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Rady Children's Specialists

Complex Sinus and Skull Base Surgery Program


The Complex Sinus and Skull Base Surgery Program at Rady Children’s Hospital provides highly specialized and comprehensive care for pediatric patients with complex sinus issues and skull base lesions. We approach these complex conditions with a multidisciplinary, team-based approach to ensure the best possible outcomes for our young patients.

What Are Complex Nasal and Sinus Conditions?

Complex nasal and sinus issues refer to a range of medical conditions and problems that affect the nasal passages and sinuses, a group of air-filled cavities located within the bones of the skull and face. Complex nasal and sinus conditions we treat include:

  • Polyps: Noncancerous, fleshy growths that develop in the lining of the nasal passages or sinuses
  • Sinusitis/Rhinosinusitis: Inflammation and swelling of the tissues lining the sinuses
  • Frequent Epistaxis: Also known as nosebleeds, this condition is bleeding from the blood vessels inside the nose
  • Primary Ciliary Dyskinesia: A genetic mutation that causes the cilia to function abnormally
  • Congenital Nasal Anomalies: Structural abnormalities or irregularities in the nose that are present at birth, like cleft lip or palate
  • Nasal Airway Obstruction: Partial or complete blockage or narrowing of the nasal passages, making it difficult for a person to breathe
  • Lymphovascular Anomalies: Abnormal development of the blood vessels and lymphatic system

Complex nasal and sinus conditions often require a multidisciplinary approach to treatment, involving various medical specialists. The specific treatment plan will depend on the underlying condition, its severity, and the patient’s individual needs. Treatments to help your child breathe easier can include:

  • Saline nasal irrigation to clear nasal passages and keep them moist
  • Surgical interventions, such as endoscopic nasal and sinus surgery, a minimally invasive procedure to treat chronic sinusitis, nasal polyps, and related conditions
  • Medications, such as antibiotics and allergy medications

What Is Skull Base Surgery?

The skull base is located at the underside of the brain or at the top few vertebrae of the spinal column. Skull-based surgery focuses on addressing conditions, tumors, and abnormalities that affect the skull base region. Our multidisciplinary team of physicians is committed to addressing a wide range of conditions, like:

  • Brain Tumors: Various types of brain tumors affecting the skull base
  • Adenomas: Benign tumors that can develop in various glands
  • Pituitary Tumors: Tumors that develop in the pituitary gland
  • Cordoma: Rare bone tumors that occur at the base of the skull or spine
  • Craniopharyngioma: Tumors that form near the base of the brain
  • Cystic Fibrosis: A genetic disorder that can impact the sinuses and nasal passages
  • Primary Ciliary Dyskinesia: A rare genetic disorder that affects cilia function in the airways


Skull base diseases, especially in kids, are rare and complex. However, our team has pioneered and refined minimally invasive and scarless options, like endoscopic endonasal surgery (EES) for multiple lesions, allowing us to offer advanced surgical treatments that remove or alleviate the source of the problem while minimizing damage to surrounding tissues.

Our Team

At Rady Children’s Hospital, you’ll find a specialized team of experts from various fields, including otolaryngology (ENT), neurosurgery, pulmonary, ophthalmology, oncology, endocrinology, cardiology, and others, working together to tackle complex conditions through a collaborative approach. This ensures a comprehensive evaluation and treatment plan for your child’s condition. Our team of highly trained specialists is solely focused on pediatric care, providing personalized and compassionate treatment.

One key strength of our team lies in the close collaboration between our ENT and neurosurgery specialists. Rady Children’s Division of Neurosurgery is nationally renowned for its exceptional care for infants, children, and adolescents with neurological conditions affecting the brain, skull, spine, and peripheral nerves. Our pediatric neurosurgeons at Rady Children’s Specialists of San Diego are experienced, performing over 600 surgeries annually. They specialize in treating various pediatric conditions, including epilepsy, hydrocephalus, brain and spinal cord tumors, cerebrovascular malformations, peripheral nerve injuries, brachial plexus injuries, craniofacial disorders, and traumatic injuries.

