About

Bryan R. McRae, MD, is a specialist in Otolaryngology-Head & Neck Surgery at the University of Utah. His clinical expertise includes treatment of common conditions in adults and children such as tonsillectomy, hearing loss, facial trauma repair, and a wide range of ear, nose, and throat disorders including laryngology, vocal lesions, nasal airway surgery, and sinus surgery. He is one of the Otolaryngology surgeons for the Hereditary Hemorrhagic Telangiectasia (HHT) team, a University of Utah referral center for this genetic disorder. Dr. McRae has extensive research experience, including years of full-time NIH-T32 training in areas such as laryngeal reinnervation, vocal fold paralysis, and artificial tracheas. His current efforts involve collaboration with the Center for Medical Innovation to develop new medical and surgical devices across various disciplines. He serves as a clinical mentor for university BioDesign and BioInnovate student teams within biomedical engineering programs, with some teams having won awards at the Bench to Bedside competitions. Dr. McRae is a member of the American Academy of Otolaryngology-Head & Neck Surgery and actively participates in local and national committees. Fluent in Mandarin Chinese, he also participates in humanitarian service, including surgical trips to Kenya, China, and Indonesia. He is a native of Bountiful, Utah, and enjoys outdoor activities, piano, and choral music in his free time.

Research topics

• Medicine
• Pathology
• Biology
• Anesthesia
• Meteorology
• Chemical engineering
• Surgery
• Genetics
• Ecology
• Internal medicine
• Environmental science

Selected publications

• Impact of a Respiratory Aerosol Containment Device on Posture Ergonomics and Perceived Workload During Intubation

  Ergonomics in Design The Quarterly of Human Factors Applications · 2026-03-05

  article

  The COVID-19 pandemic led to the development of systems like the Utah COntainment Ventilation for Exposure Reduction (U-COVER) to limit infectious aerosol spread. This study evaluates the impact of the U-COVER on ergonomics, response time, and perceived workload during simulated intubation through analysis of body posture and kinematics (RULA, Statistical Parametric Mapping) and workload assessment (NASA Task Load Index). While small differences in posture, perceived workload and intubation time were observed, they are unlikely to be clinically meaningful, supporting the feasibility of using the proposed ventilation system without substantial ergonomic or task-time drawbacks in healthcare settings.

  PublisherDOI

• Investigation of the Genetic Determinants of Telangiectasia and Solid Organ Arteriovenous Malformation Formation in Hereditary Hemorrhagic Telangiectasia (HHT)

  International Journal of Molecular Sciences · 2024 · 15 citations

  • Pathology
  • Medicine
  • Biology

  in one brain AVM sample, in which the germline mutation occurred in a different allele than a nearby somatic mutation (both are loss-of-function mutations). Eight of nine (88.9%) patients in whom telangiectasia tissues were evaluated had a somatic mutation ranging from 0.68 to 1.96% in the same gene with the germline mutation. Six of fifteen (40%) nasal and two of four (50%) dermal telangiectasia had a detectable somatic second hit. Additional low-level somatic mutations in other genes were identified in several telangiectasias. This is the first report that nasal telangiectasias and solid organ AVMs in HHT are caused by very-low-level somatic biallelic second-hit mutations.

  PublisherOA PDFDOI

• An Aerosol Containment and Filtration Tent for Intubation During the COVID-19 Pandemic

  Surgical Innovation · 2021 · 6 citations

  • Medicine
  • Environmental science
  • Meteorology

  Our simulations suggest our device has the potential to effectively decrease HCWs' exposure to infectious droplets and aerosolized viral particles.

