Mount Sinai · New York City · NIH-funded research

Specialized care
for the sinuses
and skull base.

Director of Endoscopic Skull Base Surgery at Mount Sinai. Endoscopic, image-guided sinus and skull base surgery — informed by ~100 peer-reviewed publications, two dedicated in-office surgical suites, and pioneering work on augmented reality and AI in the operating room.

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"Patients deserve a surgeon who treats every operation as both a clinical and a research question." — A.I.

What I treat

Conditions & Procedures

From recurrent sinus infections that have not responded to medical therapy, to benign and malignant tumors at the base of the skull — care is delivered through the nose whenever possible, sparing facial incisions and shortening recovery.

Chronic Rhinosinusitis

Image-guided functional endoscopic sinus surgery (FESS), balloon sinuplasty, and biologic therapy for refractory disease. Read more →

ii.

Nasal Polyposis

Comprehensive medical and surgical management, including evaluation for biologic therapy in eosinophilic disease.

iii.

Pituitary & Anterior Skull Base Tumors

Endoscopic endonasal resection in collaboration with neurosurgical colleagues — pituitary adenomas, meningiomas, craniopharyngiomas.

iv.

CSF Leaks & Encephaloceles

Endoscopic repair of spontaneous and traumatic cerebrospinal fluid leaks with multilayered reconstruction. Read more →

Sinonasal & Orbital Tumors

Inverted papilloma, esthesioneuroblastoma, orbital tumors, and other malignancies of the nasal cavity and paranasal sinuses.

vi.

Loss of Smell & Taste

Workup of olfactory dysfunction with active research on neuroplasticity of the olfactory epithelium and post-COVID anosmia. Read more →

Also seen in clinic Nasal obstruction & deviated septum · Allergic rhinitis & nasal allergies

Technology & innovation

Where surgery happens.

For many patients, complex sinus and skull base care doesn't have to mean a hospital. Two dedicated in-office surgical suites — outfitted with the same precision technology used in the OR — make care faster, calmer, and often more affordable. For the cases that do belong in the hospital, we bring advanced imaging, augmented reality, and AI to the table.

Dr. Alfred Iloreta and surgical team performing endoscopic sinus and skull base surgery in the operating room at Mount Sinai — In the OR — endoscopic skull base resection at Mount Sinai. Image-guided navigation, 4K endoscopy, and shared visualization, in real time.

In-office surgical suites.

Two dedicated rooms, hospital-grade equipment, no hospital booking — many patients leave the same morning.

a.

Image-guided navigation Precision

Real-time 3D positioning during sinus and skull base work — the same navigation used in the hospital OR.
b.

4K endoscopic visualization Clarity

Magnification beyond what the human eye can see, so even subtle anatomy is treated precisely.
c.

Neptune fluid management Clean field

Professional-grade suction system keeps the surgical field clear and the room sterile.
d.

Pronox® analgesia No IV

Patient-administered nitrous oxide — comfortable, fast on, fast off. No general anesthesia required for most in-office cases.

Innovation in the operating room.

For complex skull base cases, my work in artificial intelligence and mixed reality goes from publication to operating room.

a.

Mixed reality with HoloLens AR overlay

Holographic mapping of the internal carotid artery, cranial nerves, and tumor boundaries — overlaid on the live operative field during endoscopic skull base surgery.
b.

Shared OR display (Surgical Theater) Team-based

Otolaryngology, Neurosurgery, OMFS, and Microvascular Reconstruction reference the same real-time anatomy on a unified display — eliminating verbal handoff confusion at critical moments.
c.

5-ALA / Gleolan® fluorescence First-in-field

First-in-field clinical study of systemic 5-aminolevulinic acid for head & neck squamous cell carcinoma — 5 of 6 patients with robust intraoperative tumor fluorescence at the margin.
d.

Raman spectroscopy Sci. Reports 2025

Label-free real-time tissue chemistry — H&E-equivalent margin imaging in seconds versus 20–30 minutes for frozen section.

How I work with you

Options, not orders.

Every patient who walks in has different priorities — recovery time, anesthesia tolerance, willingness to try medical management first. My job is to lay out every reasonable path and help you choose the one that's right for your life. Surgery is offered when it's the right answer — never as the default.

Listen first.

Every visit starts with the time to actually understand what's wrong — symptoms, history, what you've already tried. Most diagnoses come from the conversation, not the scan.

ii.

Present the options.

