Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

Rhinology, Sinus Surgery and Allergy Research

Mount Sinai's Division of Rhinology, Sinus Surgery, and Allergy has long been recognized throughout the field as an international leader in research and innovation. Driven to discover, our team works collaboratively across disciplines in neurosurgery, radiology, and psychology to innovate and elevate the standard of care for individuals living with nasal and sinus disease, as well as allergies. In addition, our Division has collaborated with healthcare startups to leverage technology to provide our patients with superior access to care, offer safer and more accurate surgery and help alleviate pain.  With physicians and scientists working alongside one another, we rapidly translate new findings into clinical care allowing patients to benefit from the discoveries of modern medicine in real time. 

Now, more than ever, our researchers are forging ahead to tackle unprecedented challenges. The extensive list of research studies currently underway in our Division include exploring the effects of COVID-19 infection on the head and neck, evaluating remote technology platforms, investigating novel endoscopic sinus surgery techniques, and assessing medical management options for acute and chronic sinus conditions. We strive to accelerate efficiencies in this unique and rapidly changing environment, working extensively with health care technology including telehealth services and virtual reality applications. 

COVID-19 

Fish Oil Supplementation Study for Patients with Anosmia Post-COVID Infection
Nearly one-third of patients who recover from the COVID-19 virus continue to experience anosmia, a loss of smell, months later. Previous studies have found that omega-3 fatty acids help patients who developed anosmia after skull base surgery recover their sense of smell faster. This therapeutic study will assess the impact of a six-week daily regimen of 2,000 milligrams of omega-3 fatty acids in patients who experienced COVID-19-associated anosmia. If the study produces positive outcomes, Mount Sinai researchers plan to explore additional modalities, such as pharmaceutical-grade omega-3 fatty acids.
Contact: Alfred-Marc Iloreta, MD

Patient Satisfaction with Telehealth During COVID-19             
During the COVID-19 pandemic, many patients relied on telehealth services for their care. Patient surveys were sent to individuals who had virtual and in-patient visits. Researchers are evaluating patient satisfaction throughout various areas of rhinology as well as surgical cancellation rates in patients who booked procedures using telehealth. 
Contact: Alfred-Marc Iloreta, MD

Sinus Surgery 

7-Tesla for Sinonasal Malignancies 
7-Tesla or 7-T is one of the industry’s strongest MRI machines. Traditionally, most sinus surgery candidates receive MRI scans with a magnetic field strength of 1.5 T or 3 T. This prospective study assesses the benefit of using a higher field strength in patients with sinonasal malignancies. Previous studies have shown that 7-T scans are able to detect the borders of tumors with greater precision and capture difficult to visualize areas of the head and neck. Investigators will determine if 7-T scans are beneficial to surgeons in planning for procedures.
Contact: Priti Balchandani, PhD  

Gabapentin and Postoperative Opioid Consumption: A Double-Blind Randomized Controlled Trial of Pain Management after Sinus Surgery
National levels of opioid addiction and overdose remain at crisis levels. Gabapentin is an oral medication that has been found to relieve nerve pain associated with shingles and neuropathy. This randomized control trial compares patients with chronic rhinosinusitis who use gabapentin before functional endoscopic sinus surgery and those who are given a placebo. The goal is to evaluate if gabapentin reduces pain levels postoperatively, with a reduction of opioid consumption. 
Contact: Alfred-Marc Iloreta, MD

Effect of Preoperative Steroids on Surgical Field Visibility During Sinus Surgery
Oral steroids have long been used to manage nasal polyps, but they can also have unwarranted side effects. Traditionally, patients who are about to undergo surgery are prescribed a course of steroids to reduce the size of the nasal polyps. When nasal polyps are smaller, the surgeon has better visualization because there is less blood loss. Patients also experience fewer side effects after surgery. Participants in the study will randomly be prescribed a low, medium, or high dose of oral steroids. Researchers are seeking the lowest possible dosage that can achieve optimal outcomes.     
Contact: Alfred-Marc Iloreta, MD

