St. Luke's - Roosevelt Hospital Center

Vice-Chairman: Department of Otolaryngology - Head & Neck Surgery
Director: Center for Facial Reconstruction

Co-Director: Center for Cranial Base Surgery
Columbia University College
of Physicians & Surgeons
Director: Cranial Base Surgery

Associate Professor of Clinical Otolaryngology, Department
of Otolaryngology- Head & Neck Surgery

Clinical Offices
425 West 59th Street
10th floor
New York, NY 10019
Tel: (212) 523-6756
Fax: (212) 523 6330

Roosevelt Hospital
1000 Tenth Avenue
Suite 5g-80
New York, NY 10019
Tel: (212) 523-6756
Fax: (212) 523-6330


www.cranialbasecenter.org

CV
Specialties Craniofacial Tumor & Reconstructive Surgery

Endoscopic Cranial Base and Nasopharyn Surgery

Facial Nerve Surgery Microvascular & Microneural Reconstructive Surgery
Capabilities Dr. Costantino is formally trained as an Otolaryngologist (ENT), a Head & Neck Cancer Surgeon (American Cancer Society Fellowship), a Cranial Base Surgeon (fellowship trained), and as a Facial Plastic and Reconstructive Surgeon (Board Certified). He is also one of the very few surgeons in the United States experienced in virtually all aspects of Cranial Base Surgery (also called “skull base surgery”), capable of removing tumors by either an “open” approach involving an external incision on the scalp or face, or by minimally invasive endoscopic surgery. Endoscopic skull base surgery is usually performed through the nostrils without any external incisions. The choice of which method will be utilized is based upon the individual requirements of tumor removal, along with the specific needs and desires of the patient. With this broad capability, which is unique in New York, the optimal technique can be selected so as to achieve potentially the best outcome. 
Unique
Expertise		 In addition to his capabilities in tumor removal, he is also a Facial Plastic Surgeon. He is the first surgeon in the United States to have obtained State Department of Health, and state organ donor network (New York Organ Donor Network) for a facial transplant. He is also the developer of the first bone cement that can be sculpted in the patient to replace missing segments of the skull (Hydroxyapatite Cement). During the 1990's, he was the first surgeon to re-grow a missing segment of jawbone, utilizing Distraction Osteogenesis for this purpose.  Reconstruction of the face, facial nerve for facial paralysis, and skull are a substantial portion of Dr. Costantino’s practice, along side craniofacial tumor removal. This “dual capability” of tumor removal and post-tumor reconstruction helps achieve a more optimal outcome for patients relative to long-term survival, maintaining function, and optimizing appearance.
Endoscopic Cranial Base, Pituitary,
and Nasopharyngeal Surgery
Dr. Costantino has performed complex endoscopic skull base tumor removals for the past 6 years, being one of
the very first U.S. surgeons to remove skull base tumors through the nose without external incisions. Additionally,
over the past 3 years, he has developed the unique capability of  endoscopically removing recurrent nasopharyngeal cancer following radiation therapy. He may be the only surgeon in the United States routinely performing
such endoscopic nasopharyngeal resections, which result
in significantly less deformity and loss of function compared
to standard “open” methods of removing recurrent naso-pharyngeal cancers.  Open “standard” approaches
usually result in loss of the entire hard and soft palate
(roof of the mouth) and/or the cheek complex on one side. 
Dr. Costantino’s endoscopic approach preserves both the
palate and the patient’s appearance, as it is performed solely through the nose without external incisions.  The aggregate data from Dr. Costantino’s series indicates that at 3 years the results are at least equal to “open” surgery for removal of these recurrent tumors.  Given that many nasopharyngeal carcinomas occur in Asian patients, Dr. Costantino is supported by a robust Asian Services Office, so that the special needs of Asian patients are given special care.
Cranial Base and Craniofacial Tumor Surgery
