October 1st, 2020 the Department was upgraded as University Clinic for Flavour, Balance and Sleep.
Clinical research conducted at the Department must contribute to ensuring that patients receive evidence-based work-up and quality treatment. Furthermore, research must contribute to the development of novel diagnostic methods and treatment and rehabilitation offers. Special focus areas include vertigo (balance), olfactory and gustatory sense (flavour), snoring/apnoea (sleep) and nursing research.
The research and development work is done in cooperation with a wide range of Danish and international stakeholders. Furthermore, the Department focuses on multidisciplinary cooperation with other specialties and sectors.
Research responsibility lies with the Department’s clinical professor and the management of the Department. All employees are encouraged to participate in the research and development projects and in research methodology training activities.
Research competences
The division into themes of the Department’s research areas requires a wide range of competences and skills. The Department holds considerable experience with the planning and design of both clinical, translational and experimental studies.
Several members of the research teams master the handling of REDCap data, and the Department is authorised to extract data from Researcher Service (Danish: Forskerservice), Statistics Denmark) for use in register-based research.
The Department also holds expertise in the development and validation of questionnaires. Furthermore, the Department is well versed in processing and analysing complex imaging data.
The Department performs all clinical tests in the field of flavour research: quantitative ortho and retro-nasal testing of olfaction, quantitative testing of the sense of taste, olfactometry and electrogustometry and evaluation of 3T MR of the olfactory bulp imaging and data on neural networks/cerebral plasticity.
The Department also has the capacity to evaluate sleep monitoring including PSG and biomarkers related to sleep and OSAS.
All psycho-acoustic tests are performed as is evaluation of the function of the eustachian tube. The Department has at its disposal all test modalities relating to the vestibular field, including posturography.
Louise Devantier has developed a special chair for vestibular stimulation for use in both PET and fMRI studies.
The Department's professor holds many years of experience with animal models (mice, rats, guinea pigs, rabbits) and in-vitro studies of various different cell types, including olfactory stem cells.
Furthermore, the Department holds expertise in the execution and performance of various immuno-histochemical techniques, proteinic chemistry and qPCR.
Research in numbers
In the table you will find a list of publications that the research staff have contributed to in the 2015-2020-period.
The publication list of the Ear, Nose and Throat Department (pdf).
Research strategy
The Department's research mission is to further develop both medico-clinical and nursing research activities.
Fundamentally, free research initiative prevails but with a special focus on frequent and common ear, nose and throat conditions, treatments and procedures.
The research strategy of the Ear, Nose and Throat Department (pdf).
Platform
We intend to establish a robust research platform with activities that span broadly and go in depth to ensure coherence and continuity in the research activities over time. The research activities are rooted in:
- A scientific staff (a clinical nursing specialist, professor secretary, bio-analyst, talent/research year student, PhD student, post docs and a clinical professor).
- The Department’s medical specialists, doctors in training and nurses. This organization is intended to ensure clinically rooted research and implementation of research results in daily clinical work - and to avoid that research activities become a separate and isolated function with no link to or continuity with respect to the other functions of the Department.
Research strategy meetings counting the participation of the clinical professor are held regularly. The objective of these meetings is to coordinate clinical activity and research and ensure the implementation of new initiatives.
Dissemination
With respect to dissemination of the research activities, the aim is annually to publish a total of 10-15 articles and hold approx. 10 presentations, i.e. oral presentations or posters at national or international conferences/symposia.
In cooperation with the professor secretary, the clinical professor prepares two annual newsletters/one overall annual report to inform and take stock of the Department’s research activities. These are published at the Department’s website and at the Hospital’s and NIDO’s websites.
Core facilities
A number of core facilities are established relating to databases, literature searching, statistical data work-up and legal issues relating to research.
Collaborative efforts
Cooperation with other specialties, Aarhus University, international partners, the practice sector and industry is an essential factor in the Department's research activities. The management of the Department and the clinical professor head the dissemination of the activities.
Competence development
To ensure competence development in the context of the scientific work, a monthly journal club is held for all employees as are two annual research training workshops/boot camps.
Research topics
In line with the specialty's traditional structure and with the intention of exploring frequently occurring/common conditions and procedures, the Department's research falls within the following themes:
- Balance (otology and vestibulogy)
- Flavour (rhinology)
- Sleep (head-throat)
- Hearing/tinnitus (audiology).
To ensure a more or less equitable distribution of activities on each theme, the aim is to establish one post doc period or one PhD within each theme in addition implementing a range of more limited projects.
Balance (otology and vestibulogy)
2020 will see the initiation of a PhD project entitled "Dysfunctional eustachian tubes: causes, diagnosis, treatment and prognosis" by Doctor Niels Holm.
