Research

Clinical Profile | Research Profile

Dr. Liu is a surgeon scientist in the Department of Otolaryngology at the University of Miami, where he holds the Hotchkiss Chair in Otolaryngology and is Vice Chair for Research. Under the leadership of Dr. Liu, the Center for Hereditary Deafness (CDH), including research and clinical programs, is currently studying mechanisms, diagnosis, and treatments of deafness caused by genetic mutations. Dr. Liu’s lab has active research programs for genetic hearing loss, presbycusis, Usher syndrome, and Neurofibromatosis Type II (NF2). His research lab focuses on targeted gene, cell, and drug-based therapeutics for hearing loss using the latest cutting-edge technologies, such as gene editing, identification of new genes and establishment of diagnostic panels for deafness by next generation sequencing. His lab also carries out studies to translate molecular advances into clinical applications and collaborates with numerous different research teams around the globe on improving clinical care for these disorders. His team is on the forefront to apply NGS and CRISPR/Cas9 in auditory systems. He also studies novel forms of hearing habilitation, in particular the use of innovative genetic/genomic approaches such as genome editing to rescue hearing loss in mice and in human iPSC cell lines. Dr. Liu’s innovative work has led to exciting new ways to enhance our understanding of normal hearing and the genetic aberrations that result in hearing loss. All of his current projects are funded by multiple NIH grants.

Clinical Profile | Research Profile

Dr. Christine Dinh is a board-certified otolaryngologist and neurotologist who treats patients with hearing- and balance-related disorders. She is also a surgeon scientist, who manages a basic science and translational research laboratory focused on vestibular schwannoma, Neurofibromatosis Type 2, and hearing loss. 

Her team has strong collaborations between physicians and scientists in Neurological Surgery, Neuroscience, Neurooncology, Radiation Oncology, Neuropathology and Human Genetics. Her lab is funded by grants from the NIH/NIDCD, the NIH/NINDS, and the NIH/NCI/Sylvester Comprehensive Cancer Center. 

Her long-term goals are to: (1) identify effective therapies that reduce tumor burden, preserve hearing, and prolong survival in patients with Neurofibromatosis Type 2, (2) determine solutions for radiation resistance and radiation-induced hearing loss in patients with vestibular schwannoma, and (3) develop new techniques to improve surgical outcomes in vestibular schwannoma surgery. Furthermore, she has developed strong collaborations with researchers in head and neck surgical oncology, cancer pathology, and neuroscience to investigate the role of Schwann cells in the development of perineural invasion in head and neck squamous cell carcinoma. With this area of research, she hopes to identify useful targets and test effective therapies that can potential block perineural invasion in our head and neck patients.

Clinical Profile | Research Profile

Dr. Adrien Eshraghi is a tenured professor, board-certified in otolaryngology and neurotology, and he serves as both the Director of the Hearing Research and Communication Disorders Laboratory and as the Co-Director of the University of Miami Ear Institute. He is a surgeon scientist with a special interest in cochlear implants and hearing disorders. One major focus of his research is to understand the molecular mechanisms underlying loss of residual hearing following cochlear implantation and to develop effective therapies to protect this residual hearing. He has conducted research into the evaluation of macroscopic damage to the inner ear following cochlear implantation, and the grading system he proposed for this is now widely used by the international scientific community. He is now exploring the molecular mechanisms involved in sensory cell death that can lead to the loss of residual hearing. Parallel to investigating these mechanisms, he is also focused on developing and testing novel otoprotective and regenerative therapies, including novel drugs, targeted drug therapies with nanoparticles, therapeutic hypothermia, and stem cell therapy. These inner ear treatment modalities will potentially help patients suffering from hearing loss, tinnitus or dizziness.

He is also a Professor in the Departments of Neurological Surgery and Biomedical Engineering, and in this role, he carries out research on neurological disorders, most notably Autism Spectrum Disorders (ASD). He sees many ASD patients that are referred for the evaluation of communication disorders, such as hearing loss, speech delay, and central auditory processing disorders (CAPD), and performs cochlear implants in these patients to improve auditory outcomes when necessary. His team is actively developing experimental models of ASD and CAPD to provide insights into the pathophysiology of these neurological disorders and guide the development of novel treatment modalities. Presently he and his team are utilizing genome editing techniques such as CRISPR/Cas9 as well as neurons derived from induced pluripotent stem cells (iPSC) from ASD patients to understand the molecular mechanisms underlying this neurodevelopmental disorder.

