Research in Dr. Lott's Head and Neck Regenerative Medicine Laboratory focuses on several conditions that affect patient health, daily functions, quality of life and aesthetic outcomes, with dedicated space to support our research:
- Laryngeal dysfunction
- Tracheal dysfunction
- Larynx and trachea transplantation
- Vocal fold scarring
- Laryngeal function laboratory
- Nasal reconstruction
- Idiopathic subglottic stenosis
- Recurrent respiratory papillomatosis
- Circulating tumor cells and circulating tumor DNA
Our lab is developing bioengineered and 3D-printed implants and novel regenerative cell-based therapies to regenerate affected head and neck structures, and pioneering larynx and tracheal transplantation.
The larynx is a complex organ that regulates breathing, swallowing and voice production. Laryngeal dysfunction can have a severe impact on quality of life and in some cases can be life-threatening.
The Head and Neck Regenerative Medicine Laboratory aims to cure laryngeal dysfunction with bioengineered implants. Our long-term goal is to develop safe and effective tissue-engineered replacements for diseased laryngeal segments, including functional vocal folds. Ultimately, our research will lead to a tissue-engineered replacement for an entire larynx.
Patients with tracheal scarring or collapse are often dependent on a tracheotomy tube to breathe. For some patients, previous traditional surgeries have failed to repair the damage. For other patients, the damaged portion of the trachea is too long or the patient is too unhealthy to undergo a traditional surgery. Our lab aims to develop bioengineered implants that can be used to replace damaged tissue and restore normal tracheal function.
Larynx and trachea transplantation
Our research and clinical teams are pioneering advances in larynx and tracheal transplantation to help patients who have lost use of their voice box, leaving them unable to speak with their natural voices or breathe through their noses.
Clinical laryngotracheal transplantation is possible. The few documented cases have been shown to be safe and effective. However, a dedicated long-term clinical study is necessary to definitively evaluate this transplant option. With the creation of the Larynx and Trachea Transplant Program, Mayo Clinic has the expertise, capability and funding to perform this investigation.
Patients with severe laryngeal or laryngotracheal incompetence without other reconstructive options will be considered for laryngotracheal transplantation.
Much has yet to be learned about optimal immunosuppression for larynx and trachea transplantation. Our lab is investigating various immunosuppression and immunomodulation strategies.
Vocal fold scarring
Vocal fold scarring is one of the primary causes of voice disorders (dysphonia). Scarring is a troubling condition for patients and presents therapeutic challenges to clinicians. Vocal fold scarring is typically caused by trauma and aging.
Current treatment strategies have struggled to significantly reduce or reverse fibrosis, leaving patients without considerable improvement in their voice. There is evidence that adipose-derived stem cells accelerate healing of injured vocal folds and thereby reduce consequent vocal fold fibrosis. However, the current cost of manufacturing adipose-derived stem cells is high, current good manufacturing process must be followed, and the process takes several weeks to complete. The Head and Neck Regenerative Medicine Lab aims to discover other novel regenerative cell-based therapies for vocal fold scarring.
Laryngeal function laboratory
The laryngeal function laboratory is a dedicated space within the Head and Neck Regenerative Medicine Lab that is used to evaluate and model voice outcomes with regenerative treatments.
The laryngeal function lab possesses an anechoic sound booth, a clinical voice measurement suite and high-speed cameras. A custom-built humidified air flow control and measurement suite allows for excellent control over test conditions.
Our lab works closely with Brittany E. Howard, M.D., an otolaryngologist at Mayo Clinic in Arizona, to improve outcomes in nasal reconstruction. Complex nasal reconstruction for patients with defects from cancer, trauma, prior surgery or birth is typically completed with hand-sketched soft tissue templates or hand-carved cartilage grafts. This process is time consuming, can't be standardized and is difficult to visualize with patients preoperatively. We're working to improve this process with a regenerative medicine approach to nasal reconstruction to create patient-specific results, ultimately improving patient outcomes.
Idiopathic subglottic stenosis
Idiopathic subglottic stenosis (ISGS) is a slowly progressing disease that occurs overwhelmingly in women. ISGS is characterized by excessive accumulation of scar in the lower larynx and first two tracheal rings. All patients with ISGS develop airway stenosis manifesting as life-threatening dyspnea. Patients are often subject to surgical interventions many times a year to ease the respiratory obstruction, and they may require a tracheal resection or permanent tracheostomy. While the cause of idiopathic subglottic stenosis is still largely unknown, our lab team is using state-of-the-art DNA and RNA sequencing to investigate possibilities.
Recurrent respiratory papillomatosis
Recurrent respiratory papillomatosis (RRP) is a disease of the larynx caused by human papilloma virus (HPV) infection. There is currently no cure, and patients with RRP require multiple surgeries over their lifetime to restore the ability to breathe and speak. The immunology related to recurrent respiratory papillomatosis pathogenesis and potential treatment isn't well understood. Our lab has partnered with SangKon Oh, Ph.D., an immunology researcher at Mayo Clinic in Arizona, to gain better insight into the disease process. This knowledge can help us design novel and effective immunotherapeutic models for treatment with curative intent.
Circulating tumor cells and circulating tumor DNA
This is a research study whose goal is to determine the impact of surgical intervention on circulating tumor biomarker dynamics and to establish the prognostic role of these biomarkers. These minimally invasive liquid biopsies have significant clinical value for cancer detection and therapy. In this study, biomarker levels are determined by collecting blood samples during clinically relevant blood draws to establish early detection markers for recurrent cancers and distant metastases. The study is vital to substantiate that circulating tumor cells and circulating tumor DNA are reliable prognostic biomarkers for early detection of recurrence and survival of head and neck cancers. Read more about Detection of Circulating Biomarkers (Circulating Tumor Cells and Circulating Tumor DNA) in Patients with Head and Neck Carcinoma following Surgical Intervention.