A5070165727- Head and Neck Surgical Oncology
- Meningioma and schwannoma management
- Pituitary Gland Disorders and Treatments
- Cerebrospinal fluid and hydrocephalus
- Sinusitis and nasal conditions
- Bone Tumor Diagnosis and Treatments
- Glioma Diagnosis and Treatment
- Craniofacial Disorders and Treatments
- Neurofibromatosis and Schwannoma Cases
- Spinal Fractures and Fixation Techniques
- Oral and Maxillofacial Pathology
- Cleft Lip and Palate Research
- Teratomas and Epidermoid Cysts
- Neurosurgical Procedures and Complications
- Growth Hormone and Insulin-like Growth Factors
- Ear and Head Tumors
- Adrenal and Paraganglionic Tumors
- Ophthalmology and Eye Disorders
- Vascular Malformations Diagnosis and Treatment
- Facial Nerve Paralysis Treatment and Research
- Intracranial Aneurysms: Treatment and Complications
- Trigeminal Neuralgia and Treatments
- Facial Trauma and Fracture Management
- Spinal Dysraphism and Malformations
- Nasal Surgery and Airway Studies
The Ohio State University Wexner Medical Center
2016-2025
Neurological Surgery
2016-2025
The Ohio State University
2016-2025
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
2012-2025
University of Missouri
2022
Icahn School of Medicine at Mount Sinai
2020
Cornell University
2020
Thomas Jefferson University
2020
University of North Carolina Health Care
2020
Atrium Health Wake Forest Baptist
2020
Reconstruction of the cranial base using vascularized tissue promotes rapid and complete healing, thus avoiding complications caused by persistent communication between cavity sinonasal tract. The Hadad-Bassagasteguy flap (HBF), a neurovascular pedicled nasal septum mucoperiosteum mucoperichondrium based on nasoseptal artery, seems to be advantageous for reconstruction after endonasal surgery.We performed retrospective review patients who underwent surgery at University Pittsburgh Medical...
The development of endoscopic endonasal approaches, albeit in the early stages, represents part continuous evolution skull base surgery. During this period, it is important to determine safety these approaches by analyzing surgical complications identify and eliminate their causes.The authors reviewed all perioperative associated with surgeries performed between July 1998 June 2007 at University Pittsburgh Medical Center.This study includes data for authors' first 800 patients, comprising...
Craniopharyngiomas are notoriously difficult to treat. Surgeons must weigh the risks of aggressive resection against long-term challenges recurrence. Because their parasellar location, often extending well beyond sella, these tumors challenge vision and pituitary hypothalamic function. New techniques needed improve outcomes in patients with while decreasing treatment morbidity. An endoscopic expanded endonasal approach (EEA) is one such technique that warrants understanding evaluation. The...
Background Over the past 10 years, significant anatomic, technical, and instrumentation advances have facilitated exposure resection of intradural lesions via a fully endoscopic expanded endonasal approach (EEA). The vascularized nasoseptal flap (based on posterior artery) has become our primary reconstructive technique. goals this study are to prospectively evaluate high-risk cerebral spinal fluid (CSF) leak variables. Methods Prospective evaluation was performed EEA patients with...
ABSTRACT OBJECTIVE The endonasal route may be feasible for the resection of anterior cranial base tumors that abut paranasal sinuses. There are several case reports and mixed series discussing this approach. Other than pituitary adenomas, there is a lack literature describing outcomes approaches single-tumor types such as meningiomas. METHODS In study, we describe our current endoscopic technique demonstrate feasibility using it to access meningiomas from back wall frontal sinus sella...
Few studies have systematically analyzed the long-term recurrence rates of Cushing's disease after initial successful transsphenoidal surgery.This was a retrospective review patients treated at University Virginia Medical Center.A total 215 subjects with who underwent surgery for resection presumed pituitary microadenoma from 1992-2006 were included.Remission and examined. Recurrence defined as an elevated 24-h urine free cortisol clinical symptoms consistent disease.Of disease, surgical...
Cranial base chordomas are difficult lesions to treat. The endoscopic endonasal approach (EEA) takes advantage of the natural sinus corridor and may provide a less invasive for these midline tumors.Patients undergoing EEA were selected from database more than 800 consecutive patients at University Pittsburgh Medical Center retrospectively evaluated. Additionally, systematic review literature endonasally resected was performed compared with our personal experience.Twenty (8 females 12 males)...
Endoscopic skull-base surgery (ESBS) is employed in the management of diverse pathologies. Paralleling increased utilization ESBS, literature this field has expanded rapidly. However, rarity these diseases, inherent challenges surgical studies, and continued learning curve ESBS have resulted significant variability quality literature. To consolidate critically appraise available literature, experts produced International Consensus Statement on Skull-Base Surgery (ICAR:ESBS).Using previously...
✓ The purpose of this study was to describe the technique used safely identify petrous carotid artery during expanded endonasal approaches skull base. A series 20 cadaveric studies undertaken isolate vidian and nerve use them as landmarks internal (ICA). Twenty-five consecutive paraclival endoscopic cases were also reviewed determine consistency in vivo an intraoperative landmark ICA. These data then correlated with results from a separate which computed tomography scans 44 patients...
