Otolaryngology

(Ear, Nose and Throat)

Baylor St. Luke’s Medical Center is home to advanced ENT services for both Houston and our international community. The intersection of research and clinical applications at our hospital helps our patients access innovative care for conditions like COVID-19 related anosmia, sleep apnea, and more.

Our team of board-certified otolaryngologists is proud to combine state-of-the-art technology, expertise, and compassionate care for patients and their families in order to improve outcomes.

Simple smell therapy helps long-haul COVID-19 patients regain senses of smell and taste

For thousands of people experiencing the long-term effects of COVID-19, the loss of taste and smell can be among the most frustrating. While it’s unclear how COVID-19 alters these senses, ENT doctors at Baylor College of Medicine are employing a simple, non-invasive technique that has helped dozens of these “long-hauler” patients regain their olfactory senses after recovering from COVID-19.
Long-term anosmia—the loss of sense of smell—from COVID-19 is likely due to more than swelling and inflammation; the virus may also cause substantial nerve changes or nerve damage that can cause a prolonged loss of smell and taste over months or years, explains Dr. Sunthosh Sivam, assistant professor of Otolaryngology – Head & Neck Surgery at Baylor.
Dr. Sivam and his partner in smell therapy treatment, Dr. Tran Locke, first prescribe nasal steroids to try and root out inflammation in the nasal cavity in long-haul COVID-19 patients. But for the patients who don’t recover their senses of smell, the team prescribes smell therapy, which was first used in 2009 at the Smell & Taste Clinic in Dresden, Germany.
Smell therapy uses concentrated scents—generally, essential oils with strong aromas such as lavender, lemon, eucalyptus, and cinnamon—that patients whiff for a short amount of time—twice daily—in order to “relearn” smells. The therapy retrains the brain by associating the names of the scent and the act of smelling with the memory of what they are smelling.
Patients’ senses won’t return overnight and may not return at 100%. The therapy typically takes up to six months for most, depending on how faithful patients are about doing the therapy every day. Repeated exposure to those smells and the words associated with each, says Dr. Sivam, are key to retraining the brain and to recovery. To date, the technique has been successfully used with dozens of patients.

New, less invasive implant for treating sleep apnea gives patients permanent relief

People with sleep apnea—a condition where a person stops breathing for periods of time during sleep—can now find permanent relief with a new, less invasive surgical implant that “retrains” the muscles the body uses to breathe.
Snoring, irritability, and morning headaches are symptoms of sleep apnea. Without treatment, the condition can lead to high blood pressure, diabetes, and liver problems. Sleep apnea patients also face a greater risk of experiencing complications from COVID-19.
In the past, patients were commonly treated with an external machine—the CPAP—or faced a riskier surgery. But now, surgeons at Baylor St. Luke’s in the Texas Medical Center are having a high rate of success in treating sleep apnea with an implanted device, which controls the patient’s tongue and the muscles that help the person breathe and prevents the usual obstruction that happens with the condition. Surgeons only need to make two small incisions—one on the neck to implant the device and another on the chest to place a battery. An external remote activates the device nightly before the patient falls asleep.
Patients can monitor how the implant is working by downloading an app that is linked directly to the device to their smartphone. Baylor surgeon Andrew Tsao Huang, MD, FACS, who has performed numerous surgeries with the new device, notes that the recovery is quick and pain is typically managed with over-the-counter pain medication.
The new device is most effective in patients with BMIs under 35, Dr. Huang adds. For people with higher BMIs, weight loss is the best way to address sleep apnea.

Throat cancer screening study could revolutionize earlier detection, successful treatment of HPV-related throat cancer

While smoking-related head and neck cancers are declining in the U.S., human papillomavirus (HPV)-related oropharyngeal, or throat, cancer is on the rise. In fact, oropharyngeal cancer has surpassed cervical cancer as the leading HPV-related cancer in the country. No screening is currently available for HPV-related throat cancer. But a clinical trial now underway at Baylor College of Medicine in Houston and the University of Texas Southwestern Medical Center in Dallas aims to develop an early detection test that will do for this type of cancer what the Pap smear did for the prevention of cervical cancer.
Called TRINITY (Throat and other HPV-Related cancers IN men: Identifying Them earlY), the trial is screening 1,500 men between the ages of 50-64 who have no history of this or other head and neck cancers, for HPV biomarkers through a blood test and oral rinse. Selected individuals will receive in-person throat examinations, including oropharyngeal swab tests and ultrasound imaging. If the participant tests positive, he will be given the opportunity to be screened for oropharynx, anal and/or penile cancer.
“A routine early detection test for HPV-related oropharyngeal cancer, or at least a biomarker to identify those at high risk, could revolutionize our specialty and disrupt worrisome trends in cancer incidence and mortality, as well as the devastating effects of cancer treatment on this growing population,” said Dr. Erich Sturgis, professor and vice chair of clinical affairs in the Bobby R. Alford Department of Otolaryngology – Head and Neck Surgery and Brown Foundation Endowed Chair at Baylor College of Medicine.

