I have spent my career in Boston, MA practicing Heotology/neurotology and skull base surgery. I’ve worked to develop minimally invasive endoscopic surgical techniques in this field and developed new procedures for Eustachian tube disorders. My research activities focus on otitis media and disorders of the Eustachian tube, specifically investigating the inflammatory basis of Eustachian tube dysfunction and conducting research on novel medical and surgical treatments. I came to Boston Children’s hospital in 2003 after spending nine years in private practice and I previously worked at Tufts Medical Center and Lahey Clinic. In 2011, I completed a PhD at the University of Tampere, Finland in Pathophysiology and Surgical Treatment of the Eustachian tube and did postdoctoral work with the NanoEar European Union consortium on nanotechnology for targeted delivery of inner ear and middle ear therapy. I now work to develop new methods to understand and treat Eustachian tube disorders, offering these techniques to my patients and teaching others internationally in these methods. I run the International Eustachian Tube Study Group and I serve as the principle investigator for two multicenter clinical trials of Balloon Eustachian Tuboplasty.
Approach to Care
It has been a rewarding privilege to be able to serve my patients over the many years of my career to date. Although I initially trained in Bio-Medical Engineering, I knew that my calling would be in caring for patients. I have devoted my efforts to taking the best possible care of my patients, who are like my family when they are under my responsibility. Additionally, I have always pursued research into finding better ways to improve upon that care. Equally important has been my goal of training other doctors and surgeons to share in my values and to benefit from my experience. Ear and communication disorders are among the most common and disabling problems worldwide and it became my mission to work on the means to try to prevent these problems from occurring or worsening. We have been fortunate enough to make significant advances in these goals, creating new understanding of some of the diseases, developing diagnostic methods and surgical therapy that is making a difference in the outcomes in our patients. Joining Boston Children’s Hospital brought to me the opportunity to increasingly focus my efforts for treating these diseases in the most vulnerable times of our patients’ lives.
Publications
Bayesian nested frailty model for evaluating surgical management of patulous Eustachian tube dysfunction. View Abstract
The case for balloon eustachian tuboplasty in children. View Abstract
High prevalence of syndromic hearing loss in Mexican children undergoing cochlear implantation. View Abstract
Pediatric cerebrospinal fluid rhinorrhea caused by low flow vascular anomaly of the temporal bone: A case series. View Abstract
3D printed temporal bones for preoperative simulation and planning. View Abstract
Long-term efficacy of balloon dilation of the pediatric Eustachian tube: A six-year matched cohort study. View Abstract
Balloon dilation improves both the hearing level and the quality of life in patients suffering from obstructive Eustachian tube dysfunction. View Abstract
Vestibular Preservation in Pediatric Cochlear Implantation. View Abstract
Patulous Eustachian Tube Dysfunction Symptoms Following Balloon Dilation. View Abstract
Reconstruction of the Obliterated Eustachian Tube: A Pilot Case Series. View Abstract
Surfactant proteins and innate immunity of otitis media. View Abstract
Efficacy of Balloon Tuboplasty for Baro-Challenge-Induced Eustachian Tube Dysfunction: A Systematic Review and a Retrospective Cohort Study of 39 Patients. View Abstract
Comparison of outcomes for balloon dilation of the Eustachian tube under local vs general anesthesia. View Abstract
Measurements of The Pediatric Cartilaginous Eustachian Tube: Implications for Balloon Dilation. View Abstract
Pain at the Cochlear Implant Site Requiring Device Removal in Pediatric Patients. View Abstract
Peripheral Vestibular Dysfunction Is a Common Occurrence in Children With Non-syndromic and Syndromic Genetic Hearing Loss. View Abstract
Facial Paralysis From Post-transplant Lymphoproliferative Disorder. View Abstract
Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction. View Abstract
Further Research Needed to Understand Relationship Between Tubarial Glands and Eustachian Tube Dysfunction. View Abstract
