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Focus on the Face

Focus on the Face

When Johns Hopkins Department of Otolaryngology–Head and Neck Surgery third-year resident Jason Nellis was in the fifth grade, his class took a field trip to a cadaver lab at the University of Utah, sparking an interest in the human body. Later, he became involved in community service, where he discovered a love of forging relationships with new people and helping others through service. By the time he was wrapping up high school, his future career was becoming clear.

“I knew that I wanted to do something that involved biology and working with people. Everyone would always say, ‘You should be a doctor,’” he remembers. “It made sense to me.”

After attending the University of Maryland for his undergraduate degree and the University of Virginia for his medical degree, he landed at Johns Hopkins for his residency. Seeking a lab to join for the research portion of his training, he soon sought out Lisa Ishii, a physician-researcher in the department whose work had captivated him as a medical student.

Much of Ishii’s work centers on faces, a sight that most people view dozens of times every day without much thought. But minute details of faces, particularly facial defects—such as nasal deformities, an uneven smile or lesions after skin cancer resection—can influence perceptions and emotions, both for the observer in society and the individual whose face is on display.

Nellis currently has several research projects in progress in Ishii’s lab centered on this topic. One focuses on patients with acoustic neuromas, benign tumors that affect thousands of patients in the United States each year. Depending on tumor size and other risk factors, surgery to remove it sometimes leads to facial paralysis. To see how the aftermath of surgery in particular affects acoustic neuroma patients, Nellis and his colleagues are following patients for a year after this treatment to better understand the effect on quality of life and other psychosocial dimensions, such as depression and self-esteem.

Similarly, Nellis and his colleagues are also tracking patients who come to Johns Hopkins with facial paralysis that results from a variety of causes, such as other types of tumors and Bell’s palsy. Their early data suggest that this group has a significantly higher likelihood of depression and lower quality of life compared to those who don’t have facial paralysis. The researchers plan to follow this group long term to see if these risks change over time or after facial reanimation surgery to treat paralysis.

Both of these studies, he explains, will lend some insight on what life might be like living with various conditions and how this changes after treatment, information that could help doctors and their patients make care decisions.

“A lot of this work is just about understanding what day-to-day life is like for patients when they leave our office, giving us information to provide better patient-centered care and hopefully improve patient outcomes,” Nellis says. “That boils down to why I got into medicine in the first place. Working with patients is the greatest reward.”

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