Research on Swallowing Disorders (Dysphagia)

Jonathan E. Aviv, MD

Our various research projects all relate to the field of swallowing and sensory deprivation. We aim to translate the knowledge we gain into better technology for patients, helping people with chronic swallowing conditions live a more comfortable and ultimately satisfying life.

Main areas of Present research: 

Sensory Testing Technology: FEESST
A new medical technique developed by Dr. Aviv that can be used to prevent pneumonia in the elderly and in stroke patients.

1) We are studying the correlation between the absence of the airway protective reflex with derangements in the swallow. We are now in the process of showing that when the reflex is absent, any particular swallow will have some type of abnormality.

Furthermore, we can correlate sensory deficits with motor deficits. In other words, if the throat is motor paralyzed because of stroke or chronic neurological disease, we are finding that people with severe motor problems increase their likelihood of severe sensory problems. This new knowledge will help us develop better treatments for people with swallowing disorders.

2) We are studying the correlation between acid reflux injury of the larynx and sensory deficits in this area. We have observed that the acid-induced injury to the larynx causes swelling of the larynx, which in turn results in sensory deficits in this region. Our preliminary data indicate that treatment of laryngeal swelling from acid reflux with a proton pump inhibitor, such as Prilosec, Prevacid or Aciphex, results in diminution of laryngeal swelling and resolution of the sensory deficits.

Trans-Nasal Esophagoscopy (TNE)
We are further improving upon TNE technology, a new method to endoscopically examine the esophagus in the office without using X-rays, general anesthesia or intravenous sedation.

Optical Transesophageal Echocardiography (TE)
Traditional TE involves passing a probe through the patient's mouth and down into the esophagus. This is done by feel, without any optical guidance. During this process, the vocal cords can be inadvertently traumatized. Our current research on Optical TE is focused on developing an optical TE probe, which will allow direct visualization of the structures of the throat as the TE probe is placed into the esophagus.

A selected list of Dr. Aviv's publications

Box 21, Department of Otolaryngology/Head & Neck Surgery
630 West 168th Street
New York, NY 10032
Phone (212) 305-1602
Fax (212) 305-3975
jea10@columbia.edu

FEESST Research

Principal Investigators: Jonathan E. Aviv, MD

investigators & lab personnel: Lanny Close, MD; Jaclyn Spitzer, PhD; Manderly Cohen, CCC/SLP; Carolyn Gartner, CCC/SLP; 

Funding:
a.$17,000 Astra Zeneca. FEESST and Reflux Disease. Jonathan Aviv, MD, Principal Investigator.

b. $50,000 CPMC office of Clinical Trials, Sensory Discrimination of Larynx and Hypopharynx. 1993. JE Aviv, MD (PI).

c. $108,000 Florence Irving Assistant Professorship, Sensory Discrimination of Laryngopharynx,1993-1996: JE Aviv, MD.

d. $24,000 Pentax Precision Instrument Corporation, Unrestricted Ed. Grant, Lanny Garth Close, MD and Jonathan E. Aviv, MD FEESST, 1997.

Transnasal Esophagoscopy (TNE) Research

Principal Investigator: Jonathan Aviv

Investigator initiated (IRB approved)

Co-investigators: Thomas Takoudes, MD; Carlo Honrada, MD

Optical Transesophageal Echocardiography (Optical TE) Research

Principal Investigators: Jonathan Aviv and Marco Di Tullio, MD (Division of Cardiology, Department of Medicine)

Investigator initiated (IRB approved)

Co-investigators: Sunichi Homma, MD; Ian Storper, MD; Mark Murphy, MD; Carlo Honrada, MD; Steven Corwin, MD