We are currently engaged in a number of exciting projects investigating the physiology, pathophysiology, and pathology of the sinuses.

Chronic Rinosinusitis and Polyposis. We are investigating the physiologic and immunologic function and dysfunction in patients with chronic rhinosinusitis and polyposis. Studies include flow cytometric analysis of white blood cell populations from the tissue of such patients. We also study the cytokines and other mechanisms of intercellular communication that might stimulate and propagate a cascade of recurrent inflammation using Luminex and other techniques. Understanding these immunological changes and how these messages are transmitted throughout sinus mucosa provides an therapeutic opportunity to interfere in the pathophysiology of the process.Ciliary Function. We are investigating the physiology of cilia, including beat frequency, response to various stimuli, and changes in ciliary function over time. As normal ciliary function is central to clearing infections and pathogens, this understanding could pave the way for therapies that enhance ciliary function or eliminate factors that disrupt its function. Part of our studies involve creating air-liquid interfaces of cilia from murine septum epithelium.

Biofilms. We are actively studying the patterns of bacterial biofilm formation, their role in recurrent and chronic sinus infection, and methods of detecting their presence in patients. Using cultures, tissue samples, scanning electron microscopy, and confocal imaging, we are studying the relationship between biofilm presence and disease severity. We are also investigating potential therapeutic agents that may serve to disrupt or eliminate biofilms and ultimately reduce the rate of infection recurrence.

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Research Publications

Chennupati, S.K., Chiu, A.G., Tamashiro, E., Banks, C.A., Cohen, M.B., Bleier, B.S., Kofonow, J.M., Tam, E.S., Cohen, N.A. Effects of an LL-37 Derived Antimicrobial Peptide in an Animal Model of Biofilm Pseudomonas Sinusitis. Am. J. Rhinol. 23(1):46-51 (2009).

Bleier, B.S., O’Malley, B.W., Li, D., Chiu, A.G., Palmer, J.N., Cohen, N.A. Chitosan Glycerophospate Based Semi-Rigid Dexamethasone Eluting Biodegradable StentAm. J. Rhinol. 23(1):76-79 (2009).

Bleier, B.S., Palmer, J.N., Gratton, M.A., Cohen, N.A., In vivo Laser Tissue Welding in the Rabbit Maxillary Sinus. Am. J. Rhinol. 22(6):625-628 (2009)

Bleier B.S., Gratton, M.A., Leibowitz, J.M., Palmer, J.N., Newman, J.G., Cohen, N.A. Laser-welded endoscopic endoluminal repair of iatrogenic esophageal perforation: An animal model. Otolaryngol Head Neck Surg. 139(5):713-7 (2008).

Khalid, A.N., Woodworth, B.A., Prince, A., Quraishi, S.A., Antunes, M.B., Long, F.H.A., Bolger W.E., Chiu, A.G., Palmer, J.N., Cohen, N.A. Physiologic Alterations in the Murine Model Following Nasal Fungal Antigenic Exposure. Otolaryngology Head Neck Surgery 139(5):695-701(2008).

Woodworth, B.A., Tamashiro, E., Bhargave, G., Palmer, J.N., Cohen, N.A., An In Vitro Model of Bacterial Biofilms on Viable Airway Epithelial Cell Monolayers. Am. J. Rhinol. 22(3):235-239 (2008).

Prince, A.A., Steiger, J.D., Khalid, A.N., Dogrhamji, L., Reger, C., Eau Claire, S., Chiu, A.G., Kennedy, D.W., Palmer, J.N., Cohen, N.A. Prevalence of Biofilm Forming Bacteria in Chronic Rhinosinusitis. Am. J. Rhinol. 22(3): 239-245 (2008).

Erickson, V.R., Antunes, M.B., Chen, B., Cohen, N.A., Hwang, P.H., The Effects of Retinoic Acid on Ciliary Function of Regenerated Sinus Mucosa. Am. J. Rhinol. 22(3):334-336 (2008).

Bhargave, G., Woodworth, B.A., Xiong, G., Wolfe, S.G., Chiu, A.G., Palmer, J.N., Kennedy, D.W., Cohen, N.A., TRPV4 Channel Expression in Chronic Rhinosinusitis. Am J. Rhinol. 22(1):7-12 (2008).

