Center for Skull Base Surgery: Summer 2016

Congress Website Goes Live to the World April 2016 marked the launch of a global educational website of the UPMC Center for Skull Base Surgery (skullbasecongress.com).

The concept for the website grew out of the experience of the international skull base courses held regularly in Pittsburgh since 2005.

There was a need to build on the course experience and continue a dialog with surgeons around the globe. The Skull Base Cente r partnered with a local web development company, Treatspace, that specializes in building medical communities.

Within weeks of its launch, nearly 300 surgeons from around the globe joined the Skull Base Congress. The site is organized a round Case Presentations that represent the diversity of skull base diseases. Each case presents a surgical video with corresponding anatomy, surgical steps, and related scientific literature. Members of the Congress can test their knowledge with quizzes and participate in group discussions.

“We want this to be a true global community in the most literal sense of the word,” says Dr. Carl Snyderman.

“Social media is ubiquitous and has become the preferred medium for sharing information. We wanted to create an online home for skull base surgeons that shares the latest advances and provides a forum for discussion. We all learn from each other’s experiences and can assist each other in the care of patients despite geographic and political boundaries.”

Members responded with enthusiasm to the site. Joseph Balogun, neurosurgery instructor from Nigeria said he joined for “educational and collaborative opportunities with other skull base surgeons.” Pablo Barcelo, staff neurosurgeon from Argentina said “constant learning” is his impetus for joining. Lucas Possatti, neurosurgeon and neuroanatomy auxiliary professor from Brazil expressed his expectations of the website, “My main goal is to learn more about anatomical aspects of the different approaches to the skull base, surgical techniques and complications; improve my surgical results and consequently the care provided to the patients; to establish a network to carry out studies for scientific publications. I believe that if we master the different surgical techniques and work as a team, we can offer the best available treatment for each patient.” John Clarkson from New Zealand joined the site because “It looks like a valuable educational resource endorsed by highly credible skull base surgeons.”

In its first two months, already a new, unplanned feature has emerged on the website—an open forum blog entitled “Gray Matters,” intended to enable discussion of medical and surgical topics that are not clearly defined or that would prompt discussion among medical professionals related to newly emerging research and techniques.

The website will continue to grow and evolve based on feedback from members.

Potential future enhancements include links to other professional websites, and an informational community for medical device companies to drive the development of new technologies for skull base surgery.

Meetings & Events Spring-Summer 2016

Left: Dr. Paul Gardner lecturing to the international audience at the 12th National Congress of the Spanish Skull Base Society (SEBAC) in Barcelona, Spain. Right photo: Dr. Gardner with acclaimed skull base surgeons Dr. Jacques Morcos (far right) and Dr. Ossama Al Mefty (left of Dr. Morcos) in Barcelona.

Sociedad Espanola de Base de Craneo (SEBAC) In Barcelona this April, Dr. Paul Gardner joined a select group of surgeons to lecture at the XII National Congress of the Spanish Skull Base Society. Dr. Gardner presented talks on High Flow CSF Leak Repair: Endoscopic Approach, Cavernous Sinus: Endoscopic Approach, and presented a Master Class on Petroclival Meningioma: Endoscopic Approach. Gardner was one of only four invited lecturers from the United States.

British Skull Base Society (BSBS) Dr. Gardner opened the 2016 British Skull Base Society (BSBS) meeting. As reported by the British Society, Dr. Gardner shared “his cutting edge surgical treatment on possibly the largest series of skull base chordomas treated via endoscopic endonasal approach, which has revolutionised the treatment of these tumours. He also presented the use of the endoscope as an adjunct in lateral skull base surgery that was equally impressive.” At the meeting, Dr. Gardner led panel lecture sessions on “Anterior Skull Base Meningiomas – Endoscopic vs.

Open; and “Complex Anterior Skull Base Tumours” with surgeons from participating medical centers in Sheffield, Edinburgh, Belfast, Leeds, Dublin, Cardiff, Nottingham, Oxford, and other cities across the United Kingdom.

12th Congress of the European Skull Base Society With the theme of “connecting disciplines – creating success,“ the European Congress held in Berlin in May welcomed Paul Gardner and Carl Snyderman as invited international faculty. Dr. Snyderman presented a special lecture on the subject of “Endoscopic management of giant angiofibromas.” Dr. Gardner co-chaired the scientific session on “Reconstruction of the Skull Base” with Professor Harmut Vader of Bonn. Ten scientific papers researched and authored by the UPMC Skull Base surgeon group were presented.

