Our goal is to use optical tools and digital recordings to study and treat disease processes, analyze the way we interact with patients and teach surgery
Our proposal entitled “Ototopical Delivery of Smart Optical Contrast Agents for Middle Ear Infection Diagnosis” was selected for seed grant funding through the Stanford Predictives and Diagnostics Accelerator (SPADA) program for the 2020 CTSA-funded cycle.
Surgical training has changed with the inception of surgical simulation; however, tools to assess progress in a non-subjective, quantitative manner have not been adequately developed.
Our laboratory crosses the interface of optics and medicine utilizing video as our investigational armamentarium.
We develop new generation surgical visualization instruments to improve our ability diagnose and achieve complete excision of disease processes.
We understand that our work encompasses various fields and we welcome and value the input of experts in various disciplines.
A major effort in our laboratory is to develop surgical and diagnostic techniques focused on pediatric conditions without the use of Ionizing radiation.
Middle Ear Imaging Project
Otitis media (OM, inflammation in the middle ear) is one of the most common illnesses among children under five years of age. It is known to affect about 90% of children worldwide. Accurate diagnosis and treatment of OM is critical as it can lead to additional complications such as speech and language development delays, brain abscesses, meningitis, and even hearing loss. We have developed a medical otoscope for SWIR imaging. Due to its higher wavelengths (1-2 microns), SWIR light can penetrate deeper in the tissue compared to the visible light pneumatic otoscopy, enabling a better view of anatomy behind the tympanic membrane and higher contrast to middle ear fluid due to increase water absorption in the SWIR.
In collaboration with Bogyo lab at Stanford, we have developed smart fluorescent probes to increase the contrast of infectious OM in SWIR imagining. Our aim is to distinguish between non infected (otitis media with effusion) and infected fluid (acute otitis media) by combining SWIR otoscopy with inflammation targeted probes.
Cholesteatoma is a proliferation of abnormal skin that can develop in the middle ear and can erode and destroy important structures associated with hearing and balance. If left untreated in can lead to potentially life-threatening complications such as meningitis and brain abscesses. Surgical removal is the only alternative and often requires multiple procedures due to a high recurrence rate. We are developing imaging techniques to better identify cholesteatoma in a surgical field to prevent recurrence and understand the molecular changes that precede its formation.
The Traveling Pediatric Simulators
We have developed pediatric specific surgical simulators to teach new generations of doctors around the world. We are firm believers that surgical training is a gradual process and basic techniques and surgical fundamentals can be learned in surgical models prior to being performed in patients.
We look both at commonly performed procedures to see how they can be performed in a safer and more efficient way to minimize anesthesia exposure and to those rare conditions where it is difficult to gain adequate experience during training.
Our simulators have been around the world: Europe, Asia, North America, South America looking for partners to put us on the map in Africa, and penguins in Antarctica (Pittsburgh penguins need not apply).
Treatment of Middle-Ear Effusions
OM with effusion (OME) is characterized by the presence of middle ear fluid containing thick secretions behind the tympanic membrane (i.e., ear drum). There is no effective medicine for treating OME. Current clinical practice relies on “mechanical” removal of secretions by surgery via ventilation tube placement, which requires general anesthesia and carries the risk of a tympanic perforation. Our goal is to develop an alternative treatment, to reach the secretions and alter their rheological properties to facilitate their drainage from throat/nose.
Cisplatin Ototoxicity and Prevention
Cisplatin is one of the most widely used chemotherapeutic agents, but one of its major side effects is an irreversible sensorineural hearing loss, which occurs in 50-70% of patients with cancer treated with cisplatin. Most of the existing diagnostic approaches rely on indirectly measuring effects and morphological changes, which might not be a direct reflection of the amount of cisplatin accumulated. The purpose of this study is to develop a label-free and objective approach for real-time assessment of cisplatin accumulation in the inner ear. Successful implementation of the work would lead to a new method for identifying cisplatin-induced ototoxicity.
