Clival chordoma research
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The surgeons: sources

Research agent report, 4 September 2026, from public professional sources only. No prognosis figures. Where a statement is inference rather than something a source says, it is marked (inference). Read 07-derriford-vs-southampton.md first for the unit-level picture; this file is about the individuals.

0. How to read this

1. Who would actually operate

For a 2 x 3 cm mass in and around the right cavernous sinus, the operation (biopsy or resection) would most likely be endoscopic endonasal through the sphenoid, done by a neurosurgeon with an ENT rhinologist opening and reconstructing (nasoseptal flap). A transcranial route is possible for the lateral cavernous sinus but is not the modern default. So the relevant people are the pituitary/anterior skull base neurosurgeon and the rhinology/anterior skull base ENT surgeon at each unit, plus whoever chairs the skull base MDT.

Plymouth (Derriford), most likely pairing: Mr Samiul Muquit (neurosurgery) with Mr Marios Stavrakas or Prof Hisham Khalil (ENT). Mr Aditaya Kumar (neurosurgery, anterior and lateral skull base fellowship) is the second skull base neurosurgeon and would be involved if a transcranial or combined approach were chosen (inference from the fellowship description, which pairs Kumar and Muquit).

Southampton (Wessex), most likely pairing: Mr Nijaguna Mathad (neurosurgery, the unit's endoscopic pituitary and endonasal skull base lead since about 2004) with Prof Rami Salib (ENT rhinology). Mr Christoforos Syrris, a newly appointed pituitary and skull base neurosurgeon (King's College Hospital endoscopic pituitary and skull base fellowship, 2024 to 2025), is the likely second endonasal surgeon (inference: his job title on ResearchGate matches the consultant post UHS advertised in early 2026). Mr Emad Shenouda chairs the skull base MDT but his published and stated practice is spinal and open lateral skull base, not endonasal. Prof Diederik Bulters is a neurovascular surgeon; the earlier file (07) listed him under pituitary/endonasal and that is not supported by any public profile. Mr Andrew Durnford (neuro-oncology and skull base, microscopic and endoscopic) is a possible transcranial option.

Neither unit publishes a named list of skull base MDT members. Southampton's own pages name Shenouda as chair and Mathad as "lead pituitary surgeon". Plymouth's pages name Muquit as "lead for pituitary and skull base surgery" and Kumar as lead for lateral skull base.

Correction, 5 Sep 2026 (noted here 12 Oct): the neurosurgery registrar told the family Mr Shenouda is no longer at UHS. The website was out of date; ask who chairs the skull base MDT now.

2. Plymouth (University Hospitals Plymouth NHS Trust, Derriford Hospital)

2.1 Mr Samiul (Sam) Muquit, consultant neurosurgeon

2.2 Mr Aditaya Kumar, consultant neurosurgeon and lateral skull base surgeon

2.3 Prof Hisham Khalil, consultant ENT surgeon

2.4 Mr Marios Stavrakas, consultant ENT surgeon (rhinology and anterior skull base)

2.5 Also at Plymouth

3. Southampton (University Hospital Southampton NHS FT, Wessex Neurological Centre)

3.1 Mr Nijaguna (Nijagunashivayogi) Mathad, consultant neurosurgeon

3.2 Mr Christoforos Syrris, consultant neurosurgeon (pituitary and skull base)

Ranked for relevance to this case:

  1. Fat in the Fossa and the Sphenoid Sinus: A Simple and Effective Solution to CSF Leaks in Transsphenoidal Surgery. Cohort Study and Systematic Review. J Neurol Surg B Skull Base 2023;84(2):143-156. PMID 36895808. Syrris 6/13. 439 patients; leak requiring intervention 4.4% with fat in fossa and sphenoid, vs 20.3% multilayer repair and 12.6% no repair, with fewer reoperations, fewer lumbar drains, shorter stays. The technique paper. Appointment sheet question 5a. Directly relevant: possible endonasal surgery and an open pre-operative CSF leak question.
  2. Is Knosp enough? A novel classification for Acromegaly: a retrospective analysis of cure rates and outcome predictors in a large tertiary centre. Acta Neurochir (Wien) 2025. PMID 40055188. Syrris 5/10. A pituitary paper whose subject is grading cavernous sinus invasion around the carotid and how well that grading predicts resectability, which is the exact judgement this case turns on.
  3. Recurrent trigeminal neuralgia following MVD: a meta-analysis of second-line treatment strategies. Neurosurg Focus 2025. PMID 40889405. Syrris 8/9. Caveat stated to the family: her facial pain is compressive from tumour, not classic trigeminal neuralgia, and MVD is not on the table. Included because it shows literature-level familiarity with what to do when trigeminal pain does not answer to drugs, which is where she is now, and gives an opening to ask for a block or a pain procedure.
  4. Lumbar Drain Infection Rates: A Comprehensive Risk Factor Analysis From a Multicenter Retrospective Study of 1000+ Cases. Neurosurgery 2026. PMID 40719454. Syrris 25/36. Pairs with (1): avoiding lumbar drains is part of what the fat technique is for.

The remaining ten, none of them relevant to this case: MGMT promoter methylation in glioblastoma (J Pers Med 2023, PMID 37373988, Syrris 4/24, the paper the family found first); AI for vestibular schwannoma (JAMIA Open 2026, PMID 41502533); anticoagulation in chronic subdural haematoma (Neurosurgery 2026, PMID 42554463); time to surgery in chronic subdural haematoma (JNNP 2026, PMID 41605624); bevacizumab in brain AVMs (Neurosurg Rev 2025, PMID 40504282); ankylosing spondylitis fractures (Neurosurg Rev 2025, PMID 40234285); painful foot drop from lumbar disc herniation (J Neurosurg Spine 2025, PMID 40184689); open vs minimally invasive intradural extramedullary tumours (J Clin Med 2025, PMID 40095688); intraoperative neurophysiological monitoring for IDEM tumours (Global Spine J 2024, PMID 36411068); infected arachnoid cyst after craniotomy (BMJ Case Rep 2021, PMID 34426424, Syrris 2/4).

Honest reading of the list. Middle authorship throughout, no first-author paper, and no chordoma paper anywhere in his output. His published corridor is pituitary and transsphenoidal, not chordoma. That is the normal shape of a recent registrar and fellow's record inside large King's series, and King's is a genuine high volume endoscopic skull base unit, but it means the papers evidence fluency in the route into the tumour rather than experience of this tumour.

Disambiguation: "Syrris P" in PubMed is Petros Syrris, a cardiac geneticist, a different person. - Patient feedback / press: none. - Relevance: King's is one of the highest-volume UK endoscopic skull base units and does treat chordoma; a fellow there in 2024 to 2025 will have seen extended endonasal and clival work. As a new consultant he will not yet have a personal track record.

3.3 Mr Emad Shenouda, consultant neurosurgeon, chair of the skull base MDT

3.4 Prof Diederik Bulters, consultant neurosurgeon (neurovascular)

3.5 Mr Andrew Durnford, consultant neurosurgeon (neuro-oncology and skull base)

3.6 Prof Rami Salib, consultant ENT surgeon (rhinology)

3.7 Also at Southampton

4. Comparison

Strongest documented skull base evidence at each unit

Plymouth - A public, RCS-accredited, two-year skull base fellowship whose register entry gives actual annual numbers: 30 to 40 transsphenoidal operations, 5 to 10 extended endonasal approaches, 8 to 10 vestibular schwannomas, plus an ENT fellowship quoting 10 to 20 anterior skull base procedures and 10 sinonasal malignancies a year. This is the only hard volume figure found for either unit. - An ENT and neurosurgery team that publishes together on the exact reconstruction this operation would need (nasoseptal flap, 2026) and on sinonasal and clival pathology, and that co-edited a Springer anterior skull base textbook. - Muquit: Walton Centre skull base and pituitary training, 10 years as the unit's pituitary and skull base lead. Kumar: fresh two-year Glasgow anterior and lateral skull base fellowship. Khalil: 22 years, trained under Draf. Stavrakas: Amsterdam and Derriford trained, runs the ENT fellowship.

