Defining optimal strategies for skull base reconstruction

UCI Health rhinologist leads global team of experts to elevate care

Orange, Calif. — Ask 10 endoscopic skull base surgeons how they would reconstruct defects, you may well get 20 different answers, along with discussions about nuances and exceptions, says UCI Health rhinologist and skull base surgeon Dr. Edward C. Kuan.

"We know what we know," notes Kuan, co-director of the UCI Health Comprehensive Skull Base Program. "We also know what we need to know, but it may be hard to study. Thus, valuable knowledge can be learned from those with expertise and experience."

To refine/elevate the knowledge base for skull base reconstruction principles, Kuan collaborated with leading skull base surgeons — rhinologists, head and neck surgeons, and neurosurgeons — to compile Expert Strategies: Skull Base Reconstruction­ Global Perspectives, Insights, and Algorithms through a Mixed Methods Approach.

Published May 15 in the International Forum of Allergy and Rhinology, the highest impact journal in otolaryngology, the 38-page compendium features insights on handling both common and uncommon scenarios from 68 international and multidisciplinary experts.

"In addition to reporting algorithms for managing specific defects, we identified key commonalities to guide practice and highlight discrepancies that should inspire further research," says Kuan, professor and chief of the Division or Rhinology and Skull Base Surgery at the UC Irvine School of Medicine's Department of Otolaryngology-Head and Neck Surgery.

"We hope this work will be valuable for both early-career and seasoned surgeons alike and motivate innovation in research and protocol development."

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Kuan is a board-certified, fellowship-trained UCI Health otolaryngologist who specializes in medical and surgical treatment for disorders of the nose, paranasal sinuses and skull base. As a rhinologist and skull base surgeon, his clinical practice focuses on complex and revision endoscopic sinus surgery for challenging sinusitis and nasal polyps, especially cases that have failed prior medical and/or surgical therapy. He often partners with the UCI Head and Neck Cancer team to provide comprehensive treatment for both benign and malignant tumors of the nose and sinuses, often achievable via a minimally invasive approach. In addition, he performs endoscopic skull base surgery in close collaboration with UCI Health neurosurgeons as part of the UCI Health Comprehensive Skull Base Surgery Program, including removal of brain tumors through the nose and reconstructing defects between the brain and the nose (cerebrospinal fluid leaks and encephaloceles), and frequently collaborates with the UCI Health Facial Plastic Surgery team for the comprehensive surgical treatment of the functional nasal airway. Kuan also has published more than 260 peer-reviewed original articles, reviews and book chapters in the highest-impact otolaryngology and neurosurgery journals and is a regular invited speaker for both clinical topics and his research nationally and internationally.

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