Abstract Objectives: One of the major challenges cranial base surgery is reconstruction dural defect. Following a craniofacial resection, standard reconstructive technique direct suture repair defect with fascial graft and rotation an anteriorly based pericranial scalp flap to cover dura. The introduction endoscopic techniques endonasal approach ventral skull has created new for reconstruction. nasoseptal become workhorse vascularized reconstruction; however at times, septal mucosal may be...
Abstract Background: Expanded endonasal approaches (EEA) for the resection of lesions anterior and ventral skull base can create large defects with a significant risk postoperative cerebrospinal fluid (CSF) leaks or exposure internal carotid artery. In these cases, reconstruction using vascularized flap facilitates rapid complete healing defect. The Hadad‐Bassagasteguy (HBF), posterior pedicle nasoseptal flap, is our preferred reconstructive option; however, prior septectomy wide...
Endoscopic expanded endonasal approaches (EEAs) for the resection of lesions anterior and ventral skull base can create large defects that present a significant risk postoperative cerebrospinal fluid (CSF) leak. These defects, especially in patients who received preoperative radiotherapy, are best reconstructed with vascularized tissue. The Hadad-Bassagasteguy flap, pedicled nasoseptal is our preferred method reconstruction. This option not available, however, underwent previous posterior...
Endoscopic endonasal approaches to the ventral skull base are categorized based on their orientation in coronal and sagittal planes. For all of these approaches, sphenoid sinus is starting point, provides important vascular neural structures. Surgical petrous apex include 1) a medial approach, 2) approach with internal carotid artery (ICA) lateralization, 3) transpterygoid infrapetrous (inferior artery). The choice surgical depends relationship lesion (medial or inferior), degree expansion,...
✓The history of the endoscope exemplifies manner in which technological advances influence medicine and surgery. Endoscopic systems have evolved improved, they currently provide detailed visualization a variety deep organ structures. Otorhinolaryngological surgeons used for more than 30 years. In 1990s, number influential neurosurgeons otorhinolaryngological began performing purely endoscopic pituitary transsphenoidal operations are now extending beyond sella. The collaboration between...
The management of recurrent or residual craniopharyngiomas remains controversial. Although possible, revision surgery is more challenging than primary surgery, and often results in incomplete resection an increased risk death complications. extended (also called expanded) endoscopic endonasal transsphenoidal approach through the planum sphenoidale has been proposed over past decade as alternative surgical route for removal various suprasellar tumors including craniopharyngiomas. In this...
The introduction of the pedicled nasoseptal flap (NSF) has decreased postoperative cerebrospinal fluid (CSF) leak rates from >20% to <5% during expanded endoscopic skull base surgery. NSF must be raised at beginning operation protect posterior pedicle sphenoidotomy. However, in most pituitary tumor cases, an intraoperative CSF is not expected but times encountered. In these a "rescue" approach can used, which consists partially harvesting superior and aspect its provide access sphenoid face...
Endonasal surgery represents a radical change in the practice of cranial base and requires acquisition new knowledge surgical skills. The optimal training program for surgeons has not been established.We reviewed our experience with endonasal from 1998 to 2006 develop plan It consists modular incremental approach skull that is designed train function as team, learn endoscopic anatomy, fundamental skills.Stages are established otolaryngologist-head neck surgeon neurosurgeon based on level...
Abstract Objectives: The expanded endoscopic endonasal approach (EEA) to the odontoid process is performed for decompression of brainstem and access tumors at foramen magnum. Caudal exposure limited by nasal bones anteriorly hard palate posteriorly. We define line connecting these two points as nasopalatine (NPL) angle (NPA) between plane palate. Study Design: This study was a retrospective cohort study. Methods: Pre post‐operative computed tomographic (CT) scans 17 patients who underwent...
OBJECTIVE The interpeduncular cistern, including the retroinfundibular area, is one of most challenging regions to approach surgically. pituitary gland and infundibulum guard region when an endonasal route undertaken. Superior transposition described as a functional means access this complex through fully endoscopic, completely transnasal route. METHODs Ten consecutive patients in whom was performed during expanded at University Pittsburgh Medical Center for resection lesions were reviewed....
The importance of quality life (QOL) outcomes following treatments for head and neck tumors are now increasingly appreciated measured to improve medical surgical care these patients. An understanding the definitions in setting health use appropriate QOL instruments measures critical obtain meaningful information that guides decision making various aspects patient care. cranial base surgery is only recently being defined. In this article, we describe current published data on provide...
OBJECTIVE Tumors within Meckel's cave are challenging and often require complex approaches. In this report, an expanded endoscopic endonasal approach is reported as a substitute for or complement to other surgical options the treatment of various tumors region. METHODS A database more than 900 patients who underwent at University Pittsburgh Medical Center from 1998 March 2008 were reviewed. From these, only had considered. The technique uses maxillary sinus pterygopalatine fossa part working...