Department of Otolaryngology–Head and Neck Surgery · Johns Hopkins University School of Medicine
We build the instruments that answer it — label-free optical imaging that separates tumor from healthy tissue while the patient is still open, therapies engineered to reach what the scalpel leaves behind, and the tumor biology that tells us where to aim.
Latest
@maiestjohnResearch
Head and neck cancer is a disease decided in millimeters. A margin missed under the surgical light becomes a recurrence eighteen months later. Everything below is aimed at closing that gap — in the operating room, in the tissue, and in the cell.
Tissues fluoresce, and they stop fluorescing at different rates. DOCI turns that decay into contrast — a label-free, wide-field map distinguishing tumor from normal tissue in seconds, without dyes, sectioning, or waiting on frozen section. We have carried it from bench phantoms to oral cavity margins, parathyroid localization, thyroid pathology, and perineural invasion.
Resection removes the tumor you can see. We engineer polymer and nanoparticle systems that hold drug at the resection bed, release it on a schedule the tissue dictates, and treat the microscopic disease no scalpel reaches — turning the wound itself into a therapeutic surface.
Head and neck tumors do not grow alone. They recruit stroma, rewire immune signaling, and travel along nerves. We study perineural invasion and the neural regulation of the tumor microenvironment to understand why this cancer spreads the way it does — and which of those conversations can be interrupted.
Cell lines forget where they came from. We build organoids and patient-derived models from resected tissue, screen them against therapies the patient might actually receive, and pair the readouts with HPV status, histology, and outcome — so the model answers a question the clinic is already asking.
Method
Under surgical light, a tumor margin and the healthy mucosa beside it can look almost identical. Under DOCI they do not. Drag the divider to move between what the eye sees and what the decay reveals.
A short pulse of light hits the tissue. Endogenous fluorophores — collagen, NADH, FAD — absorb it and begin to emit. No dye, no contrast agent, no incision.
The camera collects emission in two timed windows. Because every tissue type has its own decay behavior, the ratio between those windows is a fingerprint, not a brightness.
That ratio is computed per pixel and false-colored across the field. What returns is a wide-field contrast map of the specimen — in seconds, on the surgical table.
Two concept animations — guided resection, then re-imaging the bed
01 Resection under DOCI guidance
02 Imaging the tumor bed
Both are concept animations — simulated, not surgical footage. DOCI is an investigational research tool, not a cleared device.
Approach
The lab sits inside a clinical department on purpose. Specimens come from the operating room down the hall, the questions come from the tumor board, and what we learn returns to the table it came from.
A recurrence pattern, an equivocal margin, a nerve that should not have been involved.
Optics, polymers, and models built with collaborators in engineering and pathology.
Ex vivo specimens, animal models, and blinded comparison against gold-standard pathology.
Prospective in-human studies, then the unglamorous work of making it routine.
Publications
Filter by program, or search titles and journals. Every entry links to PubMed.
No publications match that filter.
People
Andelot Professor of Laryngology and Otology · Professor of Oncology
Director, Department of Otolaryngology–Head and Neck Surgery
Johns Hopkins University School of Medicine
Dr. St. John is a head and neck surgical oncologist whose research centers on the mechanisms of tumor progression and metastasis in head and neck squamous cell carcinoma — and on translating those mechanisms into tools a surgeon can pick up. Her NIH- and NCI-funded work spans intraoperative optical imaging, targeted local delivery of therapeutics, the tumor microenvironment, and patient-derived models.
She was named Director of the Johns Hopkins Department of Otolaryngology–Head and Neck Surgery in 2025, after serving as Professor and Chair of the Department of Head and Neck Surgery at UCLA.
Senior Scientist
Department of Otolaryngology–Head and Neck Surgery
Johns Hopkins University School of Medicine
A biomedical physicist working where optics, molecular biology, and computation meet. Dr. Alhiyari has been central to the development of Dynamic Optical Contrast Imaging — building and validating the platform across oral cavity margins, parathyroid localization, thyroid pathology, perineural invasion, and vocal fold scar, and more recently pairing it with machine-learning segmentation.
His work extends past imaging: he led the design of a modular polymer platform for local delivery of head and neck cancer therapy, and contributed to the lab's work on sensory nerve signaling in the tumor microenvironment and on tissue-engineered vocal fold replacement. His earlier research, in radiation oncology, examined metabolism and Notch signaling in cancer stem cells.
Postdocs · residents · graduate students · research staff
Zeena's work has focused on biologic therapies and clinical trials. With a background in applied behavior analysis and medical device development, her research interests include emerging therapies and diagnostic technologies aimed at improving patient outcomes and quality of life.
Originally from Maryland, Dina completed her undergraduate and M.P.H. degrees at Yale University and is interested in pursuing head and neck cancer surgery. She hopes to research and help develop preventative and screening efforts for head and neck cancer, and to improve patient outcomes. Outside the lab she enjoys running, biking, exploring cafés, and traveling.
Add former lab members here, with where they went next.
Gallery
Picnics, conferences, races, and birthdays — from the department picnic at Johns Hopkins back through the lab's years at UCLA. The group moved east in 2025 and is still collecting Baltimore photographs.
Join
The lab is deliberately mixed — surgeons, engineers, biologists, and students who have not decided yet. If you want your work to end up in an operating room, write to us.
Optical engineering, cancer biology, or drug delivery. Send a CV, a short statement, and two references.
Rotations welcome through affiliated Hopkins programs. Tell us which program pulls at you, and why.
Protected research time within Otolaryngology–Head and Neck Surgery. Projects scale to the time you have.
A small number of positions each term, for students ready to commit real hours rather than a summer cameo.
Contact
The margin you cannot see is the one that comes back.