VHI Sponsors Meeting for MGH Vocal Hyperfunction Clinical Research Center

In advance of the 2023 conference of the American Speech-Language-Hearing Association (ASHA) in Boston, the Voice Health Institute (VHI) was excited to sponsor an all-day meeting hosted by The Vocal Hyperfunction Clinical Research Center (VHCRC) at the Massachusetts General Hospital. The VHCRC is an NIH-funded, comprehensive, multi-institutional research program Directed by Robert Hillman, Ph.D., CCC-SLP (Co-Director and Research Director, Mass General Voice Center) that brings together an interdisciplinary team of investigators exploring methods and technologies to prevent, diagnose and treat vocal hyperfunction, which is associated with the most frequently occurring types of voice disorders.  Their research in vocal hyperfunction is unprecedented, especially with respect to the integration of many types of data (e.g., behavioral, sensorimotor, environmental, psychological/emotional, and biomechanical data) on a large scale, across multiple institutions and areas of expertise. 

The goals of the meeting were to increase the exchange of information with outside groups that are doing research in related areas and to disseminate new research findings to the broader field. 

The morning session was devoted to intriguing progress reports from Dr. Hillman, as well as Cara Stepp, Ph.D. (Director, Sensorimotor Rehabilitation Engineering Lab, Boston University), Daryush Mehta, Ph.D. (Director, Voice Science and Technology Laboratory, Mass General Voice Center), Matías Zañartu, Ph.D. (Director, Advanced Center for Electrical and Electronic Engineering, Universidad Técnica Federico Santa María) and Jarrad Van Stan, Ph.D. CCC-SLP (Research Speech-Language Pathologist, Mass General Voice Center). 

Invited speakers were welcomed to share their remarkable work in similar areas during the afternoon session with presentations by Visar Berisha, Ph.D. (Associate Professor, College of Health Solutions & School of Electrical, Computer and Energy Engineering, Arizona State University), Pasquale Bottalico, Ph.D. (Associate Professor, Department of Speech and Hearing Science, University of Illinois), Maude Desjardins, Ph.D. (Assistant professor, Faculty of Medicine, Department of Rehabilitation, Speech Therapy Program, Laval University), Aaron Johnson, MM, Ph.D., CCC-SLP (Co-Director, NYU Langone Voice Center), and Brad Story, Ph.D. (Professor & Associate Dean, College of Science, University of Arizona). 

To learn more about the VHCRC and their multifaceted voice research, please go to: Vocal Hyperfunction Clinical Research Center

Voice Restoration Research Program

The VHI has been the main source of funding for the Voice Restoration Research Program which is a large collaborative effort between scientists and clinicians at Massachusetts General Hospital, Massachusetts Institute of Technology and Boston University to develop methods for repairing scarred vocal folds.

RESEARCHERS OF THE VOICE RESTORATION RESEARCH PROGRAM WITH JULIE ANDREWS.

RESEARCHERS OF THE VOICE RESTORATION RESEARCH PROGRAM WITH JULIE ANDREWS.

The leading cause of voice disorders is the loss of pliability in vocal cord tissue due to scarring. Scarring of the vocal cords is caused by a variety of conditions including heavy voice use, aging, surgeries and other treatments involving the larynx (e.g. radiation therapy for cancer), exposure to environmental irritants and congenital conditions. Such scarring restricts or eliminates the vibration of vocal cord tissue that is essential for the production of human voice.
There is currently no viable method for restoring pliability to scarred vocal cord tissue.

To solve this problem, researchers from the Massachusetts General Hospital, under the direction of Drs. Steven Zeitels and Robert Hillman, teamed up with scientists from other departments at MGH, Harvard Medical School and Massachusetts Institute of Technology (MIT) to launch a comprehensive multi-disciplinary research project. Other major collaborators include Dr. Robert Langer and his tissue-engineering group at MIT, as well as Dr. Rox Anderson and his laser specialty group in the MGH Wellman Laboratory for Photomedicine.

VHI support for the program has enabled the research team to attack the vocal cord scarring problem at multiple levels. Some members of the team are working on developing vocal cord bio-implants using a variety of natural and synthetic substances that are designed to replace lost pliability. Other members are developing new surgical technologies that are needed to both prepare the vocal cord recipient site and place the implant. Still others are developing innovative approaches for assessing vocal cord function in terms of better imaging to differentiate healthy from scarred tissue, and ways to directly measure vocal cord biomechanical properties to assist implant design and testing.

Reversing long-term effects of aging: Success of the program will result in restoring voice to millions of people who are suffering from the problems associated with such voice loss including negative impacts on:

  • everyday communication

  • psychological well-being

  • socio-economic function

Solving the vocal fold scarring problem would include reversing the long-term effects of aging on voice, which is rapidly becoming more of an issue as individuals are living longer.


New Laser Technologies for Treating Laryngeal Disease and Preserving/Restoring Voice

DR. JAMES BURNS PERFORMING OFFICE-BASED LARYNGEAL LASER SURGERY IN THE OUTPATIENT TREATMENT ROOM IN THE MASSACHUSETTS GENERAL HOSPITAL VOICE CENTER.