Balloon Dilation for Obstructive Eustachian Tube Dysfunction in Children. View Abstract
Prevalence and Population Estimates of Obstructive Eustachian Tube Dysfunction in US Adolescents. View Abstract
Assessment of PIV performance in validating CFD models from nasal cavity CBCT scans. View Abstract
International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Congenital Cholesteatoma. View Abstract
Three-Dimensional Printing of the Nasal Cavities for Clinical Experiments. View Abstract
Prevalence of Eustachian Tube Dysfunction in Adults in the United States. View Abstract
Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube. View Abstract
Iatrogenic Inner Ear Dehiscence After Lateral Skull Base Surgery: Therapeutic Dilemma and Treatment Options. View Abstract
Mucociliary function of the eustachian tube in the eustachian tube dysfunction. View Abstract
Iatrogenic Inner Ear Dehiscence After Lateral Skull Base Surgery: Therapeutic Dilemma and Treatment Options. View Abstract
Balloon Dilation of the Eustachian Tube: 12-Month Follow-up of the Randomized Controlled Trial Treatment Group. View Abstract
Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. View Abstract
Hairy polyps: A new case presentation and a pathogenetic hypothesis. View Abstract
Twelve-month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction. View Abstract
Bilateral congenital cholesteatoma: A case report and review of the literature. View Abstract
Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube. View Abstract
Patulous Eustachian Tube Dysfunction: Patient Demographics and Comorbidities. View Abstract
Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial. View Abstract
Can we use the status of one ear to predict Eustachian tube function of the contralateral ear? View Abstract
Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid-Anatomy, Physiology, Pathophysiology, and Pathogenesis). View Abstract
The Burden and Epidemiology of Eustachian Tube Dysfunction in Adults. View Abstract
Superior semicircular canal dehiscence syndrome. View Abstract
Critical distance between the cartilaginous Eustachian tube and the internal carotid artery. View Abstract
Eustachian Tube Dilation via a Transtympanic Approach in 6 Cadaver Heads: A Feasibility Study. View Abstract
Clinical Practice Guideline: Otitis Media with Effusion (Update). View Abstract
Clinical Practice Guideline: Otitis Media with Effusion Executive Summary (Update). View Abstract
Eustachian Tube Mucosal Inflammation Scale Validation Based on Digital Video Images. View Abstract
Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. View Abstract
Is there an optimal location for tympanostomy tube placement? View Abstract
Repair of tegmen defect using cranial particulate bone graft. View Abstract
Histopathology of balloon-dilation Eustachian tuboplasty. View Abstract
Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube. View Abstract
Comparison of stapedotomy minus prosthesis, circumferential stapes mobilization, and small fenestra stapedotomy for stapes fixation. View Abstract
Minimally invasive functional approach for cholesteatoma surgery. View Abstract
Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series. View Abstract
What is the full range of medical and surgical treatments available for patients with Eustachian tube dysfunction? View Abstract
Panel 2: Eustachian tube, middle ear, and mastoid--anatomy, physiology, pathophysiology, and pathogenesis. View Abstract
3 µm CW lasers for myringotomy and microsurgery. View Abstract
Cochlear implantation in adults: a systematic review and meta-analysis. View Abstract
Mitochondria toxin-induced acute cochlear cell death indicates cellular activity-correlated energy consumption. View Abstract
Clinical use of vestibular evoked myogenic potentials in the evaluation of patients with air-bone gaps. View Abstract
EuroQol 5D quality of life in Menière's disorder can be explained with symptoms and disabilities. View Abstract
Size-dependent passage of liposome nanocarriers with preserved posttransport integrity across the middle-inner ear barriers in rats. View Abstract
Characterization of presbyequilibrium among institutionalized elderly persons. View Abstract
Oval window transport of Gd-dOTA from rat middle ear to vestibulum and scala vestibuli visualized by in vivo magnetic resonance imaging. View Abstract
