We study the cause of subglottic stenosis, a progressive narrowing of the airway below the vocal cords. The causes can be microorganisms such as viruses, bacteria, fungi or hormonal influences.
I am employed at Region Västerbotten as senior physician (80%) and adjunct professor (20%). I have a section responsibility in voice and speech disorders since 2002. I teach/supervise at the medical, speech therapy and nursing programs as well as ST-education. I meet patients with voice, breathing and swallowing disorders in surgery and in the clinic. The research line is translational, interactive and collaborative. We have tested our study design for efficiency, effectiveness, feasibility and evaluated potential barriers within our infrastructure. We have access to critical laboratory equipment, medical record systems and skilled staff. Our research group includes laboratory expertise, clinical expertise in virology, scilifelab/clinical genomics, pathology, ear, nose and throat diseases, and statistics. We are represented at 2 educational nodes in the northern region and collaborate with all university hospitals nationally both clinically and research-wise.
Supervisor history
Main supervisor for PhD students
In October 2016, Christos Loizou "Human papillomavirus in recurrent respiratory papillomatosis, tonsillar and mobile tongue cancer"
In May 2019, Anna Holm "Human papillomavirus in sino-nasal inverted papilloma, recurrent respiratory papilloma and non-malignant tonsils".
In November 2022 Alexandra Schindele "Human papilloma virus and Epstein-Barr-virus in upper airway mucosa".
In January 2021 Anders Erlandsson was registered as a PhD student "Airway stenosis - in relation to surgical technique, causation and impact on quality of life". Anders has his mid-term reporting 2024-03-22.
In February 2017, Stina Sundstedt "Swallowing function in patients with Parkinson's disease and Deep Brain Stimulation". Stina took a licentiate degree in April 2014.
Assistant supervisor for doctoral students
Eleonor Koro, registered doctoral student in November 2019, mid-term report 2023
Elenor Lundgren, registered doctoral student in September 2020
Background
Subglottic stenosis (SGS) is a progressive narrowing of the airway just below the vocal cords, with female predominance. There is currently no cure; the condition requires recurrent surgical treatment under general anesthesia. Untreated, SGS is potentially fatal. It takes >18 months to diagnose. Including all variants of SGS, about 0.49/100,000 individuals/year are affected. The disease is relatively uncommon, but highly relevant from a healthcare cost perspective, reportedly comparable to COPD and diabetes. Not getting air has a great impact on quality of life and functionality.
Material and method
We have tested our study design for efficiency, effectiveness, feasibility and evaluated potential barriers within our infrastructure. We have access to critical laboratory equipment, medical record systems and skilled staff. To reduce the amount of human DNA and increase the amount of DNA from microorganisms in the diseased tissue, we have chosen (i) Macherey Nagel pathogen kit (ii) we use a SMARTer ThruPlex solution optimized to generate a DNA library with high molecular complexity from samples with little DNA (iii) For optimal sequencing and high cell yields, we have access to NovaSeq X technology. When analyzing female hormone receptors (RNA) in diseased tissue, we use "genome analysis" as described above or a SuperScript® III First-Strand Synthesis in an RTqPCR system.
Significance
Our study is driven by clinicians with treatment responsibility for SGS. Our reported outcome is expected to influence treatment by addressing cause and effect. By clarifying the connection between the development of SGS, female sex hormones and microorganisms, we can offer additional treatment to existing surgery in the form of vaccines, antibiotics and hormone therapy. The increased knowledge of the nature of obesity, misdiagnosis and the course of the disease over time affects the safety of care and the quality of life of those affected.
I teach/supervise at the medical, speech therapy, and nursing programs as well as ST-education. Popular science ex Fråga doktorn 2018, we filmed a surgical treatment procedure for subglottic stenosis (SGS; a progressive constriction with potentially fatal outcome located about 1 cm below the vocal cords). I have lectured on subglottic stenosis at Vetenskapsluncher 2024. I publish in popular science - e.g. Sensk ÖNH tidskrift and Läkartidningen 1 times / year. d. I lecture nationally and internationally in my research area. Have assignments as opponent (4 latest June 2023), grading committee (4 latest March 2024) and half-time seminar, > 7.