My clinical focus is in three areas:
- Sinonasal inflammatory disease, including nasal polyps, with a focus on revision/complex cases (e.g., frontal sinus surgery, modified endoscopic Lothrop, medial maxillectomy)
- Surgical treatment of sinonasal tumors, both benign (e.g., inverted papilloma) and malignant
- Endoscopic skull base surgery, including:
- Pituitary tumors (both functioning and non-functioning)
- Cerebrospinal fluid leaks and encephaloceles
- Sinonasal tumors with intracranial involvement (squamous cell carcinoma, olfactory neuroblastoma, melanoma, adenocarcinoma, adenoid cystic carcinoma, etc.)
- Intracranial/skull base pathologies (meningioma, craniopharyngioma, chordoma, chondrosarcoma, etc.)
To date, I perform over 100 cases per year for the treatment of sinonasal tumors and skull base pathologies in conjunction with our neurosurgery and head and neck colleagues. There has been steady growth in volume, averaging at least 1-3 cases per week, and we are the only tertiary academic center in Orange County able to provide these comprehensive services. Many cases are being referred from other outside institutions and/or are revision or “inoperable” cases. Our catchment area and referrals are broad, drawing patients from Orange County, Los Angeles County, the Inland Empire (both Riverside and San Bernardino Counties), and parts of San Diego County. In some instances, patients have traveled from outside of California and even from outside the United States to see us for these problems.
Many sinonasal tumor and skull base surgery patients require a multidisciplinary team-based approach care which may also enlist the support of head and neck oncology, ophthalmology/oculoplastic surgery, radiation oncology, hematology/oncology, pathology, neuroradiology, and neurocritical care, among many other subspecialists. Patient cases are presented weekly at both the Brain Tumor Board and the Head and Neck Tumor Board.