Clinical/Translational Research

We are committed to increasing our pre-surgical armamentarium to combat the pervasive problems with inflammatory sinus disease, to make sinus surgery both less common overall, but also safer when performed. Rhinology is still in an emerging specialty when compared to other disciplines like cardiac and ophthalmologic surgery, which have a smorgasbord of medical and minimally-invasive procedural options available prior to surgery. In our practice, we routinely evaluate patients who have experienced a variety of avoidable and unavoidable complications from sinus surgery, which speaks to the need for improved medical options for sinus and allergy treatment, novel tools for minimally invasive sinus approaches (one of which we have designed and patented), improved surgical education, and realistic access to surgical simulation training.

Publications

Patel, Zara M, Juan Fernandez-Miranda, Peter H Hwang, Jayakar V Nayak, Robert Dodd, Hamed Sajjadi, and Robert K Jackler. “Letter: Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic.” Neurosurgery 87, no. 1 (July 1, 2020): E66–67. https://doi.org/10.1093/neuros/nyaa125.
Chang, Michael T., Davood K. Hosseini, Sun Hee Song, Jayakar V. Nayak, Zara M. Patel, Jennifer Y. Lee, and Peter H. Hwang. “The Effect of Endoscopic Sinus Surgery on Eustachian Tube Dysfunction Symptoms.” Otolaryngology–Head and Neck Surgery, April 28, 2020, 019459982091739. https://doi.org/10.1177/0194599820917396.
Yan, Carol H, Aakanksha Rathor, Kaelyn Krook, Yifei Ma, Melissa R Rotella, Robert L Dodd, Peter H Hwang, et al. “Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial.” Neurosurgery, January 17, 2020, nyz559. https://doi.org/10.1093/neuros/nyz559.
Rahman, Arifeen S., Peter H. Hwang, Rahul Alapati, Yan Lin, Jayakar V. Nayak, Zara M. Patel, and Carol H. Yan. “Indications and Outcomes for Patients With Limited Symptoms Undergoing Endoscopic Sinus Surgery.” American Journal of Rhinology & Allergy 34, no. 4 (2020): 502–7. https://doi.org/10.1177/1945892420912159.
Tangbumrungtham, Navarat, Peter H. Hwang, Ximena Maul, Nicole A. Borchard, Sachi S. Dholakia, Zara M. Patel, Jayakar V. Nayak, and Garret Choby. “The Effect of Topical Epinephrine 1:1000 with and without Infiltration of 1% Lidocaine with Epinephrine 1:100,000 on Endoscopic Surgical Field Visualization: A Double‐blind Randomized Controlled Study.” International Forum of Allergy & Rhinology 10, no. 2 (2020): 147–52. https://doi.org/10.1002/alr.22468.
Chang, Michael T., Kawinyarat Jitaroon, Teresa Nguyen, Carol H. Yan, Jonathan B. Overdevest, Jayakar V. Nayak, Peter H. Hwang, and Zara M. Patel. “Hemodynamic Changes in Patients Undergoing Office‐based Sinus Procedures under Local Anesthesia.” International Forum of Allergy & Rhinology 10, no. 1 (2020): 114–20. https://doi.org/10.1002/alr.22460.
Walgama, Evan S., Andrew Thamboo, Navarat Tangbumrungtham, Noel Ayoub, Zara M. Patel, and Jayakar V. Nayak. “The Horizon Sign and Frontal Bar: Two Topographic Landmarks to Confirm Endoscopic Frontal Sinusotomy:” Otolaryngology–Head and Neck Surgery, January 29, 2019. https://doi.org/10.1177/0194599818825472.
Yan, Carol H., Charles C. L. Tong, Mrudula Penta, Vishal S. Patel, James N. Palmer, Nithin D. Adappa, Jayakar V. Nayak, Peter H. Hwang, and Zara M. Patel. “Imaging Predictors for Malignant Transformation of Inverted Papilloma.” The Laryngoscope 129, no. 4 (2019): 777–82. https://doi.org/10.1002/lary.27582.
Maul, Ximena A., Nicole A. Borchard, Peter H. Hwang, and Jayakar V. Nayak. “Microcurrent Technology for Rapid Relief of Sinus Pain: A Randomized, Placebo‐controlled, Double‐blinded Clinical Trial.” International Forum of Allergy & Rhinology 9, no. 4 (2019): 352–56. https://doi.org/10.1002/alr.22280.