Synchronous endoscopy and sonotubometry of the eustachian tube: a pilot study. View Abstract
The consequences of tinnitus in long-standing Ménière's disease. View Abstract
Tinnitus complaint behaviour in long-standing Menière's disorder: its association with the other cardinal symptoms. View Abstract
Clinical experience in diagnosis and management of superior semicircular canal dehiscence in children. View Abstract
Diagnostic and surgical challenge: middle ear dermoid cyst in 12 month old with branchio-oto-renal syndrome and multiple middle-ear congenital anomalies. View Abstract
Measurements of Eustachian tube dilation by video endoscopy. View Abstract
Presbyequilibrium in the oldest old, a combination of vestibular, oculomotor and postural deficits. View Abstract
Balloon dilation of the cartilaginous eustachian tube. View Abstract
Nanotechnology and the treatment of inner ear diseases. View Abstract
Manufacturing and in vivo inner ear visualization of MRI traceable liposome nanoparticles encapsulating gadolinium. View Abstract
Positive experiences and quality of life in Ménière's disorder. View Abstract
Magnetic resonance imaging of the inner ear in Meniere's disease. View Abstract
Use of ICF in assessing the effects of Meniere's disorder on life. View Abstract
In reference to Balloon dilatation Eustachian tuboplasty: a clinical study. View Abstract
MRI manifestation of novel superparamagnetic iron oxide nanoparticles in the rat inner ear. View Abstract
Balloon dilation of the cartilaginous portion of the eustachian tube: initial safety and feasibility analysis in a cadaver model. View Abstract
Posterior semicircular canal dehiscence: first reported case series. View Abstract
Self-reported effects of Ménière's disease on the individual's life: a qualitative analysis. View Abstract
Differential passage of gadolinium through the mouse inner ear barriers evaluated with 4.7T MRI. View Abstract
The presentation and management of multiple paraganglioma in head and neck. View Abstract
Carotid laceration during myringotomy. View Abstract
Multiple semicircular canals with dehiscence. View Abstract
Visualization of inner ear disorders with MRI in vivo: from animal models to human application. View Abstract
Surgery of the Ear, Glasscock & Shambaugh.
In preparation View Abstract
Complications with hydroxyapatite cement in mastoid cavity obliteration. View Abstract
The Diagnosis and Management of the Patulous Eustachian Tube View Abstract
Endoscope-Assisted Laser Stapedectomy: A Prospective Study [Thesis requirement for American Otological, Rhinological, Laryngological Society] Laryngoscope, Vol. 110:5:Part 2. Winner of the Mosher Award for Excellence in Clinical Research View Abstract
Adjunctive use of endoscopy during acoustic neuroma surgery. View Abstract
Otoendoscopic view of a persistent stapedial artery. View Abstract
Friedland, D.R., Wachym, P.A. Critical Appraisal of Spontaneous Perilymphatic Fistulas of the Inner Ear View Abstract
Imaging quiz case 2. Intraosseous cavernous-type hemangioma of the petrous temporal bone. View Abstract
Experimental CO2 Lasery Myringotomy: A Prelimary Animal Study View Abstract
Experimental CO2 Laser Myringotomy: A Preliminary Animal Study View Abstract
Endoscopy in Otology and Neuro-Otology View Abstract
Phase II study of 5-fluorouracil/leucovorin for pediatric patients with malignant solid tumors. View Abstract
Comparison of endoscopic and surgical explorations for perilymphatic fistulas. View Abstract
Erbium Laser in Middle Ear Surgery: A Laboratory Study View Abstract
Erbium Laser in Middle Ear Sugery: Labatory Study View Abstract
Thulium: YAG Laser for Stapes Surgery: Preliminary Observations View Abstract
Non-invasive Monopole Phased Array for Hyperthermia Treatment of Cranial-cavity and Skull-base Tumors: Design, Analysis, and Phantom Tests View Abstract
Cartilage tympanoplasty for management of retraction pockets and cholesteatomas. View Abstract
Translabyrinthine drillout from suboccipital approach to acoustic neuroma. View Abstract
Intravenous fluorescein for detection of perilymphatic fistulas. View Abstract
Aggressive papillary tumors of temporal bone. View Abstract
Evaluation of Vestibulocochlear Dysfunction Syndromes, Selection of Patients, and Surgical Techniques for Selective Microsurgical Vestibular Nerve Section for Intractable Meniere's Syndrome View Abstract
Clinical Applications of Endoscopy in Otology View Abstract