As mentioned, Dr. Costantino is fellowship trained in Cranial Base Surgery, and was a Founding Member of  the North American Skull Base Surgery Society.  He has performed hundreds of cranial base resections involving the paranasal sinuses (Anterior Craniofacial Resection), behind the sinuses (Infratemporal Fossa Resection), and around the ear (Temporal Bone Surgery).
Tumors that he treats include sinus cancers, olfactory tumors, meningiomas, acoustic neuromas, nasal tumors, angiofibroma, salivary gland tumors (benign and malignant) and sarcomas.  A complete list, including important information on these tumors,
can be accessed by clicking this link (insert cranial base logo to click on – links to a page with the same info as on the what we
treat page of the cranial base brochure/web site).
Cranial Defect Reconstructive Surgery
Dr. Costantino has been fortunate enough to perform nearly 500 cranioplasties (skull defect reconstructions), one of the largest series of this procedure of any practicing surgeon in the world.  This experience stems from the fact that Dr. Costantino developed Hydroxyapatite Cement (HA cement) in the late Eighties.  This material went on to be cleared by the FDA, and has since been used in at least 50,000 patients world-wide, primarily for cranial defect replacement and cranial re-contouring.  Though Dr. Costantino was instrumental in the development of HA cement, he uses all types of implants for cranial defect replacement (e.g., bone grafts, acrylic, HA cement, etc.) thereby allowing the optimal material to be chosen based upon the patient’s specific needs.  The aggregated success rate for Dr. Costantino’s cranioplasties, by all techniques, approaches 98% with maximal follow-up
nearing 15 years.
Facial Paralysis Rehabilitative Surgery
A particular interest of Dr. Costantino is the restoration of a more normal facial appearance and function following facial paralysis regardless of the cause (e.g., Bell’s palsy, tumor surgery, congenital defect, etc.).  Techniques can range from simply making the face more symmetric (a static reconstruction), up to complex nerve or nerve-muscle transfers to restore actual facial movement
(e.g., a smile).  What is ultimately possible is dependent upon the specific situation of the patient.  Dr. Costantino has performed nearly 100 static facial procedures and over 20 complex nerve and/or nerve-muscle transfers, making him one of the most experienced surgeons in the United States in this regard.
Facial Reconstruction & Face Transplantation
Dr. Costantino’s practice also includes the capability to perform all types of microvascular tissue transfer for reconstructing and replacing lost areas of the face. This includes the jawbone (mandible), cheek complex (maxilla), palate (roof of the mouth), etc.
This microvascular capability is augmented by micro-neural skills that permit the restora- tion of movement and sensation in selected patients.  Lastly, Dr. Costantino’s team is the first in the United States to achieve approval for a “face transplant’ (facial allograft tissue transfer) from regulators at the hospital, organ donor network, and state level. We hope to perform our first transplant during 2008.
Click for Dr. Costantino's awards
Click for Dr. Costantino's honors
Click to read about media coverage featuring Dr. Costantino
Education
1984 - Northwestern University Medical School, Chicago, Illinois, Doctorate of Medicine - Highest Honors
1980 - University of Notre Dame, Notre Dame, Indiana, Bachelor of Science - High Honors
Internship: Northwestern Memorial Hospital/Northwestern University Medical School, 1985
Residency Training: Northwestern Memorial Hospital/Northwestern University Medical School: General Surgery 1986, Otolaryngology/ Head & Neck Surgery, 1987-1989
Fellowship Training: Joint Council Fellowship in Head & Neck Surgical Oncology/Reconstructive Surgery 1990; Presbyterian Hospital/University of Pittsburgh School of Medicine: Cranial Base Surgery. 1991
Board Certification: Otolaryngology/Head & Neck Surgery, 1991 Facial Plastic & Reconstructive Surgery, 2000
Email: costantino@NYHNI.org
More information on Dr. Costantino and Helpful Patient Links: www.cranialbasecenter.org