Borchard, Nicole A., and Jayakar V. Nayak. “Orbital Apex Syndrome.” New England Journal of Medicine 378, no. 17 (April 26, 2018): e23. https://doi.org/10.1056/NEJMicm1703770.
Thamboo, Andrew, Aakanksha Rathor, Nicole A. Borchard, Jayakar V. Nayak, Peter H. Hwang, and Zara M. Patel. “Precision Medicine: Why Surgeons Deviate from ‘Appropriateness Criteria’ in the Management of Chronic Rhinosinusitis and Effects on Outcomes: Surgical Decision Making for CRS.” International Forum of Allergy & Rhinology 8, no. 12 (2018): 1389–94. https://doi.org/10.1002/alr.22184.
Nayak, Jayakar V., Aakanksha Rathor, Jessica W. Grayson, Dawn T. Bravo, Nathalia Velasquez, Julia Noel, Daniel M. Beswick, et al. “Porcine Small Intestine Submucosal Grafts Improve Remucosalization and Progenitor Cell Recruitment to Sites of Upper Airway Tissue Remodeling: Upper Airway Wound Healing through Donor Site Grafting.” International Forum of Allergy & Rhinology 8, no. 10 (2018): 1162–68. https://doi.org/10.1002/alr.22156.
Yan, Carol H., Navarat Tangbumrungtham, Ximena A. Maul, Yifei Ma, Jayakar V. Nayak, Peter H. Hwang, and Zara M. Patel. “Comparison of Outcomes Following Culture-Directed vs Non-Culture-Directed Antibiotics in Treatment of Acute Exacerbations of Chronic Rhinosinusitis: Utility of Routine Culture in Sinusitis Treatment.” International Forum of Allergy & Rhinology 8, no. 9 (2018): 1028–33. https://doi.org/10.1002/alr.22147.
Choby, Garret, and Jayakar V. Nayak. “The ‘Cross-Court Draf IIb’ Procedure for Advanced Nasal Septum or Frontal Sinus Pathology and Nasal Septum Pathology: Crosscourt Draf IIb.” The Laryngoscope 128, no. 7 (2018): 1527–30. https://doi.org/10.1002/lary.27016.
Ayoub, Noel, Wirach Chitsuthipakorn, Jayakar V. Nayak, Zara M. Patel, and Peter H. Hwang. “Nose Blowing after Endoscopic Sinus Surgery Does Not Adversely Affect Outcomes.” The Laryngoscope 128, no. 6 (2018): 1268–73. https://doi.org/10.1002/lary.26907.
Tangbumrungtham, Navarat, Vishal S. Patel, Andrew Thamboo, Zara M. Patel, Jayakar V. Nayak, Yifei Ma, Garret Choby, and Peter H. Hwang. “The Prevalence of Eustachian Tube Dysfunction Symptoms in Patients with Chronic Rhinosinusitis: Eustachian Tube Dysfunction in CRS.” International Forum of Allergy & Rhinology 8, no. 5 (2018): 620–23. https://doi.org/10.1002/alr.22056.
Beswick, Daniel M., Reza Vaezeafshar, Yifei Ma, Peter H. Hwang, Jayakar V. Nayak, and Zara M. Patel. “Risk Stratification for Postoperative Venous Thromboembolism after Endoscopic Sinus Surgery.” Otolaryngology–Head and Neck Surgery 158, no. 4 (2018): 767–73. https://doi.org/10.1177/0194599818755340.
Patel, Vishal S., Garret Choby, Liang-Chun Shih, Zara M. Patel, Jayakar V. Nayak, and Peter H. Hwang. “Equivalence in Outcomes between Draf 2B vs Draf 3 Frontal Sinusotomy for Refractory Chronic Frontal Rhinosinusitis: Draf 2B vs Draf 3 Outcomes.” International Forum of Allergy & Rhinology 8, no. 1 (2018): 25–31. https://doi.org/10.1002/alr.22032.
Omura, Kazuhiro, Daiya Asaka, Jayakar V. Nayak, and Yasuhiro Tanaka. “Transseptal Access with Crossing Multiple Incisions for Improved Pedicle Control and Septum Preservation: ‘How I Do It’:” American Journal of Rhinology & Allergy, March 1, 2017. https://doi.org/10.2500/ajra.2017.31.4416.