DR. JAMES BURNS PERFORMING OFFICE-BASED LARYNGEAL LASER SURGERY IN THE OUTPATIENT TREATMENT ROOM IN THE MASSACHUSETTS GENERAL HOSPITAL VOICE CENTER.

The VHI has funded several research projects at the Massachusetts General Hospital (MGH) Voice Center to develop new laser technologies that have been shown to effectively treat dysplasia, cancer and papilloma of the vocal cords while preserving and/or restoring patients' voices. This treatment employs an angiolytic KTP laser which concentrates the laser energy in the diseased tissue and optimally spares the normal vocal cord tissue to preserve and/or restore the patient's voice.

The green light of the KTP laser is highly absorbed by red blood cells which enable it to selectively ablate the increased network of blood vessels (referred to as angiolysis) in diseased tissue while preserving healthy tissue. This new laser technology was pioneered for use in the operating room and outpatient setting by Dr. Steven Zeitels and his team at the Massachusetts General Hospital in collaboration Dr. Rox Anderson of the MGH Wellman Center for Photomedicine.


Harvard-MIT PhD Students Receive VHI Funding for Voice Research

The VHI has participated in funding doctoral students pursuing voice research who are enrolled in the Speech and Hearing Biosciences and Technology PhD Program at the Harvard-MIT conjoint Division of Health Sciences and Technology.  Four of these students are Dr. Cara Stepp (currently Principal Investigator at the STEPP Lab for Sensorimotor Rehabilitation Engineering at Boston University), Dr. Asa Wehner, Dr. Yoko Saikachi (currently a staff scientist at the RIKEN Brain Science Institute in Japan), and Dr. Daryush Mehta (currently a staff scientist at Harvard University and the MGH Voice Center).

(from left) Researchers: Yoko Saikachi, Asako Masaki, Cara Stepp, and Daryush Mehta.

(from left) Researchers: Yoko Saikachi, Asako Masaki, Cara Stepp, and Daryush Mehta.


Voice Restoration Research Team

Drs. Jim Kobler and James Heaton prepare to give a lecture in the Voice Center Conference Room.

Drs. Jim Kobler and James Heaton prepare to give a lecture in the Voice Center Conference Room.

Ongoing VHI support has been instrumental in enabling Dr. Steven Zeitels (MGH Voice Center Director) and Dr. Robert Hillman (MGH Voice Center Co-Director and Research Director) to assemble a multidisciplinary group of investigators to focus on research to improve the prevention, diagnosis and treatment of larynx and voice disorders. This outstanding team currently includes three full-time doctoral-level research staff members, a research fellow, and one research technician.

James Kobler, PhD and James Heaton, PhD are the longest-standing members of the research staff, having each worked with Drs. Zeitels and Hillman for nearly two decades. Both have multifaceted backgrounds and expertise in a number of critical areas including neuroscience, vocal anatomy and physiology, tissue biology and instrumentation. Because of their versatility, Drs. Kobler and Heaton are involved in virtually all of the research projects carried out at the Center.

Taking a leading role in the group's efforts to develop bio-implants for restoring function to damaged (scarred) vocal cords is Sandeep Karajanagi, PhD. Dr. Karajanagi has extensive training and expertise in the latest tissue engineering approaches.

Daryush Mehta, PhD is focused primarily on the development of an innovative smartphone platform for long-term tracking of voice use and vocal function of patients diagnosed with voice disorders that are associated with daily patterns of vocal behavior.  Dr. Mehta's research bridges clinical voice assessment, signal and image processing and biomedical voice and speech instrumentation.


VHI Supports Research Fellowships

Drs. Matthew Broadhurst and Gerardo Lopez-Guerra are shown with a new research surgical microscope.

Drs. Matthew Broadhurst and Gerardo Lopez-Guerra are shown with a new research surgical microscope.

 VHI support has also made it possible for the Center to offer research fellowships to individuals that have already completed rigorous doctoral-level training in medicine or basic science. The fellowship program serves two main purposes. First, it extends and enhances the Center’s research programs by providing a cadre of young and talented individuals to assist in the work being directed by the senior (full-time) research staff. Second, it provides the field with a supply of new investigators that have been trained to pursue cutting-edge research that will expedite improvements in the clinical care of patients with larynx and voice disorders. Already completing residency training in Otolaryngology – Head and Neck Surgery (ear, nose and throat), these key positions have been invaluable for rapidly translating a variety of basic investigations to clinical application. These positions also facilitate the dissemination of new knowledge and training in the latest clinical and research techniques, which broaden constituencies nationally and internationally.

Drs. Yoshihiko Kumai and james heaton

Drs. Yoshihiko Kumai and james heaton

VHI research fellowships have been awarded to the following :

  • Dr. Matthew Broadhurst (Queensland, Australia)

  • Dr. Gerardo Lopez-Guerra (Barcelona, Spain)

  • Dr. Yoshihiko Kumai (Kumamoto, Japan)

  • Dr. Anca Barbu (Cleveland, OH, USA)