The Role of 5-Aminolevulinic Acid Fluorescence-Guided Surgery in Head and Neck Cancers: A Pilot Trial
5-Aminolevulinic acid (5-ALA) is a substance that can be injected into the skull base during a fluorescence-guided surgical procedure to make cancerous cells more identifiable. Researchers are investigating the use of 5-ALA on squamous cell carcinoma tumors in sinonasal and skull-based head and neck cancers. The goal of the study is to determine if injecting 5-ALA improves the overall percentage of malignant cells that can be removed. 
Contact: Alfred-Marc Iloreta, MD

Ergonomics in Endoscopic Sinus and Skull Base Surgery         
Proper posture and positioning are essential for surgeons to achieve optimal outcomes. In this study, 11 body sensors—each about the size of an Apple watch —are placed on the surgeon’s body and used to track posture by measuring the angle of the joints. Investigators plan to objectively compare the ergonomics of trainees, residents, fellows, and attending surgeons performing high volumes of sinus surgery.
Contact: Alfred-Marc Iloreta, MD

Medical Management

Budesonide Nasal Irrigations in Non-Surgical Patients with Chronic Rhinosinusitis: A Double-Blinded, Placebo-Control RCT                
Nasal saline rinses are a mainstay of treatment for any individual with chronic rhinosinusitis. However, some patients do not respond to this type of rinse. Budesonide is a steroid that can be added to the rinses to help reduce swelling and allow the nasal passageways to drain. Researchers are trying to determine if budesonide steroid rinses are more effective at improving symptoms and increasing quality of life than saline rinses alone.
Contact: Satish Govindaraj, MD

Use of Post-Operative Antibiotics in Endoscopic Sinus Surgery: A Multi-Institutional Prospective Randomized Controlled Trial
Antibiotics are administered proactively after sinus surgery to reduce the possibility of infection. However, literature shows that antibiotics are often overused and can lead to antibiotic resistance. As part of a randomized control study, investigators are comparing the rate of infection in patients who received antibiotics after endoscopic sinus surgery with those who did not take medication.
Contact: Satish Govindaraj, MD

Efficacy and Safety of Rezepelumab in Participants with Severe Chronic Rhinosinusitis with Nasal Polyposis – Industry-Funded Trial (WAYPOINT)
Steroids are typically administered to patients who have severe chronic rhinosinusitis with nasal polyps before surgery. However, some patients do not respond well to systemic steroids. This study is investigating the efficacy and safety of using the medication rezepelumab as an alternative.
Contact: Satish Govindaraj, MD

Recurrence of Nasal Polyps Following Surgical Removal in Patients with Chronic Rhinosinusitis with Nasal Polyps – Industry-Funded Trial (OXALIS)           
Nasal polyps have a high rate of recurrence. Researchers are evaluating the use of the medication benralizumab in preventing the reappearance of nasal polyps following endoscopic sinonasal surgery.
Contact: Satish Govindaraj, MD

Technology Platforms                                 

A Prospective, Randomized, Controlled, Double-Blinded, Single-Center Study Investigating the Use of a Web-Based Interactive Patient Education System to Enhance Patient Compliance and Satisfaction with the Current Chronic Rhinosinusitis Management
Web-based computer programs are used in health care to increase compliance, improve patient satisfaction, and educate the public. In collaboration with Neuma LLC, Mount Sinai researchers have developed a patient education platform to evaluate chronic rhinosinusitis management. The program alerts patients about appointments and reminds them about pre-and post-operative care. Investigators are comparing patient compliance and satisfaction in individuals who use the platform with those who rely on traditional methods. Building upon promising initial results, researchers are also beginning to explore the use of a web-based patient education system in skull base surgeries.      
Contact: Alfred-Marc Iloreta, MD

Pituitary Database                     
Designed at Mount Sinai, this database tracks patients who have undergone pituitary surgery. The goal is to track both demographics and patient outcomes.
Contact: Alfred-Marc Iloreta, MD