Abuzeid, Waleed M., Asa Z. Peterson, Aakanksha Rathor, Jordan C. Xu, Nathalia Velasquez, Ali R. Rashan, Andrew Thamboo, and Jayakar V. Nayak. “Enhanced Irrigant Delivery to the Ethmoid Sinuses Directly Following Ethmoid Punch Sinusotomy.” Annals of Otology, Rhinology & Laryngology 126, no. 12 (2017): 804–12. https://doi.org/10.1177/0003489417737323.
Patel, Vishal S., Andrew Thamboo, Jennifer Quon, Jayakar V. Nayak, Peter H. Hwang, Michael Edwards, and Zara M. Patel. “Outcomes After Endoscopic Endonasal Resection of Craniopharyngiomas in the Pediatric Population.” World Neurosurgery 108 (2017): 6–14. https://doi.org/10.1016/j.wneu.2017.08.058.
Ayoub, Noel, Evan Walgama, Andrew Thamboo, Jayakar V. Nayak, and Peter H. Hwang. “Efficacy of Endoscopic Sinus Surgery for Chronic Rhinosinusitis Following Primary Radiotherapy and Concurrent Chemotherapy for Nasopharyngeal Carcinoma: CRS Following Radiation Therapy for NPC.” International Forum of Allergy & Rhinology 7, no. 11 (2017): 1045–51. https://doi.org/10.1002/alr.22002.
Velasquez, Nathalia, Andrew Thamboo, Waleed M. Abuzeid, and Jayakar V. Nayak. “Safe Treatment of Ethmoid Sinusitis Utilizing Minimally Invasive Ethmoid Punch Sinusotomy in Chronic Rhinosinusitis without Polyposis Patients: Minimally Invasive Ethmoid Punch Sinusotomy.” The Laryngoscope 127, no. 6 (2017): 1268–75. https://doi.org/10.1002/lary.26493.
Ayoub, Noel, Andrew Thamboo, Al-Rahim Habib, Jayakar V. Nayak, and Peter H. Hwang. “Determinants and Outcomes of Upfront Surgery versus Medical Therapy for Chronic Rhinosinusitis in Cystic Fibrosis: Chronic Rhinosinusitis in Cystic Fibrosis.” International Forum of Allergy & Rhinology 7, no. 5 (2017): 450–58. https://doi.org/10.1002/alr.21912.
Paknezhad, Hassan, Nicole A. Borchard, Greg W. Charville, Noel F. Ayoub, Garret W. Choby, Andrew Thamboo, and Jayakar V. Nayak. “Evidence for a ‘Preinvasive’ Variant of Fungal Sinusitis: Tissue Invasion without Angioinvasion.” World Journal of Otorhinolaryngology - Head and Neck Surgery 3, no. 1 (2017): 37–43. https://doi.org/10.1016/j.wjorl.2017.01.003.
Patel, Zara M., Andrew Thamboo, Luke Rudmik, Jayakar V. Nayak, Timothy L. Smith, and Peter H. Hwang. “Surgical Therapy vs Continued Medical Therapy for Medically Refractory Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis: Surgery vs Medical Therapy for Refractory CRS.” International Forum of Allergy & Rhinology 7, no. 2 (2017): 119–27. https://doi.org/10.1002/alr.21872.
Vaezeafshar, Reza, Alkis J. Psaltis, Vidya K. Rao, David Zarabanda, Zara M. Patel, and Jayakar V. Nayak. “Barosinusitis: Comprehensive Review and Proposed New Classification System.” Allergy & Rhinology 8, no. 3 (2017): ar.2017.8.0221. https://doi.org/10.2500/ar.2017.8.0221.
Edward, Justin A., Alkis J. Psaltis, Ryan A. Williams, Gregory W. Charville, Robert L. Dodd, and Jayakar V. Nayak. “Endoscopic Resection of Skull Base Teratoma in Klippel-Feil Syndrome through Use of Combined Ultrasonic and Bipolar Diathermy Platforms.” Case Reports in Otolaryngology 2017 (2017): 1–7. https://doi.org/10.1155/2017/6384586.
Noel, Julia E., Neville W. Teo, Vasu Divi, and Jayakar V. Nayak. “Use of Pedicled Nasoseptal Flap for Pathologic Oroantral Fistula Closure.” Journal of Oral and Maxillofacial Surgery 74, no. 4 (2016): 704.e1-704.e6. https://doi.org/10.1016/j.joms.2015.11.010.
