Pediatric otolaryngologist Dr. Brianne Roby is director of the ENT and Facial Plastic Surgery Fellowship at Children’s Minnesota and the University of Minnesota. She is also director of the cleft and craniofacial team in the ear, nose and throat (ENT) and facial plastic surgery program on the St. Paul campus at Children’s Minnesota. She has led research studies that span a wide range of topics, including major, longer-term studies that resonate with her own interests and smaller, shorter-term studies with medical students.
Some of Dr. Roby’s most extensive research work has been to apply various medical technologies to pediatric populations. Two areas Dr. Roby is especially passionate about include the use of eye-tracking technology and the use of nasometers with children.
Eye-tracking technology research
In one protocol study, Dr. Roby and her team found eye-tracking technology could be used on children as young as five years old to determine a child’s perception of a cleft lip deformity. This was significant because it allowed clinicians to identify the age at which children first notice facial deformities or scars on their peers (usually around 10, but sometimes as young as 8.)
These data, which had never been collected before, can help in making crucial treatment decisions, such as when to perform surgery on a child. If a six-year-old’s facial scar is not likely to even be noticed by other six-year-olds, surgery to revise it can be postponed until the child is older and combined with another procedure. This can reduce the total number of surgeries a child has to go through and potentially saving on cost. As a result, the child’s needs can dictate the timing of treatment, not the perceptions or desires of adults in the child’s life, such as the parents or surgeon.
Dr. Roby’s research using a nasometer (a device that measures the amount of air that comes out of the nose versus the mouth when a person says a word) with children has had major implications for clinical practice – a nasometer is now used with all cleft and craniofacial patients at Children’s Minnesota. Kids with a resonance disorder have an opening, inconsistent movement or obstruction that changes the way air flows through the mouth and nose. A nasometer can diagnose these types of issues.
Submucous cleft palate research
Shorter-term studies led by Dr. Roby provide medical students, resident and fellows with hands-on research experience and have produced important findings.
For example, in a retrospective chart review of children with submucous cleft palate, Dr. Roby and colleagues found kids with this condition who have a 22q11.2 deletion will need surgery much more often than kids with this condition who do not have that deletion. This result has far-reaching implications for how treatment decisions are made, as families of kids with the deletion can opt for surgery at a much younger age and sidestep years of other treatment regimens that would not have been effective. These findings have led to changes in clinical practice at Children’s Minnesota and other hospitals throughout the field.
Other shorter-term studies by Dr. Roby include examining the different syndromes she and her colleagues find in their cleft and craniofacial patients, the accuracy of lateral neck x-rays, and the genetic makeup of hearing loss.
“I feel very strongly that the project should be one [the students] own,” said Dr. Roby. “Rather than analyzing data I have already collected, the students develop for themselves the full breadth of skills involved in performing research. The medical students who have worked with us have universally matched into really great residency programs, largely because of what we have been able to help them do.”
“As an ENT surgeon, Dr. Roby has played a pivotal role in advancing science at Children’s Minnesota and she has been a strong champion of our research volunteer program,” said Dr. Stuart Winter, chief research officer at Children’s Minnesota Research Institute.
About the Ear, Nose and Throat (ENT) and facial plastic surgery program
Children’s Minnesota ear, nose and throat (ENT) and facial plastic surgery program diagnoses and treats simple and complex conditions in babies, children and teens. It’s the only ENT program in the state dedicated exclusively to kids with disorders of the head and neck. Our full range of ENT and facial plastic and reconstructive surgery services, includes prenatal counseling, advanced imaging, and innovative surgeries for cleft and craniofacial issues. Our pediatric ENT and facial plastic surgery team includes some of the most experienced pediatric otolaryngologists in the country.
About Children’s Minnesota Research Institute
Children’s Minnesota Research Institute (CMRI) plays an integral role in transforming clinical research into real-world therapies that prevent and treat childhood illness and improve the quality of children’s daily lives. CMRI’s programs and services help ensure that researchers throughout Children’s Minnesota have the means and the opportunity to conduct safe, efficient, and ethical research involving children. Learn more about CMRI here.