Thaler, E.R., Huang, D., Giebeig, L., Palmer, J.N., Lee, D., Hanson, C.W., Cohen, N.A. (2008) Use of an Electronic Nose for Detection of Biofilms. Am. J. Rhinol.22(1): 29-33 (2008)

Chiu A.G., Palmer, J.N., Woodworth, B.A., Doghramji, L., Cohen, M.B., Prince, B.A., Cohen, N.A., Baby Shampoo Nasal Irrigations for the Symptomatic Post-FESS Patient. Am. J. Rhinol. 22(1):34-37 (2008)

Woodworth B.A., Antunes, M.B., Bhargave, G., Cohen, N.A.: Murine Tracheal and Nasal Septal Epithelium for Air-Liquid Interface Cultures:  A Comparative Study. Am. J. Rhinol. 21(5):533-537 (2007). [PubMed abstract]

Bleier, B.S., Sparano, A.M., Palmer, J.N., Cohen, N.A.: Laser assisted cerebrospinal fluid leak repair: An animal model to test feasibility.  Otolaryngol Head Neck Surg137(5):810-4 (2007). [PubMed abstract]

Antunes, M.B., Feldman, M.D., Cohen, N.A., Chiu, A.G. Dose-dependent effects of topical tobramycin in an animal model of Pseudomonas sinusitis. Am J Rhinol. 21(4):423-7 (2007). [PubMed abstract]

Antunes, M.B.,  Woodworth B.A., Bhargave, G., Xiong, G., Aguilar, J.L., Ratner, A.J., Kreindler, J.L., Rubenstein, R.C., Cohen, N.A.: Murine Nasal Septa for Respiratory Epithelial Air-liquid Interface Cultures.  Biotechniques 43:195-204 (2007). [PubMed abstract]

Chen, B., Antunes, M.B.,  EauClaire, S., Palmer, J.N., Chiu, A.G., Kennedy, D.W., Cohen, N.A.: Reversal of Chronic Rhinosinusitis Associated Sinonasal Ciliary Dysfunction.  Am. J. Rhinol 21(3): 346-353 (2007). [PubMed abstract]

Chiu, A.G., Antunes, M.B., Palmer, J.N., Cohen, N.A.:  Evaluation of the In Vivo Efficacy of Topical Tobramycin against Pseudomonas Sinonasal Biofilms.  J. Antimicrob. Chemother. 59(6):1130-4 (2007). [PubMed abstract]

Chiu, A.G., Antunes, M.B. Feldman, M, Cohen, N.A.: An Animal Model for the Evaluation of Topical Medications in Sinusitis.  Am J Rhinol. 21(1):5-9 (2007).[PubMed abstract]

Chen, B., Shaari, J., Eau Claire, S., Palmer, J.N., Chiu, A.G., Kennedy, D.W., Cohen, N.A.: Altered Sinonasal Ciliary Dynamics in Chronic Rhinosinusitis. Am. J. Rhinol 20(3):325-9 (2006). [PubMed abstract]

Shaari, J., Palmer, J.N., Chiu, A.G., Judy, K.D., Kennedy, D.W., Cohen, A.S., Cohen, N.A.  Regional Analysis of Sinonasal Ciliary Beat Frequency. Am. J. Rhinol. 20(2):150-4 (2006). [PubMed abstract]

Cohen, N.A., Widelitz, J.S., Chiu, A.G., Palmer, J.N., Kennedy, D.W.:  Familial Aggregation of Sinonasal Polyps (NP) Correlates with Severity of Disease.  Otolaryngology – Head and Neck Surg. 134(4):601-4 (2006). [PubMed abstract]

Schipor, I., Palmer, J.N., Cohen, A.S., Cohen, N.A.  Quantification of Ciliary Beat Frequency in Sinonasal Epithelial Cells Using Differential Interference Contrast Microscopy and High Speed Digital Video Imaging.  Am. J. Rhinol. 20(1):124-7 (2006). [PubMed abstract]

Chiu AG, Jackman A, Antunes MA, et al., Radiographic and Histologic Analysis of the Bone Underlying Inverted Papillomas. Laryngoscope 2006; 116. [PubMed abstract]

Perloff JR, Palmer JN., Evidence of bacterial biofilms in a rabbit model of sinusitis. American Journal of Rhinology 2005 Jan-Feb;19(1):1-6. [PubMed abstract]

Cryer J, Schipor I, Perloff JR, Palmer JN., Evidence of bacterial biofilms in human chronic sinusitis. ORL J Otorhinolaryngol Relat Spec. 2004;66(3):155-8.[PubMed abstract]

Perloff JR, Palmer JN., Evidence of bacterial biofilms on frontal recess stents in patients with chronic rhinosinusitis. American Journal of Rhinology 2004 Nov-Dec;18(6):377-80. [PubMed abstract]

Clinical Publications

Bleier BS. Gawthrop CS. Thaler ER. Sewell DA. Montone KT. Marvel DM. Chiu AG. Diffuse Intranasal Papillomatosis and its Association with the Human Papillomavirus. Archives of Otolaryngology – Head & Neck Surgery. In press

Cohen, M.A., Cohen, N.A., Moonis, G., Kennedy, D.W. Long Term Follow up of a Loculated Arachnoid Cyst of the Middle Cranial Fossa. ENT Journal 86(6): 338-341 (2007).