Orlandi, Richard R., Todd T. Kingdom, Peter H. Hwang, Timothy L. Smith, Jeremiah A. Alt, Fuad M. Baroody, Pete S. Batra, et al. “International Consensus Statement on Allergy and Rhinology: Rhinosinusitis: International Consensus on Rhinosinusitis.” International Forum of Allergy & Rhinology 6, no. S1 (2016): S22–209. https://doi.org/10.1002/alr.21695.
Mohammadi, Fatemeh, Ali Rashan, Alkis Psaltis, Agnieszka Janisewicz, Peter Li, Tarek El-Sawy, and Jayakar V. Nayak. “Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome.” JAMA Otolaryngology–Head & Neck Surgery 141, no. 6 (June 1, 2015): 562. https://doi.org/10.1001/jamaoto.2015.0524.
Costa, Milena L., Alkis J. Psaltis, Jayakar V. Nayak, and Peter H. Hwang. “Medical Therapy vs Surgery for Recurrent Acute Rhinosinusitis: Recurrent Acute Rhinosinusitis.” International Forum of Allergy & Rhinology 5, no. 8 (2015): 667–73. https://doi.org/10.1002/alr.21533.
Huang, Zhenxiao, Amal Hajjij, Gang Li, Jayakar V. Nayak, Bing Zhou, and Peter H. Hwang. “Clinical Predictors of Neo-Osteogenesis in Patients with Chronic Rhinosinusitis: Clinical Predictors of Neo-Osteogenesis in CRS.” International Forum of Allergy & Rhinology 5, no. 4 (2015): 303–9. https://doi.org/10.1002/alr.21485.
Saedi, Babak, Ali R. Rashan, Michael Lipan, Jayakar V. Nayak, and Sam P. Most. “Consistent Ipsilateral Development of the Posterior Extension of the Quadrangular Cartilage and Bony Spur Formation in Nasal Septal Deviation.” Otolaryngology–Head and Neck Surgery 152, no. 3 (2015): 444–48. https://doi.org/10.1177/0194599814564549.
Suh, Jeffrey D., Vijay R. Ramakrishnan, Christopher F. Thompson, Bradford A. Woodworth, Nithin D. Adappa, Jayakar Nayak, John M. Lee, Jivianne T. Lee, Alexander G. Chiu, and James N. Palmer. “Inverted Papilloma of the Sphenoid Sinus: Risk Factors for Disease Recurrence: Inverted Papilloma of the Sphenoid Sinus.” The Laryngoscope 125, no. 3 (2015): 544–48. https://doi.org/10.1002/lary.24929.
Soudry, Ethan, Alkis J. Psaltis, Kun H. Lee, Reza Vaezafshar, Jayakar V. Nayak, and Peter H. Hwang. “Complications Associated with the Pedicled Nasoseptal Flap for Skull Base Reconstruction: Nasoseptal Flap Complications.” The Laryngoscope 125, no. 1 (2015): 80–85. https://doi.org/10.1002/lary.24863.
Costa, Milena L., Alkis J. Psaltis, Jayakar V. Nayak, and Peter H. Hwang. “Long-Term Outcomes of Endoscopic Maxillary Mega-Antrostomy for Refractory Chronic Maxillary Sinusitis: Outcomes of Maxillary Mega-Antrostomy.” International Forum of Allergy & Rhinology 5, no. 1 (2015): 60–65. https://doi.org/10.1002/alr.21407.
Santa Maria, Peter, Waleed Abuzeid, Jayakar Nayak, Steven Chang, and Nikolas Blevins. “A Case of Stereotactic Radiation in Skull Base Solitary Fibrous Tumor: More Harm Than Good?” Journal of Neurological Surgery Reports 75, no. 02 (August 11, 2014): e214–16. https://doi.org/10.1055/s-0034-1387196.
Cho, Kyu-Sup, Ethan Soudry, Alkis J. Psaltis, Kari C. Nadeau, Sean A. McGhee, Jayakar V. Nayak, and Peter H. Hwang. “Long-Term Sinonasal Outcomes of Aspirin Desensitization in Aspirin Exacerbated Respiratory Disease.” Otolaryngology–Head and Neck Surgery 151, no. 4 (2014): 575–81. https://doi.org/10.1177/0194599814545750.