Southampton - The longer history: endoscopic endonasal surgery since about 2004 under Mathad, a 2014 paper reporting 151 endonasal skull base patients, and BSBS hosting in 2011. - Mathad's 23 years as the unit's endoscopic pituitary lead is the longest personal endonasal track record on either side. - A newly appointed pituitary and skull base consultant (Syrris) straight from the King's endoscopic fellowship, a unit that does treat clival chordoma. - A skull base MDT chaired by a Manchester-fellowship-trained skull base neurosurgeon (Shenouda) and the largest UK neurovascular practice (Bulters) in the same building, which matters if the carotid is involved. - Salib: Amsterdam anterior skull base fellowship, Guildford skull base course faculty, but his research and stated practice are inflammatory sinus disease and his skull base work is described as "increasing exposure".

What could not be found

What this research can and cannot tell the family

It can tell you that both units have credible, fellowship-trained endonasal pairs, that nobody at either unit has a published record with chordoma or cavernous sinus tumours specifically, and that Plymouth is the only one of the two that publishes a number for extended endonasal approaches (5 to 10 a year, unit-wide). Southampton's equivalent number is unknown, not zero; the unit has been doing this longer and is investing in it now.

It cannot tell you who is the better surgeon. Individual outcome data for these operations are not published in the UK. The national chordoma cohort (Glancz et al. 2024, in file 07) shows that unit volume of chordoma and chondrosarcoma cases predicts complete resection; neither unit's volume is public. A unit doing 5 to 10 extended endonasal cases a year across all diagnoses will see a skull base chordoma rarely, and that is likely true of Southampton too (inference from national incidence: roughly 30 to 40 skull base chordomas a year in the whole UK, spread over 18 referring units in the national cohort). This is the strongest argument for insisting the case goes to the national chordoma MDT regardless of which unit holds it, and for asking whether surgery, if needed, should be done where the national MDT's surgeons sit rather than at either regional unit.

The personal case volume question has to be asked directly of the named surgeon, in the consultation, and the answer written down.

5. Questions for each surgeon or unit

  1. Who exactly would operate (neurosurgeon and ENT surgeon by name), and how many endoscopic endonasal skull base operations beyond the pituitary fossa (extended, transcavernous, transclival) have you personally done in the last three years?
  2. How many skull base chordomas or chondrosarcomas have you personally operated on, and how many has the unit referred to the proton panel since 2017?
  3. For a lesion in and around the cavernous sinus, would you biopsy first or go straight to resection, and by which route? What is your unit's CSF leak rate after extended endonasal surgery (CRANIAL gave a national 7 percent)?
  4. Will this case be discussed at the National Chordoma and Chondrosarcoma Skull Base MDT before any operation, and who at your unit sends that referral?
  5. If the tumour encases the internal carotid artery, who manages that, and does the unit have a neurovascular surgeon in the skull base MDT and access to bypass or endovascular balloon occlusion testing?
  6. Is the named neurosurgeon operating regularly now (relevant at Southampton given the 2026 recruitment and at Plymouth given Kumar's recent start), and would a trainee or fellow be doing any part of the operation?
  7. Where do you send patients whose skull base tumour you would not operate on yourself, and would you consider this one of them?
  8. Can we have the MDT outcome in writing, including the histology plan, the named surgeon and the proton referral route?

