Salib, Mr Rami J

Rami SalibB Med Sci, BM BS, FRCSI (Otol), FRCS (Otol), DLO, PhD, FRCS (ORL-HNS)

Specialty

ENT

Sub-specialty

Rhinology

Training and education

B.Med.Sci in Physiology & Pharmacology (Hons.), University of Nottingham Medical School - 1992
B.M., B.S. (Hons.), University of Nottingham Medical School - 1994
DLO, The Royal College of Surgeons of England - 1998
FRCS (Otol), The Royal College of Surgeons of Ireland - 1998
FRCS (Otol)), The Royal College of Surgeons of England - 1999
PhD, University of Southampton - 2005
FRCS (ORL-HNS), The Royal College of Surgeons of England - 2006

Experience

Mr Salib has worked for Southampton University Hospitals Trust since May 2009.

Higher specialist surgical training in Otorhinolaryngology / Head & Neck Surgery in the Wessex Deanery (2001-2008). Certificate of Completion of Training (CCT) in October 2008. Subspecialist overseas fellowship in Rhinology & Anterior Skull Base Surgery at the Academic Medical Centre in Amsterdam between October and December 2008.

During my training, I have developed a special interest in Rhinology and in particular Endoscopic Sinus Surgery (ESS). My training in ESS has included its “extended” applications including powered endonasal dacryocystorhinostomy, endoscopic orbital decompression, endoscopic medial maxillectomy, septal perforation closure, endoscopic CSF leak closures, sphenopalatine artery ligation, mini frontal trephines, and mini Caldwell Luc procedures. I have also performed a number of endoscopic modified Lothrop (frontal sinus drillout) procedures for complex and recurrent frontal sinus disease. More recently I have had increasing exposure to more complex anterior skull base surgical procedures undertaken jointly with neurosurgical colleagues, including management of pituitary tumours, and CSF leaks My surgical training has been backed up by participation in multidisciplinary Allergy and Lacrimal clinics. I am also a faculty member on the internationally renowned Advanced Endoscopic Sinus Surgery Course in Winchester, UK.

Key achievements

PhD, University of Southampton, 2005.
Hunterian Professorship of Surgery, Royal College of Surgeons of England, 2006.
Clinical Senior Lectureship Award – Higher Education Funding Council for England, 2008.

Key awards and prizes

Louis Alexander Royal College of Surgeons of England Research Fellowship, 2001.
Frances and Augustus Newman Foundation two-year Royal College of Surgeons of England Research Fellowship, 2002.
The Royal Society of Medicine GlaxoSmithKline Fellowship 2004-2005.
Royal College of Surgeons of England Hunterian Professor of Surgery 2006.
Clinical Senior Lectureship Award – Higher Education Funding Council for England 2008.

Research

Undergraduate, Postgraduate & Future Research

I undertook undergraduate research at the department of Physiology & Pharmacology in the University of Nottingham Medical School, with the aim of developing and validating an assay to measure sodium dependent high affinity choline uptake (SDHACU) in rat synaptosomes; and then to use this assay in order to investigate the effects of various neuropeptides, namely Thyrotrophin releasing Hormone (TRH) on the SDHACU system. The results suggested a mechanism by which endogenous TRH altered the release and turnover of Acetylcholine from central nervous system neurones was via modulation of choline uptake. The work culminated in the award of a B Med Sci (Hons.) in 1992.

The Royal College of Surgeons of England funded me for three years (2001-2004) to carry out postgraduate basic science research into the mechanisms of epithelial activation and mast cell chemotaxis in allergic rhinitis. This research based at the sub-Division of Respiratory Cell and Molecular Biology of the Infection, Inflammation and Immunity Division of the School of Medicine in the University of Southampton. This work has culminated in a PhD thesis which was awarded in July 2005.

As a Clinical Senior Lecturer, my main research interest will focus on the mucosal immune responses in nasal airways disease, with the aim of creating a constructive channel between the NHS ENT clinical service and the academic excellence in Southampton in airways disease mucosal biology. I would now like to build on that liaison in the next few years to develop further bi-directional benefits in not only establishing an academic presence to develop ENT research but would also facilitate translational research for patient benefit within this area, building on the strengths of the Infection, Inflammation & Immunity Research Division and enabling better understanding of the upper and lower airway interactions.

My future work will focus primarily on rhinosinusitis, a condition that affects 15% of the UK population and represents a major unmet need, as treatment approaches are limited in their impact. Rhinosinusitis has been closely linked as a causal factor in asthma severity. Infective agents are considered important in this mucosal inflammatory disorder, with both viral and bacterial aetiologies implicated in acute exacerbations and immune responses against bacterial and fungal components implicated, but poorly characterised in persistent disease. This work will thus focus on three main areas: (1) use of non-culture molecular techniques to better understand the bacteriology of the nasal airways and sinuses; (2) use of tissue and tissue explants in evaluating the involvement of fungal and bacterial antigens as immune stimulants underlying the T-cell driven mucosal inflammatory process, and (3) to develop tissue explant models, utilising sinus tissue, that enable the study of viral infections and novel therapeutic molecules in a human based model system. Such work would also be extended to clinical proof of principle studies. This work thus encompasses a full spectrum from basic science, through applied research to clinical research, translating the science into patient benefit.