  PublisherOA PDFDOI

• Radiofrequency Ablation vs Electrocautery Blinded Randomized Trial: Impact on Clinically Meaningful Outcomes

  Otolaryngology · 2020 · 4 citations

  • Medicine
  • Anesthesia
  • Surgery

  OBJECTIVE: To analyze patients' return to normal activity, pain scores, narcotic use, and adverse events after undergoing tonsillectomy or adenotonsillectomy with monopolar electrocautery or radiofrequency ablation. STUDY DESIGN: Randomized double-blinded clinical trial based on prospective parallel design. SETTING: Academic medical center and tertiary children's hospital between March 2018 and July 2019. METHODS: Inclusion criteria included patients aged ≥3 years with surgical indication of recurrent tonsillitis or airway obstruction/sleep-disordered breathing. Patients were randomly assigned to monopolar electrocautery or radiofrequency ablation. Patients were blinded to treatment assignment. Survey questions answered via text or email were collected daily until postoperative day 15. The primary outcome was the patient's return to normal activity. Secondary outcomes included daily pain score, total amount of postoperative narcotic use, and adverse events. RESULTS: = .13). CONCLUSIONS: As one of the largest randomized controlled trials examining instrumentation in tonsillectomy, our data do not show a difference between monopolar electrocautery and radiofrequency ablation with regard to return to normal activity, daily pain scores, total postoperative narcotic use, or adverse events.

  PublisherDOI

• The effects of nasal closure on quality of life in patients with hereditary hemorrhagic telangiectasia

  Laryngoscope Investigative Otolaryngology · 2018-04-19 · 13 citations

  articleOpen access

  Introduction Epistaxis is the most common symptom of hereditary hemorrhagic telangiectasia (HHT). Complete nasal closure is one of the treatment options for patients with severe, intractable epistaxis. In our experience, this surgery can be life changing in a positive sense; but many patients as well as their physicians understandably fear that such a procedure will diminish certain aspects of quality of life (QOL). Methods Case‐control study of HHT patients treated at the University of Utah HHT Center of Excellence with and without nasal closure from January 2005 to January 2016. Patients were matched according to epistaxis severity. Each included patient was issued three surveys: Epistaxis Severity Score (ESS), the Pittsburg Sleep Quality Index (PSQI), and the Nasal Obstruction Symptom Evaluation (NOSE). Results After treatment, the mean PSQI and NOSE scores were not significantly different between the two groups. However, the mean ESS score in the nasal closure group was significantly lower at 1.10 compared to the severe epistaxis group with a mean score of 3.99 ( P = .027). Conclusion The results of this study demonstrate that nasal closure significantly improves epistaxis severity without having a significant effect on sleep or nasal obstruction as they relate to QOL. These findings suggest that nasal closure should be considered for HHT patients with chronic severe epistaxis. Level of Evidence 4.

  PublisherOA PDFDOI

• Differences in Laryngeal Neurotrophic Factor Gene Expression after Recurrent Laryngeal Nerve and Vagus Nerve Injuries

  Annals of Otology Rhinology & Laryngology · 2013-10-01 · 7 citations

  articleSenior author

  OBJECTIVES: Recurrent laryngeal nerve (RLN) and vagus nerve (VN) injuries characteristically are followed by differing degrees of spontaneous reinnervation, yet laryngeal muscle neurotrophic factor (NF) expression profiles after RLN and VN injuries have not been well elucidated. This study's objective was to determine the relative changes in gene expression of 5 well-characterized NFs from laryngeal muscle after RLN or VN injuries in a time-dependent fashion, and demonstrate how these changes correspond with electromyography-assessed innervation status. METHODS: Thirty-six male rats underwent left RLN transection (12 rats), left VN transection (12 rats), or a sham procedure (12 rats). The primary outcomes included electromyographic assessment and laryngeal muscle NF expression quantification with reverse transcription polymerase chain reaction at 3 days and at 1 month. RESULTS: Electromyography at 3 days demonstrated electrical silence in the VN injury group, normal activity in the sham group, and nascent units with decreased recruitment in the RLN injury group. Reverse transcription polymerase chain reaction demonstrated that changes in NF gene expression from laryngeal muscles varied depending on the type of nerve injury (RLN or VN) and the specific laryngeal muscle (posterior cricoarytenoid or adductor) assessed. CONCLUSIONS: Laryngeal muscle NF expression profiles after cranial nerve X injury depend both upon the level of nerve injury and upon the muscles involved.