More than 80% of oropharyngeal cancer patients have metastatic cancer by the time they are diagnosed and require advanced treatment. The combination of surgery, radiation and chemotherapy can leave patients with significant side effects like pain, dry mouth, altered taste and difficulty swallowing. Early detection has the potential to reduce treatment toxicity and greatly improve chances of achieving a cure.

Erich M. Sturgis

Erich M. Sturgis, MD, MPH

Professor , Vice-Chair of Clinical Affairs
Bobby R. Alford Department of Otolaryngology – Head & Neck Surgery
Baylor College of Medicine
Director of Head & Neck Cancer Program
Brown Foundation Endowed Chair
Baylor College of Medicine
Head, Neck, and Thyroid Cancer Multidisciplinary Program Director
Baylor College of Medicine
Head, Neck, and Thyroid Cancer Multidisciplinary Program Director
Dan L Duncan Comprehensive Cancer Center
Baylor St. Luke’s Medical Center

BCM team finds proton pump inhibitors to be more effective in sensitizing cancer cells to radiation therapy

A team of scientists from Baylor College of Medicine has discovered a new use for the FDA-approved and widely used class of drug, proton pump inhibitors (PPIs), as radiosensitizers of cancer cells to radiation therapy to improve tumor control.
The resistance of cancer cells to radiation therapy is a significant clinical problem in treating cancer. Solid tumors tend to respond only partially to radiation therapy and increasing the dosage can be harmful to healthy tissue. However, few safe and effective radiosensitizers—drugs that kill or inhibit the growth of cancer cells and make them more vulnerable to radiation—exist that can be combined with radiation to enhance tumor control.
Yet, the researchers found that an entire class of PPIs, such as esomeprazole and lansoprazole, directly target and inhibit a particular enzyme that is overexpressed in cancer cells that are considered aggressive, highly vascularized and radioresistant. The team made the discovery after screening a library of 130,000 small molecules to search for compounds that inhibit that enzyme.
“Subsequent studies demonstrated that PPIs sensitize cancer cells to ionizing radiation, depending on the dose. This is a previously unrecognized yet important effect,” noted the study’s senior author, Dr. Yohannes Ghebre, Associate Professor of Radiation Biology at Baylor College of Medicine (BCM) and member of the Dan L Duncan Comprehensive Cancer Center.
“A significant fraction of head and neck cancer patients present with aggressive disease that demonstrates an incomplete response to radiation, resulting in rapid recurrence and cancer-associated death,” observed Dr. Vlad Sandulache, Assistant Professor of Otolaryngology- – Head & Neck surgery at BCM and co-author of the study. “As a result, it is critically important to identify drugs that can be used to sensitize tumors to radiation. Repurposing existing, FDA-approved drugs is an excellent strategy since it largely eliminates the potential for severe unanticipated toxicities.”
Given the unmet medical need for the sensitization of cancer cells to radiation therapy, the Baylor team conducted preclinical studies to evaluate the radiosensitizing effect of the PPI esomeprazole when combined with radiation. This research demonstrates the efficacy of PPIs in radiosensitizing cancer cells isolated from various tissue sites, including the head and neck, the breast, and the lungs, using cancer cell colony formation assay in vitro and in animal models.
The team aims to launch clinical studies to evaluate the efficacy of PPIs as radiosensitizers in cancer patients soon.
Yohannes T Ghebre

Yohannes T Ghebre, PhD, FAHA, ATSF

Associate Professor; Director of Radiation Biology Research and Education
Radiation Oncology
Baylor College of Medicine
Assistant Professor
Houston Methodist Research Institute
Postdoctoral Scientist
Medicine
Cardiovascular Medicine
Stanford University
Member
Dan L Duncan Comprehensive Cancer Center
Baylor College of Medicine
Vlad Sandulache

Dr. Vlad Sandulache, MD, PhD

Associate Professor
Otolaryngology-Head & Neck Surgery
Baylor College of Medicine
Member
Dan L Duncan Comprehensive Cancer Center
Baylor College of Medicine