Tulio Valdez, Pediatric Otolaryngologist, PI
Fan of everything Boston except the snow.
Improving patient outcomes through better diagnostic
surgical and educational tools
Raana Kashfi Sadabad, Postdoctoral Fellow
Dr. Raana Kashfi Sadabad is a postdoctoral research fellow at Stanford OHNS. She received her Master’s and Ph.D. in Inorganic Chemistry. She is specialized in design, synthesis, and characterization of various nanoparticles for applications in imaging and therapy. She is currently exploring the design of liposomal nanoparticles for ototopical delivery of imaging and therapeutic agents for diagnosis and treatment of middle ear diseases.
Prior to joining Stanford, she worked as a research specialist at the University of Connecticut, where she developed nanoparticle solutions in applications ranging from cancer diagnosis and therapy to energy storage and electro-catalysis, in collaboration with pharmacists, engineers, and chemists.
Anping Xia, Sr. Research Scientist
Dr. Anping Xia is a Senior Research Scientist specializing in inner ear research. She has been assisting and advising Dr. Valdez on the setup of his lab. She has been working in topical drug delivery and ototoxicity testing in the lab. She also trains and helps junior researchers to achieve their research goals.
In her prior role, she was working in Dr. John Oghalai’s Lab in creating a transgenic mouse model, gene regulation, and gene therapy in the inner ear. In recent years, she also worked on cochlea physiology and cochlea mechanics in different animal models including mouse, gerbil, and chicken.
Sujuan Li,Visiting Scholar
Sujuan Li is a visiting scholar at Stanford OHNS. She received her Master’s degree of clinical medicine in Zhengzhou University, China. She is specialized in otology and her research field is about diagnosis and treatment of all kinds of ear diseases. She is currently working on the fields of prevention or treatment of cisplatin-induced ototoxicity. Prior to joining Stanford, she worked in the First Affiliated Hospital of Zhengzhou University for over 10 years. She is an associate chief physician of otology from China, and she has the knowledge and surgical skills in treatment of the ear diseases.
Guorun Fan, Visiting Scholar
Guorun Fan is a visiting scholar at Stanford OHNS. He received his Doctor’s degree of clinical medicine in Huazhong University of Science and Technology, China. He is specialized in otology and his research field is about diagnosis and treatment of all kinds of ear diseases. He is currently working on the fields of prevention or treatment of cisplatin-induced ototoxicity.
Prior to joining Stanford, he worked in the Wuhan Union Hospital for over 8 years. He is an associate chief physician of otology from China, and he has the knowledge and surgical skills in treatment of the ear diseases.
Andrea Paola Solis-Pazmino, Visiting Scholar
Dr. Paola Solis is a medical doctor born and raised in Ecuador, interested in Otolaryngology, Head and Neck Surgery. She attended medical school at Universidad Central in Quito Ecuador (2019). During her last year of medical school, she had the opportunity to get trained in systematic reviews and meta-analysis at the Knowledge, Evaluation, and Research (KER) Unit – Mayo Clinic. After this training, along with doctors from the USA, Ecuador, Colombia, and Peru she decided to form a group called CaTaLiNA which aims is to generate knowledge around thyroid disease, and to train medical students in clinical and research skills.
She joined Stanford as Research Fellow in September 2019 where she started working on preclinical studies and imaging with shortwave infrared light (SWIR) to improve diagnosis and treatment in cholesteatoma.
Sahith Kudaravalli, Research Intern
Sahith Kudaravalli is a high school research intern at Stanford OHNS. He will graduate from Bellarmine College Preparatory in 2021. Sahith’s research focuses on applying 3D modelling and simulation to enhance surgical training. He is currently contributing to designing an interactive, lifelike system for practicing lingual tonsillectomy.
Please specify “Tulio Valdez Lab” in the “Special Instructions/Other Designation” field.