Nasal Dorsum Collapse following Endonasal Endoscopic Surgery What happens to the shape of the nose after endoscopic endonasal surgery? The skull base team at UPMC was the first to discover that endoscopic approaches to the skull base can alter the shape (profile) of the nose in a small percentage of patients. In order to better understand the factors that play a role, Dr. Carl Snyderman and his team are conducting a rigorous analysis of operative data. This study will allow surgeons to avoid this complication and better counsel patients about the risks of University of surgery.
Pittsburgh Effect of Sidedness of Naso-Septal Flap Elevation on Olfaction
Can a person still “smell the roses” after skull base surgery? Is a person’s sense of smell altered following surgery ? The sense of smell (olfactory region), is located high in the nasal cavity and can be diminished following surgery. Dr. Eric Wang is conducting a study to better understand why some patients are less affected than others. By measuring olfactory ability before surgery on each side of the nose, the surgeons hope to plan their surgeries to maximize preservation of the sense of smell so that patients can continue to smell the roses and savor the complex bouquet of wine.
Extraocular Cranial Nerve Monitoring with Minimally Invasive Electrodes How can surgeons remove tumors that are wrapped around nerves without losing nerve function? The nerves that move the eye are often affected by tumors such as pituitary tumors, meningiomas, and chordomas. Injury to these nerves causes double vision. Currently, small needles are inserted into the tissues around the eye to monitor and protect these nerves during surgery. Dr. Paul Gardner and his team are working with neurophysiologists to improve the monitoring technique to simplify the process and improve the monitoring of nerve signals. This research will make it possible for all surgeons to monitor nerve function more effectively.
Acoustic Patterns of Bone Drilling From a multiple choice list, we might be tempted to select “sense of sight” and “sense of touch” if we were asked what senses the surgeon needs and uses most. No doubt we would add “sense of hearing” or even “musical training” upon learning of Dr. Carl Snyderman’s team’s research into acoustic analysis of bone drilling. While imaging systems guide surgeons in the operating room, the most adept, experienced surgeons learn to listen for a pitch change that occurs when the drill reaches thinner bone that indicates soft tissue is near. Snyderman and his team have discovered a way to monitor the sounds of bone drilling and predict with 95% accuracy when the bone is getting very thin. This has wide application for cranial and spine surgery and will allow surgeons to drill more safely and avoid injury to tissues next to the bone.
Vidian Nerve Function following Endoscopic Endonasal Transpterygoid Approach Excessive “dry eye” discomfort can be a result of a particular surgical approach when it involves dissection of the vidian nerve. Loss of “emotional” tearing (crying, laughing) can cause dry eye problems for patients who already have decreased tear production. The nerve responsible for emotional tearing, the vidian nerve, may be injured with some surgical approaches. Dr. Eric Wang is directing a study to measure the function of this nerve before and after surgery to better understand the impact of surgery on tear production.
Genomic Sequencing of Skull Base Tumors When surgery and medical therapies do not stop a skull base tumor, what are the next steps? When tumors occur rarely, physicians have limited data to guide them in eradicating relentlessly occurring disease. Emerging genomic information provides a hopeful option to understand rare skull base disease. Dr. Paul Gardner and his team are studying patients who have been diagnosed with a chordoma, a generally slow -growing tumor with a tendency to recur after treatment. The tumor’s proximity to critical anatomic structures, such as the spinal cord, brainstem, and nerves, makes chordoma especially difficult to treat. The team is analyzing tumor tissue using the most current molecular techniques to better understand and reveal the development of these tumors.
His rare tumor drives him to find answers . . Josh Sommer’s story is on page 5
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