Medical, surgical, in-office, hospital OR — every reasonable path is laid out with the trade-offs. You leave understanding what's available, not feeling rushed to a decision.

iii.

Use the least invasive technique.

Endoscopic, image-guided, through the natural openings of the nose — no facial incisions, faster recovery. When appropriate, performed in-office to skip the hospital entirely.

iv.

Stay with you after surgery.

Clear post-op instructions, recovery support, and direct access. The operation is one part — the rest is making sure your healing goes smoothly.

The team

Who you'll actually see.

Specialty care is a team effort — and the team you meet matters as much as the surgeon. Every visit, before and after surgery, is supported by clinical and research staff who know your case and follow you closely.

[ Photo of Yaniz ]

Care team

Yaniz Melendez

[ Role / title ]

[ Brief bio — 1-2 sentences on Yaniz's role with patients, training, and what they handle in the practice. ]

[ Photo of Alex ]

Care team

Alex Ferrera

[ Role / title ]

[ Brief bio — 1-2 sentences on Alex's role and what they handle. ]

Studio portrait of Dr. Alfred Iloreta in Icahn School of Medicine at Mount Sinai white coat — Co-Director of Endoscopic Skull Base Surgery

About

A surgeon, scientist, and innovator at Mount Sinai.

Dr. Alfred Iloreta is Co-Director of Endoscopic Skull Base Surgery at Mount Sinai Health System and Director of Rhinology and Skull Base Research. He holds a triple Assistant Professor appointment at the Icahn School of Medicine at Mount Sinai — in Otolaryngology, Neurosurgery, and Artificial Intelligence & Emerging Technology. His clinical focus is endoscopic and open surgery for paranasal sinus and skull base tumors, orbital tumors, and CSF leaks, alongside advanced therapies for inflammatory sinus disease.

As an investigator, he leads research on neurostimulation for pain and stroke, intraoperative tumor fluorescence, and the neuroplasticity of the olfactory epithelium. He is co-founder of Pharyvac Surgical Technology and a clinical collaborator at Sinai Biodesign, the institution's biotech accelerator.

Training

Fellowship · Rhinology & Endoscopic Skull Base Surgery, Thomas Jefferson
Residency · Otolaryngology HNS, Mount Sinai
MD · University of Kansas
MS · Physiology & Biophysics, Georgetown

Recognition

Super Doctors NY Metro
NIH R41 PI Award (2024)
NSF iCorps Award (2024)
Mount Sinai Teacher of the Year (2×)
NASBS Research Grant

Mentorship & education

Training the next generation of surgeons and scientists.

Within Mount Sinai's training pipeline, my teaching focuses on chief residents and fellows — trainees at the most advanced, formative stage of their careers, when surgical judgment and philosophy are being set. Mentorship is the second half of the academic mission.

Clinical fellows

Trained in Rhinology & Endoscopic Skull Base Surgery — now practicing across the country.

Research fellows

Year-long appointments contributing to the lab's publication pipeline and the methodological habits of surgeon-scientists.

Biodesign

Sinai accelerator

Working with engineers and entrepreneurs in Mount Sinai's biotech accelerator on early-stage surgical device innovation.

Chiefs &
Fellows

Primary teaching focus

Most advanced stage of training — where judgment and surgical philosophy are formed, not technique alone.

Two-time recipient of the Mount Sinai Department of Otolaryngology Head and Neck Surgery Teacher of the Year Award (2019, plus prior Resident Teacher of the Year, 2012–2013).

Research & Innovation

An active investigator — pushing the field forward.

Active clinical and translational research in surgical innovation. ~100 peer-reviewed publications, primary investigator on 20+ investigator-initiated clinical trials, multiple industry-sponsored studies, and the Director of Research for the Division of Rhinology & Endoscopic Skull Base Surgery at Mount Sinai.

Mixed reality in surgery

HoloLens overlay of carotid, cranial nerves, and tumor margins during skull base resection.

5-ALA fluorescence-guided surgery

First-in-field HNSCC clinical study using systemic Gleolan®.

Raman + Surgical Intelligence

Label-free real-time margin imaging (Sci. Reports 2025); AI applied to operative data.

Neurostimulation & devices

Patent-pending neuromodulation system; Pharyvac surgical aspirator (USPTO 63/037,930).

Selected cases

Recent multi-disciplinary skull base resections.

Two representative infratemporal fossa cases coordinated across Mount Sinai's skull base team — both leveraging mixed reality, image-guided navigation, and shared visualization.

