu, Chang; Müller, Ulrich; Zhao, Bo; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Aminoglycosides (AGs) are potent antibiotics capable of treating a wide variety of life-threatening infections, however, they are ototoxic and cause irreversible damage to cochlear hair cells. Despite substantial progress, little is known about the molecular pathways critical for hair cell function and survival that are affected by AG exposure. We demonstrate here that gentamicin, a representative AG antibiotic, binds to and triggers within minutes translocation of RIPOR2 in murine hair cells from stereocilia to the pericuticular area. Then, by interacting with a central autophagy component GABARAP, RIPOR2 affects autophagy activation. Reducing the expression of RIPOR2 or GABARAP completely prevents AG-induced hair cell death and subsequent hearing loss in mice. Additionally, abolishing the expression of PINK1 or Parkin, two key mitochondrial autophagy proteins, prevents hair cell death and subsequent hearing loss caused by AG. In summary, our study demonstrates that RIPOR2-mediated autophagic dysfunction is essential for AG-induced hearing loss.
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    Large-scale annotated dataset for cochlear hair cell detection and classification
    (bioRxiv, 2023-09-01) Buswinka, Christopher J.; Rosenberg, David B.; Simikyan, Rubina G.; Osgood, Richard T.; Fernandez, Katharine; Nitta, Hidetomi; Hayashi, Yushi; Liberman, Leslie W.; Nguyen, Emily; Yildiz, Erdem; Kim, Jinkyung; Jarysta, Amandine; Renauld, Justine; Wesson, Ella; Thapa, Punam; Bordiga, Pierrick; McMurtry, Noah; Llamas, Juan; Kitcher, Siân R.; López-Porras, Ana I.; Cui, Runjia; Behnammanesh, Ghazaleh; Bird, Jonathan E.; Ballesteros, Angela; Vélez-Ortega, A. Catalina; Edge, Albert S. B.; Deans, Michael R.; Gnedeva, Ksenia; Shrestha, Brikha R.; Manor, Uri; Zhao, Bo; Ricci, Anthony J.; Tarchini, Basile; Basch, Martin; Stepanyan, Ruben S.; Landegger, Lukas D.; Rutherford, Mark; Liberman, M. Charles; Walters, Bradley J.; Kros, Corné J.; Richardson, Guy P.; Cunningham, Lisa L.; Indzhykulian, Artur A.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Our sense of hearing is mediated by cochlear hair cells, localized within the sensory epithelium called the organ of Corti. There are two types of hair cells in the cochlea, which are organized in one row of inner hair cells and three rows of outer hair cells. Each cochlea contains a few thousands of hair cells, and their survival is essential for our perception of sound because they are terminally differentiated and do not regenerate after insult. It is often desirable in hearing research to quantify the number of hair cells within cochlear samples, in both pathological conditions, and in response to treatment. However, the sheer number of cells along the cochlea makes manual quantification impractical. Machine learning can be used to overcome this challenge by automating the quantification process but requires a vast and diverse dataset for effective training. In this study, we present a large collection of annotated cochlear hair-cell datasets, labeled with commonly used hair-cell markers and imaged using various fluorescence microscopy techniques. The collection includes samples from mouse, human, pig and guinea pig cochlear tissue, from normal conditions and following in-vivo and in-vitro ototoxic drug application. The dataset includes over 90'000 hair cells, all of which have been manually identified and annotated as one of two cell types: inner hair cells and outer hair cells. This dataset is the result of a collaborative effort from multiple laboratories and has been carefully curated to represent a variety of imaging techniques. With suggested usage parameters and a well-described annotation procedure, this collection can facilitate the development of generalizable cochlear hair cell detection models or serve as a starting point for fine-tuning models for other analysis tasks. By providing this dataset, we aim to supply other groups within the hearing research community with the opportunity to develop their own tools with which to analyze cochlear imaging data more fully, accurately, and with greater ease.
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    Selection of viral capsids and promoters affects the efficacy of rescue of Tmprss3-deficient cochlea
    (Elsevier, 2023-08-11) Aaron, Ksenia A.; Pekrun, Katja; Atkinson, Patrick J.; Billings, Sara E.; Abitbol, Julia M.; Lee, Ina A.; Eltawil, Yasmin; Chen, Yuan-Siao; Dong, Wuxing; Nelson, Rick F.; Kay, Mark A.; Cheng, Alan G.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Adeno-associated virus (AAV)-mediated gene transfer has shown promise in rescuing mouse models of genetic hearing loss, but how viral capsid and promoter selection affects efficacy is poorly characterized. Here, we tested combinations of AAVs and promoters to deliver Tmprss3, mutations in which are associated with hearing loss in humans. Tmprss3tm1/tm1 mice display severe cochlear hair cell degeneration, loss of auditory brainstem responses, and delayed loss of spiral ganglion neurons. Under the ubiquitous CAG promoter and AAV-KP1 capsid, Tmprss3 overexpression caused striking cytotoxicity in vitro and in vivo and failed to rescue degeneration or dysfunction of the Tmprss3tm1/tm1 cochlea. Reducing the dosage or using AAV-DJ-CAG-Tmprss3 diminished cytotoxicity without rescue of the Tmprss3tm1/tm1 cochlea. Finally, the combination of AAV-KP1 capsid and the EF1α promoter prevented cytotoxicity and reduced hair cell degeneration, loss of spiral ganglion neurons, and improved hearing thresholds in Tmprss3tm1/tm1 mice. Together, our study illustrates toxicity of exogenous genes and factors governing rescue efficiency, and suggests that cochlear gene therapy likely requires precisely targeted transgene expression.
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    Reducing Taperin Expression Restores Hearing in Grxcr2 Mutant Mice
    (Elsevier, 2022) Liu, Chang; Luo, Na; Zhao, Bo; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Recessive mutations in GRXCR2 cause deafness in both humans and mice. In Grxcr2 null hair cells, the sensory receptors for sound in the inner ear, stereocilia are disorganized. Reducing the expression of taperin, a protein that interacts with GRXCR2 at the base of stereocilia, corrects the morphological defects of stereocilia and restores hearing in Grxcr2 null mice. To further validate this finding, this study generated two novel taperin mutant mouse lines that exhibit progressive hearing loss. Then Grxcr2 null mice were crossed with one of these taperin mutant mice. The following morphological analysis revealed that reducing taperin expression indeed corrected stereocilia morphological abnormalities in Grxcr2 null mice. Functional analysis further confirmed that reducing taperin expression partially restored hearing in Grxcr2 null mice.