The research of Carlos D. Pinheiro Neto, M.D., Ph.D., is based on the development of innovative surgical techniques to improve outcomes of patients who undergo endoscopic nasal, sinus or skull base surgery. His work in the anatomy laboratory aims to enhance the description of key anatomical landmarks to make surgeries safer. In the laboratory, he also develops new surgical approaches to minimize surgical nasal trauma, particularly during endoscopic resection of intracranial tumors through the nose. Dr. Pinheiro Neto also works extensively on the optimization of skull base reconstruction to minimize the risk of cerebrospinal fluid leaks after endonasal cranial base surgery.
- Identification of key anatomical landmarks in endoscopic endonasal cranial base surgery. The cranial base is surrounded by crucial neurovascular structures. Dr. Pinheiro Neto works extensively to identify new landmarks and establish important measurements to facilitate surgical procedures in this area, and potentially decrease the risk of neurovascular injuries.
- Minimizing surgical nasal trauma. The surgical techniques originally described in endoscopic endonasal cranial base surgery entail substantial resection of sinonasal structures with great impact on nasal physiology and potential damage to the sense of smell. Dr. Pinheiro Neto's innovative research focuses on decreasing the resection of intranasal structures during those approaches to maintain nasal physiology and attempt to preserve the sense of smell.
- Improving reconstruction of the cranial base. Cerebrospinal fluid (CSF) leak is one of the main complications associated with endoscopic endonasal cranial base surgery. Dr. Pinheiro Neto researches new reconstructive options and surgical techniques to reinforce the skull base and decrease the CSF leak rate.
- Prospective multicentric study on sellar reconstruction after resection of pituitary tumors. Dr. Pinheiro Neto is the lead in this study that involves 12 institutions and aims to establish the best reconstructive surgical technique for sellar defects.
- Extended dissection of the nasoseptal flap pedicle to the internal maxillary artery. Dr. Pinheiro Neto pioneered this technique to completely release the nasoseptal flap with dissection of the internal maxillary artery. This technique allowed for the improvement of the flap reach and consequent expansion of its indications. Currently he researches further applications of this surgical technique.
Significance to patient care
The ultimate goal of Dr. Pinheiro Neto's research is to improve the patient's quality of life after endoscopic nasal, sinus or skull base surgery. Understanding better the anatomy of this complex region allows safer procedures with less risk of debilitating or life-threatening surgical injuries. Minimizing surgical nasal trauma helps with less nasal crusting formation postoperatively, provides less risk of damage to the sense of smell, and maintains a more physiologic airflow through the nose. Improving the reconstructive techniques decreases the risk of CSF leaks and serious infections, such as meningitis, after the surgery.