In addition to translational laboratory research, his efforts are also directed at clinical studies. He is conducting clinical research in various complex cases of cochlear implant surgery such as patients having dual diagnosis of hearing loss and autism, cerebral palsy, cytomegalovirus infection, Usher Syndrome, inner ear abnormalities, or revision cochlear implant surgery. He is actively conducting clinical trials in patients with hearing loss, tinnitus, and dizziness. Dr. Eshraghi is enthusiastically involved in mentoring undergraduate and medical students, visiting scholars, residents, as well as national and international scholars.

Clinical Profile | Research Profile

There are over 529,000 new cases of oral cavity and oropharyngeal cancer, together here referred to as oral cancer, with more than 292,000 deaths each year worldwide. The main risk factors are tobacco use, excessive alcohol consumption and infection with the human papilloma virus (HPV). HPV infection is responsible for a rising number of oropharyngeal cancers, one of the few cancers increasing in incidence in the US (ACS Facts and Figures 2012). More than 40% of patients with oral cancer die within five years due to a late-stage diagnosis. Early diagnosis can more than double a patient's chances of survival.

Our group has invented an inexpensive and noninvasive early detection test based on solCD44 and total protein levels in oral rinse specimens, which helps distinguish individuals with molecular features associated with oral cancer from the billions at risk due to tobacco and alcohol use and  human HPV infection. 

Our research interests include human oral cancer risk, prevention and treatment. We focus on characterizing salivary molecular markers for future commercial application as inexpensive and noninvasive early detection tests, and investigating CD44 as potential target for oral cancer therapy.

Clinical Profile | Research Profile

Dr. Michael Hoffer is a tenured Professor in Otolaryngology and Neurological Surgery and a member of the neuroscience faculty. Dr. Hoffer came to the University of Miami after retiring from the U.S Navy and serves as a clinician-scientist (half clinical/half research). Dr. Hoffer’s lab focuses on traumatic damage to the ear and brain, particularly blast head trauma, blunt head trauma, noise trauma, and directed energy trauma. Dr. Hoffer’s lab performs basic science work examining the mechanisms of cellular damage after mild trauma as well as pharmaceutical countermeasures to reduce the sequelae of ear and brain damage after trauma.

Dr. Hoffer also performs clinical work examining novel methods of diagnosing and treating mild traumatic brain injury, balance disorders, and hearing loss. In addition, Dr. Hoffer’s lab is studying the relationship between balance disorders and cognition. These translational projects serve as excellent training for researchers to learn the skills necessary to conduct human studies as well as clinical trials. Dr. Hoffer’s lab is multi-disciplinary and includes otolaryngologists, neurologists, neuro-psychologists, engineers, neuroscientists, physical therapists, audiologists, and other basic scientists.

Clinical Profile | Research Profile

Chronic sinusitis is a debilitating disease that causes swelling and infection in the sinuses. The disease is common and impacts 31 million people in the United States. The disease symptoms can be severe including nasal and sinus congestion, severe headaches, sinus pressure, and thick nasal drainage. Chronic sinusitis has a severe impact on a patient’s quality of life and can make it very difficult to do normal activities. As a chronic sinusitis patient myself, I have a unique understanding of the frustration both patients and clinicians experience from the inability to tailor treatments to individual patients in order to address debilitating symptoms. The lack of customized treatment programs for patients leads to delays in chronic sinusitis care and results in worsening disease severity, symptom progression, lung illnesses, complications (such as eye infections), work absences and productivity losses, and staggering healthcare burden.

My research aims to improve care and quality of life for chronic sinusitis patients by:

1. Advancing our understanding of chronic sinusitis disease
2. Improving the ability to create individualized chronic sinusitis treatment for patients
3. Addressing health disparities in chronic sinusitis

My work focuses on applying a new approach to chronic sinusitis research. I am looking at both the biological aspects of chronic sinusitis disease, and the patient as a whole by including potential social determinants of health and information on patient experiences. My research combines clinical outcomes research, translational research, and advanced biostatistical strategies to develop a better understanding of what factors are the important contributors to chronic sinusitis disease and treatment outcomes. Additionally, I am using community participatory research in our diverse South Florida communities to develop a greater understanding of delays and barriers to chronic sinusitis care. This work is funded by the University of Miami Clinical and Translational Institute and the National Institutes of Health, as well as the Triological Society.