Publications

Salib R.J. Developing and validating an assay for the measurement of Sodium-Dependent High Affinity Choline Uptake in rat synaptoneurosomes. B.Med.Sci. Thesis, University of Nottingham, 1992.

Salib R.J., Fone K.C.F., Bennett G.W. Effect of Thyrotrophin-Releasing Hormone on high affinity choline uptake in rat brain synaptoneurosomes. Br J Pharmacol 1992; 107: No 223P.

Salib R.J., Khan N. A pain in the neck. CME Bulletin Otorhinolaryngol Head Neck Surg J 1998; 2 (3): 24.

Salib R.J., Khan N. Airway obstruction in children with infectious mononucleosis: A potentially lethal complication. CME Bulletin Otorhinolaryngol Head Neck Surg J 1999; 3 (2): 57 - 58.

Salib R.J., Prior A., Howard D.J. Prevention before cure. Lancet 1999; 353: 2124.

Salib R.J., Valentine P., Akhtar S. Surgical emphysema following dental treatment. J Laryngol Otol 1999; 113: 756 – 758.

Salib R.J., Thirlwell A., Croft C.B., Parikh A., Kotecha B.T. Predictor value of sleep nasendoscopy in the management of patients with snoring and obstructive sleep apnoea. J Laryngol Otol 1999; 113 (Supp. 23): 44.

Salib R.J., Sadek S. A., Dutt S. N., Pearman K. Antrochoanal polyp presenting with cachexia and obstructive sleep apnoea. Int J Ped Otorhinolaryngol 2000; 54: 163-166.

Dutt S., Salib R.J., Chavda S., Irving R. Chronic cerebrospinal fluid leak into skull base causing intramedullary osteolysis. J Laryngol Otol 2000; 114: 888-890.

Salib R.J., Radcliffe G., Gallimore A.  Intra-parenchymal thyroid epidermal cyst presenting with a left recurrent laryngeal nerve palsy. J Laryngol Otol, 2001; 115: 247-249.

Salib R.J., Tziambazis E., McDermott A.L., Chavda S., Irving R.M. The crucial role of imaging in detection of facial nerve haemangiomas. J Laryngol Otol, 2001; 115: 510-513.

Salib R.J., Dutt S.N., Chavda S.V., Irving R.M. The radiology of paragangliomas of the skull base. Skull Base, 2001; 11 (Suppl. 2): 23.

Salib R.J., Chaudri S.A., Rockley T.J. Sinusitis in the hypoplastic maxillary antrum: the crucial role of radiology in diagnosis and management. J Laryngol Otol, 2001; 115: 676-678.

Salib R.J., Howarth P.H. Drug therapy of intermittent and persistent allergic rhinitis. Prescriber, 2002; 13(9): 47-57.

Singh S., Salib R.J., Oates J. Traumatic fracture of the stapes suprastructure following minor head injury. J Laryngol Otol, 2002; 116: 457-459.

Salib R.J., Ghori M.U. Hyperpigmentation of the pinnae following otoplasty. CME Bulletin Otorhinolaryngol Head Neck Surg J, 2002; 6(3):104-105.

Salib R.J., Kaul G., Oates J. Benign idiopathic cystic chondromalacia. CME Bulletin Otorhinolaryngol Head Neck Surg J, 2003; 7(2):12-13.

Salib R.J., Afoakwah E. De novo papillary squamous carcinoma of the lacrimal sac. In press, Auris Nasus Larynx, 2003; 30(2):205-208.

Salib R.J., Drake-Lee A.B., Howarth P.H. Allergic rhinitis: Past, present and the future. Clin Otol 2003; 28(4):291-303.

Salib R.J., Hewitt L., Wilson S.J., Davies D.E., Holgate S.T., Howarth P.H. The epithelial repair phenotype and EGFR in allergic rhinitis. Resp Crit Care Med 2003; 167(7): A220.

Mochizuki A., Lau L.C., McEuen A.R., Salagean E.M., Salib R.J., Howarth P.H., Walls A.F. Basophil activation in the upper airways of rhinitis subjects indicated by the secretion of basogranulin. Resp Crit Care Med 2003; 167(7):A478.

Salib R.J., Howarth, P.H. Safety and tolerability profiles of intranasal antihistamines and intranasal corticosteroids in the treatment of allergic rhinitis. Drug Saf 2003; 26(12):863-893.