This PhD project will be based on cooperation particularly with the Ear, Nose and Throat Department in Aalborg and a wide range of ENT doctors in the Central Denmark and North Denmark regions.
In the longer term, these efforts will cover all of Denmark as all Danish patients who undergo balloon dilatation of the eustachian tube are registered in a joint database. Even at this early point, the national cooperation was consolidated in a published status article counting one author from each of the Danish regions.
Louise Devantier continues her vestibulogy studies as a post doc. The focus of her work is visualisation of cerebral networks through vestibular stimulation in collaboration with several international researchers.
Flavour (rhinology)
Alexander Fjælstad is a post doc in the flavour field. His study focuses on the sense of taste from tongue to brain and includes, among others, cancer patients. Additionally, Alexander is engaged in a considerable number of collaborative projects with a wide range of reputable international researchers. An altogether unique feature of the Flavour Clinic is its link to the Flavour Institute.
Andreas Niklasson's PhD project "Olfactory training and brain plasticity" aims to elucidate the scope of and the physiological mechanisms underlying the effect of olfactory training. The population basis for the study is patients with post-inflammatory and post-traumatic hyposmia/anosmia.
Talent and research year student Jelena Stankovic explores food fussiness and neophobia (fear of new foods). Her project compares a group of healthy children/adolescents in the town of Ringkøbing with a group of ADHD patients from the Child and Adolescent Outpatient Clinic in Skejby and counts Professor Per Hove Thomsen as a co-supervisor.
Sleep (head-throat)
Obstructive sleep apnoea (OSA) is common in Denmark - among children and adults alike. This topic is therefore the focus of Tina Lildals PhD study, in which children suspected of OSA are sleep-monitored before and after tonsillectomy.
The work is performed in cooperation with Professor An Boudewyns from the Antwerp University Hospital.
Hearing/tinnitus (audiology)
With a view to establishing a PhD project in the field of audiology, a REDCap database is being established focusing on the paediatric area.
Annual Reports
Research Staff and Contacts
The research activities of the Ear, Nose and Throat Department are undertaken by the Department’s doctors and nurses along with scientific staff members, including the contact persons listed below.
Therese Ovesen
Professor, senior consultant, DMSc.
As head of research at the Department, I strive for being inspiring, motivating, and including - all staff members are welcome in our research environment anytime. I intend to be a good ambassador for the Department when acting with the surroundings and partners. I appreciate freedom of research, transparency, and openness about our ideas, projects, and outcomes. And of course, our research conduct must reflect propriety and honesty.
Infectious diseases and sensory disorders are main themes in my research activities throughout the past 30 years. Especially, infections of the middle ear and the pharynx have been focus areas as well as loss of smell and taste, hearing impairment, and vertigo.
As a more novel field, I have engaged myself in sleep related research. Clinical and pre-clinical studies are parts of my research methodologies, but I have also solid experience with animal models and in vitro studies.
Together with my fabulous colleagues I founded Flavour Institute in 2015 and Flavour Clinic in 2016.
Therese Ovesen - Pure-profile.
Alexander Fjældstad
Associate professor, MD, PhD.
I am a medical doctor and associate professor at Aarhus University. I cofounded the Flavour Clinic in Holstebro and Flavour Institute at Aarhus University. In my research, I work with both clinical and basic research within the fields of taste and smell.
As a result of COVID-19 the year 2020 has been filled with challenges for Flavour research, as many projects have been delayed due to restrictions while many knowledge gaps have emerged in the association between COVID-19 and taste- and smell loss.
I was the primary investigator on the first study to confirm that COVID-19 can result in test-verified combined taste and smell loss.
Subsequently, I have initiated a follow-up study on the duration of taste and smell loss following COVID-19, where the first paper has been published from the cohort highlighting that many patients suffer from prolonged chemosensory deficits.
I am the Danish representative in the international collaboration Global Consortium for Chemosensory Research, where several studies on the matter are published and ongoing.
Alexander Wieck Fjældstad - Pure profile.
Kasra Zainali-Gill
ENT specialist, PhD.
In collaboration with Jannik Bertelsen I am focused on investigation and surgical treatment of obstructive sleep apnea.
Prior to introduction of specific surgical modalities at the Department, we conducted a feasibility study and the article was submitted for review in 2020. The study addresses the possibility for novices to become familiar with evaluation of drug induced sleep endoscopy (DISE) by means of DISE videos.
In 2020, we were fortunate to see that DISE was implemented in our clinical setup. As of March, the first patient was included in the DISE database, and 75 patients have been included by the end of the year. Furthermore, the first sleep surgeries were performed in 2020.
All data is stored in the DISE database and patients will be followed for 12 months. Unfortunately, due to COVID-19 lockdown, courses in sleep surgery was postponed in 2020.
In 2020, I received a grant of 1.000.000Dkr from Pulje til styrkelse af sundhedsforskning i Region Midt allocated to investigate sleep surgery for the next two years.