Case 01 · ITF · cavernous sinus extension

86-year-old female · progressive visual loss

Expansile ITF mass with cavernous sinus extension; lateral skull base access required. Multi-team approach planned in a shared 3D digital twin pre-operatively — every surgeon entered the OR with the same spatial model.

Outcome. Gross total resection. Internal carotid artery preserved. Negative frozen-section margins. HoloLens holographic ICA overlay maintained spatial awareness throughout dissection.

Case 02 · 4-team coordination

34-year-old male · osteosarcoma

Bilateral nasal cavity, orbit, maxilla, ITF, and middle cranial fossa involvement. Coordinated approach across Rhinology, Neurosurgery, OMFS, and Microvascular Reconstruction.

Outcome. R0 negative-margin resection. Orbit preserved. No vascular injury. Mixed reality and 3D modeling enabled a morbidity-minimizing transmaxillary corridor that avoided mandibular osteotomy and parotid translocation.

Selected lectures

Speaking on the future of surgery.

Invited lectures on Surgical Intelligence, mixed reality in skull base surgery, and fluorescence-guided oncology.

Dr. Alfred Iloreta on stage during a keynote panel on mixed reality and augmented reality in skull base surgery — On stage — keynote panel on mixed reality and augmented reality in surgery, with intraoperative AR footage projected behind.

Surgical Intelligence

Surgical Intelligence: The Future or An Oxymoron

A foundational framework for using AI, computer vision, and neural networks to connect patient data, surgical methodology, and outcomes.

Video coming soon

5-ALA · Fluorescence

5-ALA Fluorescence-Guided Surgery for Skull Base Tumor Margins

First-in-field clinical study of systemic 5-aminolevulinic acid for HNSCC — five of six patients with robust intraoperative tumor fluorescence at the margin.

Video coming soon

Augmented reality · VMED 2022

Use of Augmented Reality in Skull Base Surgery

Talk delivered at Virtual Medicine 2022 — practical experience overlaying carotid, cranial nerves, and tumor boundaries onto the live operative field during endoscopic skull base resection.

Watch on YouTube →

Additional lecture videos forthcoming.

Specialized carefor the sinusesand skull base.

Conditions & Procedures

Chronic Rhinosinusitis

Nasal Polyposis

Pituitary & Anterior Skull Base Tumors

CSF Leaks & Encephaloceles

Sinonasal & Orbital Tumors

Loss of Smell & Taste

Where surgery happens.

In-office surgical suites.

Image-guided navigation Precision

4K endoscopic visualization Clarity

Neptune fluid management Clean field

Pronox® analgesia No IV

Innovation in the operating room.

Mixed reality with HoloLens AR overlay

Shared OR display (Surgical Theater) Team-based

5-ALA / Gleolan® fluorescence First-in-field

Raman spectroscopy Sci. Reports 2025

Options, not orders.

Listen first.

Present the options.

Use the least invasive technique.

Stay with you after surgery.

Who you'll actually see.

Yaniz Melendez

Alex Ferrera

A surgeon, scientist, and innovator at Mount Sinai.

Training the next generation of surgeons and scientists.

An active investigator — pushing the field forward.

Mixed reality in surgery

5-ALA fluorescence-guided surgery

Raman + Surgical Intelligence

Neurostimulation & devices

Recent multi-disciplinary skull base resections.

86-year-old female · progressive visual loss

34-year-old male · osteosarcoma

Technique in motion.

Pure Endoscopic Resection of a Pediatric Nasal Dermoid Tumor

Juvenile Nasopharyngeal Angiofibroma — Endoscopic Resection

JNA — Postoperative Endoscopic View

SonoPet Ultrasonic Resection — Piriform Aperture

Press & selected media.

Pharyvac — surgical device innovation from Mount Sinai Biodesign

Using 5-ALA fluorescence to resect head and neck tumors

Southampton man receives pioneering brain tumor surgery

How virtual and augmented reality are transforming the operating room

Doctor shares tips for managing allergies in the city

How to differentiate between seasonal allergies and coronavirus

Speaking on the future of surgery.

Surgical Intelligence: The Future or An Oxymoron

5-ALA Fluorescence-Guided Surgery for Skull Base Tumor Margins

Use of Augmented Reality in Skull Base Surgery

For colleagues and curious researchers.

Faculty profile

Publications

Citation index

Research network

Professional

Physician network

Recognition

Patient reviews

Considering a second opinion or a new approach to a stubborn problem? Let's talk.

Specialized care
for the sinuses
and skull base.