  PublisherDOI

• The Effect of Cartilaginous Reinforcing Sutures on Initial Tracheal Anastomotic Strength

  Otolaryngology · 2012-04-23 · 5 citations

  article

  OBJECTIVE: During tracheal resection with primary anastomosis, cartilaginous reinforcing sutures may be placed outside of the primary anastomosis with the goal of preventing early dehiscence. The direct effect of such reinforcing sutures on anastomotic strength has not been previously investigated. The goal of this study was to determine if the addition of cartilaginous reinforcing sutures adds to tracheal anastomosis stability. STUDY DESIGN: Prospective cadaver study. SETTING: This research was conducted at an anatomy lab at Indiana University School of Medicine. SUBJECTS AND METHODS: Twelve cadaver tracheas were harvested. Each trachea was bifurcated, with 1 segment of each trachea transected and anastomosed using circumferential sutures and the remaining tracheal segment undergoing the same procedure with the addition of cartilaginous reinforcing sutures. Segments (proximal versus distal) were alternated to control for potential anatomic-based strength differences. The force necessary for anastomotic rupture was measured, and a Wilcoxon signed-rank test was used to compare means. RESULTS: Analysis demonstrated the mean anastomotic rupture point for tracheas with reinforcing sutures was 297 N (95% confidence interval = 241.1-352.9), while the mean for trials without reinforcing sutures was 173 N (95% confidence interval = 142.63-203.37; P = .0054). The point of rupture occurred at the anastomosis in 1 case with reinforcing sutures and in 8 of 11 cases without reinforcing sutures. CONCLUSIONS: Cartilaginous reinforcing sutures were found to provide a higher force requirement for tracheal anastomotic rupture when compared with anastomoses without these sutures. This improved stability in tracheal anastomosis may result in a decreased risk of early tracheal rupture after anastomosis.

  PublisherDOI

• A rapid, novel model of culturing cranial nerve X-derived motoneurons for screening trophic factor outgrowth response

  Neurological Research · 2012-06-05 · 4 citations

  article1st author

  OBJECTIVES: After cranial nerve X (CN X) injury, vocal fold paralysis treatments currently face a myriad of obstacles in achieving non-synkinetic, functional reinnervation. Of particular therapeutic interest is the targeted administration of locally expressed biological neurotrophic factors (NFs). To date, a method to culture mature CN X motoneurons for NF responsiveness screening has not been described. METHODS: We herein present a novel method for establishing mature murine CN X motoneuron cultures, and use the model to test CN X motoneuron outgrowth response to individual and paired ascending concentrations of selected neurotrophic factors [glial cell-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), and ciliary neurotrophic factor (CNTF)]. RESULTS: Findings demonstrated low concentration (5 ng/ml) CNTF to have the greatest positive effect on motoneuron outgrowth, beyond that of both indivual NF and paired NF combinations, based on total neurite outgrowth [mean total neurite outgrowth = 445.7±84.45 μm in the (5 ng/ml) CNTF group versus 179.7±13.63 μm in saline controls (P<0.01)]. Paired treatments with CNTF/GDNF, and CNTF/BDNF promoted motoneuron branching at a variety of concentrations beyond saline controls, and paired GDNF/BDNF had inhibitory effects on motoneuron branching. DISCUSSION: Our described in vitro model of establishing mature CN X cultures allowed rapid screening for responsiveness to therapeutic NFs at a variety of concentrations and combinations. While the model ultimately may be used to investigate the molecular mechanisms of CN X motoneuron regeneration, the current study identified CNTF as a promising therapeutic candidate for the promotion of CN X outgrowth.

