Patients undergoing surgery and others who are critically ill may need to have tubes placed down their throat to help them breathe. While this process, known as intubation, is medically necessary and can be life-saving, the pressure that the tube places on the throat tissue can also cause injury. For example, some patients may experience issues with their voice, swallowing, or breathing as a result of this injury once the breathing tube is removed.
When the glottic tissue at the back of the throat becomes irritated and inflamed by the breathing tube, this can lead to the development of scar tissue. When this scar narrows the airway and limits breathing, this is called posterior glottic stenosis (PGS). With the help of a new two-year, $40,000 Career Development Award from the Triological Society, Division of Otolaryngology-Head and Neck Surgery Assistant Professor Ruth Davis, MD will be conducting research to better understand what causes post-intubation laryngeal injury to progress into PGS.
Davis is particularly interested in how disruption of the microbiome of the throat may contribute to PGS.
“We have some preliminary data that suggests that many patients with intubation injuries have an overgrowth of bacteria in the injured glottic tissue,” explained Davis. “The bacteria could enter the injury site, triggering inflammation, and cause more scar tissue to develop. We want to evaluate this further.”
Davis is interested in strategies to increase the rate of wound healing to reduce bacterial entry to the site of injury. Specifically, she is interested in understanding the role of the recently discovered Piezo receptors in this process. In studies involving mice and flies, reducing the number of Piezo receptors has been found to reduce inflammation and increase the rate of wound healing in such tissue as the kidneys and skin. While Piezo receptors are present in the throat, Davis will be the first to look at whether these receptors play a role in the healing of throat injuries.
The results of Davis’ study have the potential to help researchers better understand the cause of throat injuries resulting from breathing tubes, which could in turn point to possible ways to prevent and treat these injuries. Davis plans to use these results as preliminary data to apply for a career development award from the National Institutes of Health, which will help her extend this line of research and also support her long-term plan of becoming an independently-funded surgeon-scientist.