6. Sources

Plymouth - https://www.plymouthhospitals.nhs.uk/muquit-mr-s/ - https://www.nhs.uk/profiles/consultant/6052275 (GMC number in URL; page did not render) - https://www.plymouthhospitals.nhs.uk/kumar-a/ - https://www.plymouthhospitals.nhs.uk/khalil/ - https://www.plymouth.ac.uk/staff/hisham-khalil - https://www.entplymouth.co.uk/about-me/ - https://www.plymouth.ac.uk/news/medical-academic-awarded-prestigious-national-teaching-fellowship - https://www.plymouthhospitals.nhs.uk/stavrakas-m/ - https://www.plymouthhospitals.nhs.uk/kanaan-y/ - https://www.rcseng.ac.uk/education-and-exams/accreditation/rcs-senior-clinical-fellowship-scheme/national-surgical-fellowship-scheme-register/neurosurgery/ (Plymouth Anterior and Lateral Skull Base Fellowship, volumes) - https://www.rcseng.ac.uk/education-and-exams/accreditation/rcs-senior-clinical-fellowship-scheme/national-surgical-fellowship-scheme-register/otolaryngology/ (Plymouth Rhinology and Skull Base Fellowship, volumes) - https://link.springer.com/book/10.1007/978-3-030-66865-5 - https://www.iwantgreatcare.org/doctors/mr-samiul-muquit - https://www.doctify.com/uk/specialist/professor-hisham-khalil - PubMed: Muquit S[Author]; Khalil HS[Author]; Stavrakas M[Author]

Southampton - https://www.uhs.nhs.uk/departments/brain-spine-and-nerves/wessex-neurological-centre/neurosurgery - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-nijaguna-mathad - https://www.uhs.nhs.uk/whats-new/press-releases/teenager-diagnosed-with-brain-tumour-after-eye-test-has-sight-saved-by-surgeons-at-university-hospital-southampton - https://www.ratemds.com/doctor-ratings/3552901/Dr-N-Mathad-Southampton-ENG.html/ - https://www.researchgate.net/profile/Christoforos-Syrris-2 - https://apps.trac.jobs/documents?vdoc=9737127 (UHS Consultant Neurosurgeon, Pituitary and Skull Base, job pack, February 2026; not fetchable) - https://www.jobs.nhs.uk/candidate/jobadvert/C9188-25-0724 (UHS locum skull base neurosurgeon, 2025; not fetchable) - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-emad-shenouda - https://www.spirehealthcare.com/consultant-profiles/mr-emad-shenouda-c4767932/ - https://www.finder.bupa.co.uk/Consultant/view/79186/mr_emad_shenouda - https://www.doctify.com/uk/specialist/mr-emad-shenouda - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-diederik-bulters - https://www.phin.org.uk/profiles/consultants/mr-diederik-bulters-163821 - https://www.doctify.com/uk/specialist/mr-diederik-bulters-1 - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-andrew-durnford - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-rami-j-salib - https://www.southampton.ac.uk/people/5wzp6f/professor-rami-j-salib - https://www.spirehealthcare.com/consultant-profiles/professor-rami-j-salib-c4095370/ - https://www.doctify.com/uk/specialist/professor-rami-salib - https://www.uhs.nhs.uk/for-patients/find-your-consultant/mr-sebastien-thomas - https://www.spirehealthcare.com/spire-southampton-hospital/treatments/neurosurgery-and-neurology/meet-our-neurosurgeons/2/ - PubMed: Mathad N[Author]; Syrris C[Author]; Shenouda E[Author]; Bulters D[Author]; Durnford AJ[Author]; Salib RJ[Author]

Societies, registers, national - https://skullbase.co.uk/pages/council-members - https://www.gmc-uk.org/registration-and-licensing/the-medical-register - https://www.mpts-uk.org/hearings-and-decisions - https://www.ncaresearch.org.uk/news/national-chordoma-chondrosarcoma-skull-base-mdt/ - https://www.england.nhs.uk/commissioning/spec-services/highly-spec-services/pbt/ - https://pmc.ncbi.nlm.nih.gov/articles/PMC11347697/ (Glancz et al. 2024, national chordoma cohort) - https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1049627/full (CRANIAL)

Research thread 09 · source file em-research/09-surgeons.md · last edited 12 October 2026