  PublisherDOI

• Neurotrophic factor‐secreting autologous muscle stem cell therapy for the treatment of laryngeal denervation injury

  The Laryngoscope · 2012-09-10 · 32 citations

  articleOpen access

  OBJECTIVES/HYPOTHESIS: To determine if the spontaneous reinnervation that characteristically ensues after recurrent laryngeal nerve (RLN) injury could be selectively promoted and directed to certain laryngeal muscles with the use of neurotrophic factor (NF)-secreting muscle stem cell (MSC) vectors while antagonistic reinnervation is inhibited with vincristine (VNC). STUDY DESIGN: Basic science investigation involving primary cell cultures, gene cloning/transfer, and animal experiments. METHODS: MSC survival assays were used to test multiple individual NFs in vitro. Motoneuron outgrowth assays assessed the trophic effects of identified NF on cranial nerve X (CNX)-derived motoneurons in vitro. Therapeutic NF was cloned into a lentiviral vector, and MSCs were transduced to secrete NF. Sixty rats underwent left RLN transection injury, and at 3 weeks received injections of either MSCs (n = 24), MSCs secreting NF (n = 24), or saline (n = 12) into the left thyroarytenoid muscle complex; half of the animals in the MSC groups simultaneously received left posterior cricoarytenoid injections of VNC, whereas half of the animals received saline. RESULTS: Ciliary neurotrophic factor (CNTF) had the greatest survival-promoting effect on MSCs in culture. The addition of CNTF (50 ng/mL) to CNX motoneuron cultures resulted in enhanced neurite outgrowth and branching. In the animal model, the injected MSCs fused with the denervated myofibers, immunohistochemistry demonstrated enhanced reinnervation based on motor endplate to nerve contact, and reverse transcriptase-polymerase chain reaction confirmed stable CNTF expression at longest follow-up (4 months) in the CNTF-secreting MSC treated groups. CONCLUSIONS: MSC therapy may have a future role in selectively promoting and directing laryngeal reinnervation after RLN injury.

  PublisherOA PDFDOI

• Cartilaginous Reinforcing Sutures in Tracheal Anastomosis

  Otolaryngology · 2011-08-01

  articleOpen access

  Objective 1) Determine what additional stability, if any, the addition of cartilaginous reinforcing sutures adds to tracheal stability. 2) Further clarify mechanisms of tracheal rupture. Method Prospective cadaver study. Eleven cadaver tracheas were harvested and divided in half. Each half trachea was cut and anastomosed using circumferential sutures. The other half underwent the exact same procedure with the addition of cartilaginous reinforcing sutures. The force necessary for anastomosis rupture was measured for each half trachea. Results Eleven tracheas were used for a total of 22 trials. Analysis demonstrated a mean anastomotic rupture point for tracheas with reinforcing sutures was 297 N ± 94.6, while the mean for trials without reinforcing sutures was 173 N ± 51.4 ( P &lt;. 05). The point of rupture occurred at the anastomosis in 1 out of 11 cases with reinforcing sutures and in 8 out of 11 cases without reinforcing sutures. In all trials, the reinforcing sutures remained intact. Conclusion Cartilaginous reinforcing sutures were found to provide a higher force requirement for rupturing tracheal anastomoses when compared to anastomoses without these sutures. This improved stability in tracheal anastomoses may result in a decreased risk of tracheal rupture after anastomosis.

  PublisherOA PDFDOI

Frequent coauthors

• Stacey L. Halum

  Indiana University

  27 shared

• Khadijeh Bijangi‐Vishehsaraei

  University of Indianapolis

  12 shared

• Peter N. Schilt

  9 shared

• Kelly Hiatt

  University Hospitals of Leicester NHS Trust

  6 shared

• Swapna Musunuru

  Indiana University School of Medicine

  5 shared

• Mimi S. Kokoska

  5 shared

• David L. Sycamore

  Indiana University School of Medicine

  4 shared

• Ozan Akkuş

  Case Western Reserve University

  4 shared

Education

• M.D.

  University of Utah