7th International Congress of the World Federation of Skull Base Societies Dr. Snyderman and Dr. Gardner were invited as moderators and lecturers for this meeting in Osaka, Japan.

Dr. Gardner moderated a panel discussion on “Controversies in Skull Base Surgery.” Dr Snyderman moderated a panel on “Angiofibroma Management” and lectured on “Trending Endsocopic Techniques.”

Combined Otolaryngology Spring Meetings (COSM) At the 2016 Triological Society meeting during the Combined Otolaryngology Spring Meetings, Dr. Snyderman presented the Skull Base Team’s paper, “Oncological Outcomes of Endoscopic Endonasal Skull Base Surgery (EES) for Olfactory Neuroblastoma,” which represents the largest study to date analyzing outcomes following endoscopic surgery.

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North American Skull Base Society (NASBS) Annual Meeting In his Presidential Address at NASBS, Dr Snyderman emphasized the importance of creativity in surgical innovation and provided examples, citing leaders from across many disciplines to highlight the characteristics of innovators, the innovative process, and tools for enhancing creativity.

With the statement, “A successful life is not something you simply pursue, it is something that you create, moment by moment,” as his enduring vision and mission, Pittsburgh resident and native Bill Strickland delivered a keynote address.

Strickland is recognized nationally as a visionary leader who creates educational and cultural opportunities for students and adults. CEO of Manchester Bidwell Corporation, he built his organization on the foundation of a life-changing high school class, a pottery class taught by a skilled artisan. Strickland sees entrepreneurs and artists as interchangeable. “I see a connection between the creativity instilled by a love of the arts, and the skills needed for business success. Artists . . can visualize something that doesn't exist.”

William Strickland: “Make the Impossible Possible”

Other keynote speakers included Eric Meyhofer, leader of Uber’s Advanced Technologies Center in Pittsburgh, who presented a talk on innovative robotics and Alison Levine, author of On The Edge: The Art of High-Impact Leadership, who spoke of her experiences summiting Mount Everest. From the perspective of their own life experiences, speakers addressed teamwork, problem-solving, and making progress despite challenging situations.

The UPMC Skull Base Center directors, fellows, and residents presented over 20 lectures, case reports, brainstorming sessions, and scientific papers to the audience of surgeons.

Dr. Eric Wang focused his presentations on the Skull Base Team’s research on sinonasal malignancy as moderator of a panel discussion on “Controversies in the Management of Sinonasal Malignancy” and as leader of the session, Audience attending Dr. Carl Snyderman’s NASBS presidential lecture “Choosing the Right Metrics in Sinonasal Malignancy.”

Days packed with educational sessions and demonstrations, evenings provided opportunity for surgeons at NASBS to try out some western cowboy culture — including a quick-draw competition and bull riding.

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Skull Base Center Hosts Global Visitors Spring 2016 In their first session of 2016, the leaders of the Center for Skull Base Surgery hosted surgeons from around the world at their course “Comprehensive Endoscopic Endonasal Surgery of the Skull Base.”

Course attendees came from China, South Africa, Pakistan, Israel, Mexico, Kenya, India, Korea, Argentina, United Arab Emirates, Denmark, Canada, Ghana, and 9 states.

A surgeon from Chennai, India who had attended the course several years ago wrote to Dr. Snyderman: “This follow up is with regard to the optic nerve tumor I had sought your valuable opinion. I have to say the confidence to take up these cases all boils down to the workshop I attended at UPMC in 2012.

Honestly speaking, if I had the finances I would attend every year. As of now, it’s in my agenda to make it in December of 2017.”

Pittsburgh’s PNC Park was a Spring entertainment destination for research fellows with anatomy program director Juan Fernandez-Miranda as they enjoyed watching the Pittsburgh Pirates defeat the Milwaukee Brewers.

Innovations in Endoscopic Surgery Course 2016

Course Leaders were (left to right) Juan Fernandez-Miranda MD, Jonathan Engh MD, Director of the UPMC adult neurosurgical oncology program, Guest Faculty Andre Grotenhuis MD, PhD of Radboud University Medical Center in the Netherlands, Paul Gardner MD, and Brian Jankowitz MD, UPMC neurosurgeon specialist in open and endovascular cerebrovascular surgery.