The next step is a systemic review of sleep surgery according to DISE findings. The review will be our guideline how to approach the heterogenous group of patients suffering from obstructive sleep apnea.
Jannik Bertelsen
Associate professor, ENT specialist, PhD.
My current scientific activity involves obstructive sleep apnea and surgery methods for benign tonsillar diseases.
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep. Surgical management of OSA is an alternative if first-line treatment with continuous positive airway pressure (CPAP) is not succeeded.
Drug induced sedation endoscopy (DISE) is a valuable diagnostic tool when deciding the proper surgical management of the upper airways.
The tonsil surgery register covers indications and choices of surgical methods for benign tonsillar diseases in our hospital and the ambition is to spread it to a national register. The results are used in a Nordic collaboration with Norway and Sweden to compare the results across countries and to compare outcomes of different clinical practice and to create a foundation for research collaborations.
In 2021, we initiate a multicenter study in the ENT departments in Aalborg, Vejle, Esbjerg and Holstebro to investigate the frequency of post-tonsillectomy bleeding in cold steel tonsillectomy versus impedancedependent-tissue-sealing (BiZact) tonsillectomy in a randomized controlled trial.
Jannik Bertelsen - Pure profile
Tina Lildal
MD, PhD-student.
Obstructive sleep apnoea (OSA) is common among children (1-3%), but obtaining accurate diagnostics is challenging.
Polysomnography, an extensive sleep study conducted in a sleep lab, is the gold standard for diagnostics, but due to high cost and low accessibility in Denmark, the diagnosis is currently based solely on clinical examination. Home sleep apnea test (HSAT) is a simplified version of polysomnography used for diagnosing OSA in adults.
In my PhD project, we investigate the validity of HSAT for diagnosing OSA in children. Additionally, we evaluate the use of OSA specific questionnaires and urinary biomarkers for assessing severity of morbid conditions associated with childhood OSA.
Ultimately, this could lead to better selection of candidates for surgical treatment.
Andreas Steenholt Niklassen
MD, PhD-student.
My research interests involve smell, taste and quality of life related to the senses.
Currently, I am investigating if treatment options for olfactory dysfunction can be improved, by improving olfactory training. At the same time, I am investigating the central plasticity in relation to the olfactory system by using structural and functional MRI in health and disease.
The quality-of-life changes when losing or regaining the sense of smell, and this is extremely important to be able to measure, to quantify the effect of treatment.
In my research I am using modern psychometric methods to develop patient reported outcome measures.
Research skills: Clinical studies, human neuroplasticity, functional and structural magnetic resonance imaging, modern and classical psychometrics, olfaction and gustation.
Andreas Steenholdt Niklassen - Pure profile
Niels Holm
MD, PhD student.
I will complete my training as ENT Specialist by May 31th 2021.
In 2020 I published a systematic review on acute otitis media and antibiotics in children in Danish Medical Journal.
My PhD protocol about Eustachian tube dysfunction has been approved by the Graduate School, Aarhus University, and I will initiate the Ph.D. project June, 2021. The PhD study involves use of the new acquisition: the conebeam-CT.
Meanwhile I participate in studies about stapedotomies, and the need for Eustachian tube dilation after myringoplasty.
Ali Abdul-Hussein Abood
ENT-specialist, Ph.D. student.
Dorthe Rasmussen
Laboratory Technician.
Mainly, I participate in Research Year studies and PhD projects at the ENT Department as well as in our laboratory facilities, Department of Clinical Medicine, Aarhus University.
My research compentences include all kinds of lab techniques, such as cell cultures, biochemical analyzes and immunohistochemistry.
I produce the taste drop test, which is developed by Alexander Fjældstad, and conduct all smell and taste tests among both adults and children.
Currently, I perform smell and taste tests in children with diabetes. I am also involved in COVID-19-related projects as we test smell and taste in patients referred from the post-COVID-clinics in Skejby and Herning.
Tascha Hovmøller Sørensen
Research Secretary.
I take care of administrative assistance for Therese Ovesen. It means that I provide updates on the research homepage including all ongoing projects, list of publications and funding. Together with Therese Ovesen, I prepare the annual reports.
Furthermore, I ensure communication with the Department of Clinical Medicine at Aarhus University; I have knowledge of PURE; the financial management program Indfak; and AURUS (travel settlement at Aarhus University), hereunder travel arrangement for PhD assessors, guests from abroad, and conferences participation.
I also assist researchers at the Department with regard to application formulas, synopsis and protocol schemes.
I coordinate the journal clubs and research workshops at the Department, and I link to various partners and colleagues.
Finally, I constantly upgrade my qualifications by participation in relevant courses/fora, e.g. at the Department of Clinical Medicine.