The Division of Rhinology and Skull Base Surgery studies medical and surgical management of the paranasal sinuses and anterior skull base.
Rhinology and Skull Base Surgery
The Mayo Clinic Department of Otolaryngology — Head and Neck Surgery's Division of Rhinology and Skull Base Surgery is committed to investigating novel ways to help treat patients with disease processes and improve their quality of life for diagnoses including chronic rhinosinusitis, sinonasal or skull base tumors, and thyroid eye disease. Researchers aim to provide cutting-edge insights into how these diseases develop and to provide better treatment options.
To accomplish these goals, the division works with a number of Mayo Clinic groups, including specialists in:
- 3D anatomical modeling
- Allergy and immunology
- Anatomic pathology
- Individualized medicine
Researchers also collaborate with colleagues at other leading national academic institutions.
Nearly every patient that comes to the division for consultation for chronic rhinosinusitis, sinonasal or skull base tumors, or receives care in Mayo Clinic's Thyroid Eye Disease Clinic, can participate in research in one way or another.
- Low CM, Morris JM, Matsumoto JS, Stokken JK, O'Brien EK, Choby G. Use of 3D-printed and 2D-illustrated international frontal sinus anatomy classification anatomic models for resident education. Otolaryngology — Head and Neck Surgery. 2019; doi:10.1177/0194599819860832.
- Low CM, Morris JM, Price DL, Matsumoto JS, Stokken JK, O'Brien EK, Choby G. Three-dimensional printing: Current use in rhinology and endoscopic skull base surgery. American Journal of Rhinology & Allergy. 2019; doi:10.1177/1945892419866319.
Researchers focused on chronic rhinosinusitis seek to understand why this disease develops and how to better treat it.
Through a partnership with the Mayo Clinic Division of Allergic Diseases, a comprehensive clinical and immunology program focused on chronic rhinosinusitis with nasal polyps (CRSwNP) and aspirin-exacerbated respiratory disease (AERD, formerly known as Samter's triad) is underway. Particular areas of interest include T cell subset differential expression in patients with nasal polyposis and immune profile markers in patients with CRSwNP and AERD.
Given the division's high level of experience treating patients with AERD, researchers have developed several studies specifically for these patients. Ongoing investigations include:
- Translational work to understand the specific immune dysregulation in the nasal polyps of patients with AERD
- Research to understand the potential for altered blood clotting in these patients
- Studies on how biomarkers may play a role in evaluating this disease process
Countless patients come to Mayo Clinic with challenging sinus diseases for which multiple previous surgeries or rounds of medical therapy have failed. As clinician-investigators, faculty members in the Division of Rhinology and Skull Base Surgery are deeply invested in helping these patients. They are also focused on improving outcomes and long-term quality of life in patients undergoing endoscopic sinus surgery, especially revision sinus surgery.
Along with other leading institutions, the rhinology division is involved in several multicenter prospective studies examining outcomes of endoscopic sinus surgery and optimizing patients' quality of life.
- Hagan JB, Laidlaw TM, Divekar R, O'Brien EK, Kita H, Volcheck GW, Hagan CR, Lal D, Teaford HG 3rd, Erwin PJ, Zhang N, Rank MA. Urinary leukotriene E4 to determine aspirin intolerance in asthma: A systematic review and meta-analysis. Journal of Allergy and Clinical Immunology: In Practice. 2017; doi:10.1016/j.jaip.2016.11.004.
- Hura N, Xie DX, Choby GW, Schlosser RJ, Orlov CP, Seal SM, Rowan NR. Treatment of post-viral olfactory dysfunction: An evidence-based review with recommendations. International Forum of Allergy & Rhinology. 2020; doi:10.1002/alr.22624.
- Onerci Altunay Z, Bly JA, Edwards PK, Holmes DR, Hamilton GS, O'Brien EK, Carr AB, Camp JJ, Stokken JK, Pallanch JF. Three-dimensional printing of large nasal septal perforations for optimal prosthetic closure. American Journal of Rhinology & Allergy. 2016; doi:10.2500/ajra.2016.30.4324.
- Oliver JD, Lim KG, O'Brien EK. Correlation of exhaled nasal nitric oxide with sinus computed tomography and sinonasal outcome test scores: A cross-sectional pilot study. American Journal of Rhinology & Allergy. 2018; doi:10.1177/1945892418801389.
- Yin LX, Spillinger A, Lees KA, Bailey KR, Choby G, O'Brien EK, Stokken JK. An internally validated diagnostic tool for acute invasive fungal sinusitis. International Forum of Allergy & Rhinology. 2021; doi:0.1002/alr.22635.
Sinonasal and skull base tumors
The division's clinicians treat a large number of patients with benign or malignant tumors located in the sinonasal cavity or anterior skull base. These tumors can be challenging to treat and significantly affect patients' quality of life, including vision, sense of smell, sensation and nasal function. In response, the Division of Rhinology and Skull Base Surgery has initiated a major research effort to better understand how these tumors develop and how to optimize treatment outcomes.
In collaboration with colleagues in the Department of Neurosurgery, researchers are prospectively evaluating tumor outcomes and quality of life after skull base surgery.
Investigations are focused on understanding factors that affect survival and outcomes in patients with sinonasal cancers, including the genomic and transcriptomic analysis of sinonasal mucosal melanoma and how this affects disease prognosis. In particular, researchers are focused on sinonasal cancers such as esthesioneuroblastoma, mucosal melanoma and adenocarcinoma.
Studies on olfaction after endoscopic skull base surgery, skull base reconstruction and quality of life are also underway. Several published and ongoing studies using large national databases have helped researchers better understand factors affecting survival in rare sinonasal malignancies.
In addition, investigators in the Division of Rhinology and Skull Base Surgery frequently collaborate with colleagues at other leading institutions to investigate novel surgical techniques and methods to improve sinonasal outcomes after endoscopic skull base surgery.
- Low CM, Price DL, Moore EJ, Stokken JK, Van Abel KM, Janus JR, Choby G. Nodal and distant metastases in sinonasal mucosal melanoma: A population-based analysis. Laryngoscope. 2020; doi:10.1002/lary.28065.
- Marcellino CR, Peris-Celda M, Link MJ, Stokken JK. Endoscopic endonasal resection of orbital apex cavernous hemangioma: 2-dimensional operative video. Operative Neurosurgery. 2019; doi:10.1093/ons/opy192.
- Puccinelli CL, Yin LX, O'Brien EK, Van Gompel JJ, Choby GW, Van Abel KM, Janus JR, Stokken JK. Long-term olfaction outcomes in transnasal endoscopic skull-base surgery: a prospective cohort study comparing electrocautery and cold knife upper septal limb incision techniques. International Forum of Allergy & Rhinology. 2019; doi:10.1002/alr.22291.
- Yin LX, Low CM, Puccinelli CL, O'Brien EK, Stokken JK, Van Abel KM, Janus JR, Link MJ, Van Gompel JJ, Choby G. Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis. The Laryngoscope. 2019; doi:10.1002/lary.28003.