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Dr. Fernandez-Miranda is Author in Gray’s Anatomy

“It is a privilege to be part of the 41st edition of Gray’s Anatomy, a text most physicians are familiar with to learn anatomy,”

says Juan Fernandez-Miranda MD. “To be invited to write a chapter for the ‘Bible’ of Human Anatomy is a great honor as it recognizes our international leadership in the field of intracranial anatomy and cranial base surgery.”

Remembering Dr. Peter Jannetta

Remembering Dr. Albert Rhoton

Dr. Peter Jannetta Albert Rhoton Jr, MD died passed away in at age 83 in February.

April at age 84.

Dr. Rhoton was Director of the Albert L. Rhoton It was only a few Neuroanatomy Lab at University days before his of Florida in Gainesville, where death that Dr. Juan Fernandez-Miranda Jannetta was at was a research fellow.

UPMC to deliver a lecture, “Remember- Dr. Fernandez-Miranda recalls, ing Walter Dandy.” Dr. “When I started training in Jannetta retired Professor Rhoton’s lab in from the University of Pittsburgh as Walter 2005, he was a living legend, E. Dandy Chair of the Department of father of microsurgical neuroNeurological Surgery in June 2000, then anatomy, and mentor for joined Allegheny General Hospital to world-class neurosurgeons.” establish the Jannetta Cranial Nerve Center.

Dr. Jannetta’s legacy is the “Jannetta Procedure,” a microvascular decompression (MVD) surgical technique he developed that offers trigeminal neuralgia patients an effective surgical therapy to relieve unrelenting pain caused by a blood vessel compressing the trigeminal nerve.

Jannetta’s legacy continues—surgical departments from Maine to California perform the Jannetta procedure for patients diagnosed with trigeminal neuralgia. The many residents he trained while teaching and performing surgery in Pittsburgh carry on his work in Pittsburgh and throughout the world.

Dr. Fernandez-Miranda is pictured with Dr. Rhoton, center, and Dr. Paul Gardner, right, when Dr. Rhoton was the invited guest of the Endoscopic Endonasal Surgery of the Cranial Base & Pituitary Fossa Course held at UPMC in September 2012.

“I remember vividly the initial meeting in his office to discuss the goals for my fellowship, and there I felt for the first time his magic aura of love and kindness that would radiate and comfort everyone around. At the beginning, we fellows did not fully understand the importance of accurate and meticulous dissections but early on Dr. Rhoton would clearly explain: ‘We want perfect anatomical dissections because we want perfect surgical operations.’”

“The beauty and perfection of his anatomy pictures were just an extension of his own beauty and perfection. His monumental work is a fundamental masterpiece of contemporary neurosurgery and we should all try to continue his work in our own way as neurosurgery continues evolving.”

Under the directorship of Dr. Fernandez-Miranda, the University of Pittsburgh Surgical Neuroanatomy Lab carries on the philosophy of Dr. Rhoton - meticulous anatomical microdissections to elucidate the complex anatomy of the human brain and skull base to enable the best patient surgical outcomes.

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Center for Skull Base Surgery University of Pittsburgh 203 Lothrop Street Suite 500 Pittsburgh, PA 15213 Directors: Paul A. Gardner, MD gardpa@upmc.edu Carl H.Snyderman, MD snydermanch@upmc.edu

In future newsletters, you will hear about some of the new exciting educational projects initiated at the Center for Skull Base Surgery.

Your support is essential.

If you would like to learn more about our activities or sponsor a project, please contact the Eye & Ear Foundation.* To support the Center for Skull Base Surgery, please use the enclosed envelope or visit eyeandear.org. If sending a check, please make payable to the Eye & Ear Foundation.

The University of Pittsburgh Skull Base Team is pictured above.

Additional information about the educational and clinical work of the Surgeons of the Center for Skull Base Surgery is found at: UPMC.com/skullbasesurgery

www.eyeandear.org 203 Lothrop Street Suite 251 EEI Pittsburgh, Pennsylvania 15213 Tel: 412 864 1300 *The Eye & Ear Foundation is a non-profit (C)(3) organization created solely to support the educational and research efforts of the Departments of Otolaryngology and Ophthalmology at the

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