Salib R.J., Oates J. KTP laser fine fenestra stapedotomy with vein graft interposition in the surgical management of otosclerosis: How I do it. Surg J R Coll Surg Edinb Irel 2003; 1(5):269-272.

Salib R.J., Howarth, P.H. Remodelling of the upper airway in allergic rhinitis. Is it a feature of the disease?. Clin Exp Allergy 2003; 33(12):1629-1633.

Salib R.J., Salagean M., Lau L., DiGiovanna I., Brennan N., Scadding G., Howarth P.H. The anti-inflammatory response of anti-eotaxin monoclonal antibody CAT-213 on nasal allergen-induced cell infiltration and activation. J Allergy Clin Immunol 2003; 111:S347

Pereira S., Clark T., Darby Y., Salib R.J., Salagean M., Hewitt L., Powell J., Howarth P.H. Effects of anti-eotaxin monoclonal antibody CAT-213 on allergen-induced rhinitis. J Allergy Clin Immunol 2003; 111:S268.

Salib R.J., Singh S., Ghori M.U., De P.R. Globus pharyngeus secondary to lingual tonsil hyperplasia: Treatment with KTP laser. CME Bulletin Otorhinolaryngol Head Neck Surg J, 2004; 7(3):85-88.

Salib R.J., Howarth P.H. Choosing the right pharmacological therapy in allergic rhinitis. Nurse Prescribing, 2004; 2(2):76-82.

Salib, R.J., Hewitt, L., Tuck, A., Wilson, S., Howarth, P.H. Immunohistochemical expression of mast cell chemoattractants and their receptors within the nose in allergic rhinitis. Clin Otol, 2004; 29:401.

Salib R.J., Wilson, S.J., Lau L.C.K., Howarth P.H. Expression of eotaxin and alpha-2 macroglobulin in nasal lavage in naturally occurring allergic rhinitis. Otolaryngol Head Neck Surg, 2004; 131(2):119.

Bhimrao S.K., Hashemi S., Salib R.J., Wilson S.J., Howarth P.H., Church M. Immunoexpression of cytokeratin and adhesion molecules within the atopic nasal epithelium. Otolaryngol Head Neck Surg 2004; 131(2):119.

Salib R.J., Kumar S., Wilson S.J., Howarth P.H. Nasal mucosal immunoexpression of the mast cell chemoattractants transforming growth factor-beta, eotaxin and stem cell factor and their receptors in allergic rhinitis. J Allergy Clin Immunol 2004; 114(4):799-806.

Salib R.J., Lau L.C., Howarth P.H. The novel use of the human nasal epithelial cell line RPMI 2650 as an in vitro model to study the influence of allergens and cytokines on TGF- gene expression and protein release. Clin Exp Allergy 2005; 35(6):811-9.

Salib R.J., Lau L.C., Howarth P.H. Nasal lavage fluid concentrations of eotaxin-1 (CCL11) in naturally occurring allergic rhinitis: relationship to disease activity, nasal luminal eosinophil influx, and plasma protein exudation. Clin Exp Allergy 2005; 35(8):995-1002.

Anand R., Salib R.J., Mourouzis C., Wilbourn M., Resouly A., Brennan P.A. A simple technique for improving access to the conchal bowl. Br J Oral Maxillofac Surg 2006; 45(5):427-8.

Salib R.J. Hunterian Lecture - Transforming growth factor-beta gene expression studies in nasal mucosal biopsies in naturally occurring allergic rhinitis. Ann R Coll Surg Engl 2007; 89:563-73.

Davis S., Buchan H., Salib R.J., Nilssen E. Miller Fisher syndrome – a diagnosis not to be missed. J Laryngol Otol. 2008; 122(1):82-5.

Salib R.J., Harries P.G., Nair S.B., Howarth P.H. Mechanisms and mediators of nasal symptoms in non-allergic rhinitis. Clin Exp Allergy 2008; 38(3):393-404.

Salib R.J., Nair S.B., Howarth P.H. Rhinitis. J ENT Masterclass 2009; 1(1):65-71.

Marshall L.R., Salib R.J., Mitchell T.E., Moore I. A case of cranial fasciitis masquerading as acute mastoiditis. J Laryngol Otol 2009; 123(2):245-7.

Salib R.J. Remodelling in the upper airway in allergic rhinitis. Kido no Arerugi (Allergy From the Nose to the Lung) 2009; 7(1):15-20.

Sunkaraneni V.S, Ismail-Koch H, Salib R.J., Jain P.K. Guillotine tonsillectomy: a neglected technique. J Laryngol Otol. 2009 Mar 11:1-3. [Epub ahead of print].

Salib R.J., Howarth P.H. Transforming growth factor-beta in allergic inflammatory disease of the upper airways: friend or foe? Clin Exp Allergy. 2009 Apr 21. [Epub ahead of print]