Vijay Patel, MD, Our experienced team is led by Vijay Patel, MD, a renowned expert in the field of complex sinus care and skull base surgery. In fact, he is the only dual fellowship-trained rhinologist and pediatric otolaryngologist on the West Coast. In addition to caring for all children with pediatric ear, nose, and throat disorders and conditions as a pediatric otolaryngologist, Dr. Patel’s specific clinical and research interests include skull base surgery, cystic fibrosis, primary ciliary dyskinesia, congenital nasal anomalies, rhinosinusitis, sinonasal disorders, nasal airway obstruction, lymphovascular anomalies, surgical outcomes, cost analysis, and quality improvement metrics in surgery. He has over 70+ peer-reviewed publications and 50+ regional/national presentations in otolaryngology and is active across several professional expert networks worldwide. Dr. Patel and our team are dedicated to providing compassionate care and the highest level of expertise to our patients and their families.’


Michael Levy, MD, is chief of Pediatric Neurosurgery at Rady Children’s Hospital-San Diego and UC San Diego School of Medicine and a professor at UC San Diego School of Medicine.

Dr. Levy’s expertise as a health professional and pediatric neurosurgery chief providing treatment and care for children lies in the treatment of complex pediatric brain tumors and cerebrovascular malformations. He is also involved with the design and utilization of endoscopy and three-dimensional imaging technologies to facilitate surgery, including pediatric surgery.


Matthew Brigger MD, MPH, is the chief of the Division of Otolaryngology at Rady Children’s Hospital-San Diego and a professor of surgery at UC San Diego School of Medicine. Dr. Brigger’s clinical interests focus on diseases of the upper aerodigestive tract, with a particular focus on surgical management of breathing and swallowing disorders in children.

Dr. Brigger is a pioneer of the Pediatric Aerodigestive Vascular Ring Program at Rady Children’s Hospital with the goal of providing comprehensive and accessible care to children with this ailment.


Michael Gottschalk, MD, PhD,  is chief of the Endocrinology/Diabetes Division at Rady Children’s Hospital-San Diego and a clinical professor at UC San Diego School of Medicine.

Dr. Gottschalk treats children and adolescents with a wide range of endocrine disorders and diabetes mellitus. He continues to focus time on various research pursuits, including growth hormone treatments and type 1 and 2 diabetes mellitus.



David Gonda, MD, is the director of Epilepsy Surgery at Rady Children’s Hospital-San Diego and an assistant clinical professor of neurosurgery at UC San Diego School of Medicine.

Dr. Gonda’s clinical areas of expertise are epilepsy surgery, MRI laser thermal ablation surgery, pediatric spine abnormalities, and craniovertebral junction abnormalities. His research area of expertise is minimally invasive epilepsy surgery.

Kathryn Akong, MD, oversees the Cystic Fibrosis Transition Program in the Cystic Fibrosis Center at Rady Children’s Hospital-San Diego, in which young cystic fibrosis patients “graduate” to adult-centered care. She is also the associate director of the Cystic Fibrosis Center and an assistant professor of pediatrics at UC San Diego School of Medicine.




Meerana Lim, MD, is the director of the Rady Children’s/UC San Diego Cystic Fibrosis Care Center and a professor of pediatrics at UC San Diego. She is board-certified in pediatric pulmonology and sleep medicine. At Rady Children’s, Dr. Lim seeks to make the cystic fibrosis center a place of excellence, one that actively participates in research to better understand the pathophysiology of cystic fibrosis in order to impact treatments and therapeutics that will benefit patients.



Patricia Lenhart-Pendergrass, MD, PhD





Clinical Trials

Participating in clinical trials can provide access to groundbreaking treatment approaches for skull base conditions. Our program actively engages in research to advance the field of complex sinus conditions and pediatric skull base surgery.

Appointments and Referrals

Access our referral forms below to request an appointment at Rady Children’s Hospital. If you or potential patients have any questions about the conditions we treat, please contact our Center for Pediatric Aerodigestive Disorders and Airway Surgery Nurse Coordinator at 858-966-8336 ext: 223403