Woodworth, B.A., Bhargave, B.S., Palmer, J.N., Chiu, A.G., Cohen, N.A., Lanza, D.C., Bolger, W.E., Kennedy, D.W. Clinical Outcomes of Endoscopic and Endoscopic-assisted Resection of Inverted Papillomas: A 15-year Experience.  Am. J. Rhino. 21(5):591-600. (2007) [PubMed abstract]

Woodworth, B.A., Chiu, A.G., Cohen, N.A., Kennedy, D.W., OMalley, B.W., Palmer, J.N.: Real-time Computed Tomography image update for endoscopic skull base surgery.  J Laryngol Otol. Aug 16;:1-5 (2007) [PubMed abstract]

Chiu AG. Surgical Management of the Lateral Frontal Sinus Lesion. Op Tech Otolaryngol 2006; 17.

Tan JL, Palmer JN, Chiu AG. Incidence of osteitis in clinical chronic rhinosinusitis. Am J Rhinol 2006; 20. [PubMed abstract]

Chiu AG. Frontal Sinus Surgery: Its Evolution, Present Standard of Care and Recommendations for Current Use. Ann Otol Rhin Laryng 2006; 115:9. [PubMed abstract]

Steiger JC, Chiu AG, Francis Do, et al. Endoscopic-assisted reduction of anterior table frontal sinus fractures. Laryngoscope 2006; 116. [PubMed abstract]

Chiu AG. Osteitis in Chronic Sinusitis. Clin Otolaryngol North Am 2005; 38. [PubMed abstract]

Hockstein, N.G., Cohen, N.A., Palmer, J.N. Letter to the Editor re: Beta-trace Protein Test: New Guidelines for the Reliable Diagnosis of Cerebrospinal fluid Fistula.  Otolaryngol Head Neck Surg.  133(2):310 (2005). [PubMed abstract]

Monin, D.L., Blummer, K., Cohen, N.A., Brooks, J.S.J., Chen, C., Kennedy, D.W. Endoscopic Resection of a Venous Hemangioma of the Optic Nerve Sheath.  Ear Nose Throat J. 84(9):586, 588, 590 (2005) [PubMed abstract]

Chiu AG, Schipor I, Cohen N.A., Kennedy D.W., Palmer J.N. Surgical decisions in the management of frontal sinus osteomas. Am J Rhinol 2005; 19. [PubMed abstract]

Woodworth BA, Schlosser RJ, Palmer JN., Endoscopic repair of frontal sinus cerebrospinal fluid leaks. J Laryngol Otol. 2005 Sep;119(9):709-13 [PubMed abstract]

Chiu AG, Palmer JN, Cohen N., Use of image-guided computed tomography-magnetic resonance fusion for complex endoscopic sinus and skull base surgery. Laryngoscope. 2005 Apr;115(4):753-5. [PubMed abstract]

Palmer JN, Kennedy DW., Historical perspective on image-guided sinus surgery. Otolaryngology Clin North Am. 2005 Jun;38(3):419-28. [PubMed abstract]

Chiu AG, Schipor I, Cohen NA, Kennedy DW, Palmer JN., Surgical decisions in the management of frontal sinus osteomas. American Journal of Rhinology 2005 Mar-Apr;19(2):191-7. [PubMed abstract]

Chiu AG, Kennedy DW. Surgical management of chronic rhinosinusitis and nasal polyposis. Curr Opin Aller Asth 2004. [PubMed abstract]

Schlosser RJ, Wilensky EM, Grady MS, Palmer JN, Kennedy DW, Bolger WE., Cerebrospinal fluid pressure monitoring after repair of cerebrospinal fluid leaks. Otolaryngol Head Neck Surg. 2004 Apr;130(4):443-8. [PubMed abstract]

Chandra RK, Palmer JN, Tangsujarittham T, Kennedy DW., Factors associated with failure of frontal sinusotomy in the early follow-up period. Otolaryngol Head Neck Surg. 2004 Oct;131(4):514-8. [PubMed abstract]

Chandra RK, Kennedy DW, Palmer JN., Endoscopic management of failed frontal sinus obliteration. American Journal of Rhinology. 2004 Sep-Oct;18(5):279-84.[PubMed abstract]

Palmer JN, Kennedy DW., Medical management in functional endoscopic sinus surgery failures. Curr Opin Otolaryngol Head Neck Surg. 2003 Feb;11(1):6-12. Review. [PubMed abstract]