The research focus of Michael J. Marino, M.D., is sinonasal and skull base disorders, including the histopathology and epidemiology of these conditions. One of the main disorders Dr. Marino studies is chronic rhinosinusitis. Chronic rhinosinusitis is an inflammatory condition that substantially impacts patient quality of life and comprises subtypes with heterogenous inflammatory mechanisms. Characterization of chronic rhinosinusitis histopathology allows for clinical subtyping, which more accurately reflects the underlying pathophysiology. Dr. Marino also works to develop biomarkers for chronic rhinosinusitis histology and applies artificial intelligence and machine learning for data analysis and predictive modeling.
Additionally, Dr. Marino investigates epidemiologic relationships among related sinonasal conditions, such as chronic rhinosinusitis, eustachian tube dysfunction, gastroesophageal reflux disease, and head and neck malignancy. Defining these relationships is useful for identifying candidates for disease screening and populations at risk of comorbid conditions.
Characterizing histopathology and biomarkers for chronic rhinosinusitis subtypes. Chronic rhinosinusitis has traditionally been subtyped according to phenotypic classification of patients with and without nasal polyps. Characterization of disease endotypes, which are better aligned with underlying inflammatory mechanisms, is of increasing interest and allows for targeted therapeutic approaches.
Dr. Marino's previous studies have characterized the histopathology of different chronic rhinosinusitis subtypes, as well as response to surgical treatment according to histology. Furthermore, these data were used to train a machine learning model of biomarkers and clinical observation for prediction of chronic rhinosinusitis subtypes.
Epidemiologic relationships of inflammatory disorders with head and neck malignancy. Inflammatory disease may have a role in the development of neoplastic disease. Several studies are examining associations between upper airway inflammatory disease and subsequent malignancy. Dr. Marino participates as co-investigator on population-based research using the Surveillance, Epidemiological, and End Results (SEER)-Medicare linked database to study risk factors for nasopharyngeal and sinonasal malignancy.
One of the SEER-Medicare database studies demonstrated an association of chronic rhinosinusitis and allergic rhinitis with paranasal sinus and nasopharyngeal cancers in the American population of older adults. A second SEER-Medicare database study demonstrated a similar association of gastroesophageal reflux disease with laryngeal and pharyngeal cancers. Additional analyses of the SEER data sets examine the role of diagnostic tests for malignancy in populations with inflammatory conditions.
Diagnosis and epidemiology of eustachian tube dysfunction and relationship with sinonasal disorders. Dr. Marino has been an author on several publications investigating the prevalence and diagnosis of eustachian tube dysfunction. One study examined the prevalence of eustachian tube dysfunction symptoms in patients with chronic rhinosinusitis and the relationship between sinonasal symptoms and ear symptoms. A population-based study investigated the prevalence of eustachian tube dysfunction in Americans receiving Medicare coverage. This study also examined the relationship of eustachian tube dysfunction with head and neck cancer and radiation treatment.
Additionally, Dr. Marino was part of the creation of a validated nasal endoscopy grading scale of the eustachian tube orifice to aid clinicians in standardizing findings on endoscopic examination.
Significance to patient care
Improved prediction and characterization of chronic rhinosinusitis inflammatory subtypes make individualized prognosis and treatment possible and are important goals for patient care. Recently, targeted biologic therapies have been approved for chronic rhinosinusitis, and accurate biomarker strategies may be useful for identifying patients who would most benefit from these treatments. Novel therapeutic targets also may be discovered through the identification of biomarkers and characterization of chronic rhinosinusitis histopathology.
Screening recommendations for head and neck malignancy have been difficult to develop. Understanding epidemiologic associations between inflammatory upper airway conditions and malignancy may be useful for identifying populations that would benefit from diagnostic screening.
- Third Prize Scientific Poster Award, American Rhinologic Society, 2021
- Third Prize Scientific Poster Award, American Laryngological, Rhinological, and Otological Society (Triological Society), 2017
- Scientific Poster Award, Society of Military Otolaryngologists, 2015