Ali, Mohammad Javed, Jayakar V. Nayak, Reza Vaezeafshar, Gang Li, and Alkis James Psaltis. “Anatomic Relationship of Nasolacrimal Duct and Major Lateral Wall Landmarks: Cadaveric Study with Surgical Implications: Endoscopic Landmarks of the Nasolacrimal Duct.” International Forum of Allergy & Rhinology 4, no. 8 (2014): 684–88. https://doi.org/10.1002/alr.21345.
Kumar, Anisha R., Jayakar V. Nayak, Agnieszka M. Janisiewicz, Gordon Li, and John S. Oghalai. “The Combined Subtemporal-Transfacial Approach for the Resection of Juvenile Nasopharyngeal Angiofibromas with Intracranial Extension:” Otology & Neurotology, 2014, 1. https://doi.org/10.1097/MAO.0000000000000498.
Soudry, Ethan, Justin H. Turner, Jayakar V. Nayak, and Peter H. Hwang. “Endoscopic Reconstruction of Surgically Created Skull Base Defects: A Systematic Review.” Otolaryngology–Head and Neck Surgery 150, no. 5 (2014): 730–38. https://doi.org/10.1177/0194599814520685.
Soudry, Ethan, Paul K. Mohabir, Amar Miglani, Justin Chen, Jayakar V. Nayak, and Peter H. Hwang. “Outpatient Endoscopic Sinus Surgery in Cystic Fibrosis Patients: Predictive Factors for Admission: Outpatient Sinus Surgery and Cystic Fibrosis.” International Forum of Allergy & Rhinology 4, no. 5 (2014): 416–21. https://doi.org/10.1002/alr.21285.
Choudhri, Omar, Stefan A. Mindea, Abdullah Feroze, Ethan Soudry, Steven D. Chang, and Jayakar V. Nayak. “Experience with Intraoperative Navigation and Imaging during Endoscopic Transnasal Spinal Approaches to the Foramen Magnum and Odontoid.” Neurosurgical Focus 36, no. 3 (2014): E4. https://doi.org/10.3171/2014.1.FOCUS13533.
Turner, Justin H., Ethan Soudry, Jayakar V. Nayak, and Peter H. Hwang. “Survival Outcomes in Acute Invasive Fungal Sinusitis: A Systematic Review and Quantitative Synthesis of Published Evidence: Survival Outcomes in Invasive Fungal Sinusitis.” The Laryngoscope 123, no. 5 (2013): 1112–18. https://doi.org/10.1002/lary.23912.
Patel, Zara M., Peter H. Hwang, Ary Chernomorsky, Dawn T. Bravo, Bryan L. Nguyen, Klementina Nesterova, and Jayakar V. Nayak. “Low-Frequency Pulsed Ultrasound in the Nasal Cavity and Paranasal Sinuses: A Feasibility and Distribution Study.” International Forum of Allergy & Rhinology 2, no. 4 (2012): 303–8. https://doi.org/10.1002/alr.21039.
Ramakrishnan, Vijay R., Todd T. Kingdom, Jayakar V. Nayak, Peter H. Hwang, and Richard R. Orlandi. “Nationwide Incidence of Major Complications in Endoscopic Sinus Surgery.” International Forum of Allergy & Rhinology 2, no. 1 (2012): 34–39. https://doi.org/10.1002/alr.20101.
Lee, John M., Jayakar V. Nayak, Laurie L. Doghramji, Kevin C. Welch, and Alexander G. Chiu. “Assessing the Risk of Irrigation Bottle and Fluid Contamination after Endoscopic Sinus Surgery.” American Journal of Rhinology & Allergy 24, no. 3 (2010): 197–99. https://doi.org/10.2500/ajra.2010.24.3481.
Nayak, Jayakar V., Lisa A. Teot, Yatin Vyas, Carl H. Snyderman, Elizabeth H. Toh, and Frederic W.-B. Deleyiannis. “Head and Neck Epithelioid Sarcoma in a Child: Diagnostic Dilemma and Anterolateral Thigh Free Flap Reconstruction.” International Journal of Pediatric Otorhinolaryngology 72, no. 5 (2008): 719–24. https://doi.org/10.1016/j.ijporl.2008.01.032.
Leibowitz, Michael S., Jayakar V. Nayak, and Robert L. Ferris. “Head and Neck Cancer Immunotherapy: Clinical Evaluation.” Current Oncology Reports 10, no. 2 (2008): 162–69. https://doi.org/10.1007/s11912-008-0025-8.