Research Profile

Dr. Suhrud Rajguru is an Associate Professor in the Departments of Biomedical Engineering and Otolaryngology at the University of Miami. In addition, he is the Co-Director of the University’s Institute for Neural Engineering and Assistant Director of the Miami CTSI Team Science Program.

The long-term goal of NIH and Industry-funded research within the Sensory Electrophysiology Laboratory is to improve human health, with a particular emphasis on hearing and balance-related functions. The laboratory has two major foci: using novel optical stimulation strategies to interface with the inner ear organs in order to improve the efficacy of neural prostheses and developing applications of therapeutic hypothermia (or cooling) for protection of auditory sensory hair cells, neurons and hearing function against noise- and blast-overexposures or surgical traumas. The research on developing novel applications of infrared optical stimulation in neuroscience is funded by NIDCD R01s DC013798 (Rajguru) and DC008846 (Holstein, G.R.), whereas development and testing of the localized hypothermia system for neuroprotection and protection of residual hearing function in patients undergoing surgical cochlear implantation has been funded by R21 DC014324 (Rajguru) and a research contract from Cochlear Limited (Rajguru). We use molecular biology techniques, imaging, electrophysiology in preclinical and clinical models and are focused on translating these devices and therapies for clinical application.

Clinical Profile | Research Profile

The Auditory Spatial Perception Lab at the UM Ear Institute aims to study variability in auditory processing of hearing impaired individuals in novel ways. The lab hosts a 32 m3 sound-isolated audiometric sound booth, with a 24-speaker array and custom designed computer system. This allows for custom generation of simulated auditory scenes for rapid assessment of speech perception in complex listening environments and localization of sounds.

Our work is committed to research that results in clinically applicable assessment models to improve outcomes in the hearing impaired population. Auditory spatial perception is an important aspect of everyday life. It is a marker of binaural hearing ability, allowing for discrimination of and localization of multiple speakers even in a noisy environment. The importance of binaural processing in sound localization is increased in environments with background noise. In patients with hearing loss the localization ability is adversely impacted despite improvements in hearing technology. This may be related to the limited information that these devices are able to provide with software and/or hardware constraints.

The Auditory Spatial Lab has generated interdepartmental research collaborations and established a program of study of the auditory processing of complex acoustic stimuli in simulated real-world listening environments. Standard behavioral and qualitative assessments of device performance are limited in their ability to demonstrate hearing benefits as relates to processing of the complex auditory signals encountered in everyday life. The brain uses specific timing and loudness cues delivered from the ear to interpret auditory signals that give rise to speech understanding in noise and spatial perception tasks. Objective and behavioral studies of the brain’s response to different auditory signals will lead to a better understanding of how these cues are interpreted and processed in the hearing impaired individual. The Auditory Spatial Perception lab maintains ongoing collaborations with industry partners to bring new and innovative technological solutions to patients that are both non-invasive and low-cost.

Clinical Profile

My current research has been translational in nature and has involved the design and implementation of clinical trials investigating novel immunotherapies as adjuvant treatments for patients undergoing surgical resection of advanced head and neck cancers. I have been the principal investigator for a clinical trial at the University of Miami that has recently been completed (NCT00843635) in which patients with head and neck squamous cell carcinoma (HNSCC) were given the Phosphodiesterase Type 5 (PDE5) inhibitor Tadalafil prior to surgical resection of their tumor and subsequent administration of standard adjuvant therapy to assess the effect of tadalafil as an immune system modulator in these patients. Paolo Serafini, PhD, was the Basic Science PI on the clinical trial, and is my close collaborator on this and related projects. 

I also have extensive experience in the regulatory aspects of a successful investigator initiated clinical trial as I hold INDs as both Sponsor and Investigator for the use of Tadalafil as an immunomodulator in HNSCC for our completed clinical trial (IND 102,495) and for the use of Tadalafil in combination with the anti-MUC1 vaccine in combination with salvage surgery for recurrent resectable HNSCC (IND 16403). I have been a head and neck surgical oncologist at the University of Miami Sylvester Comprehensive Cancer Center for the past 24 years, and serve as the Co-Leader of the Head and Neck Site Disease Group of the Cancer Center as well as the Co-Director of the Head and Neck Division of the Department of Otolaryngology of the University of Miami Miller School of Medicine. I have been involved in clinical and basic research in the field of Head and Neck Cancer throughout my tenure at the University of Miami. I have enjoyed a productive collaboration with Dr. Serafini, and together we have established a program of study of the immunologic infiltrate and methods of modulating the host tumor immune response in HNSCC patients.