Nigel Mendoza:Consultant Neurosurgeon

Postgraduate Diploma in Neurology
The National Hospital for Neurology and Neurosurgery

Clinical Surgery in General
The Royal College of Surgeons of England

Surgeons in Training Education Program
The Royal College of Surgeons of England

Demonstrator: Workshop on Cervical Spine Fixation
British Cervical Spine Society

Neurological Intensive Care Nursing Course
The National Hospital for Neurology and Neurosurgery

S.H.O Induction Course in A&E
Ealing Hospital and Central Middlesex Hospital

Undergraduate Teaching:

Lecturer North Thames Neurosurgical Teaching Programme
The National Hospital for Neurology & Neurosurgery (1997, 1998 & 1999)

Musculoskeletal Course
Charing Cross Hospital ( November 1999 & November 2000)

BSc Project Supervisor
Imperial College School of Medicine 2002

Clinical Neuroscience Induction Course
Charing Cross Hospital (October 2002)

Postgraduate Teaching:

Surgical Workshop and Prosection
Royal College of Surgeons of England
Faculty Member
(1998, 1999, 2000, 2001 & 2002)

Hospital Medical Staff
West Middlesex Hospital
Wexham Park Hospital

General Practitioners
Princess Margaret Hospital

Lecturer: Accident and Emergency SHO Induction Course
Central Middlesex Hospital

North West Thames Regional Training for Orthoptists
Charing Cross Hospital
(January 2000)

Imperial Spine 2000 Course
Hammersmith Hospital

Lecturer: Imperial College FRCS Course
Hammersmith Hospital

Regional ENT training programme
Chelsea and Westminster Hospital
(December 2000)

GP Update Day
Wexham Park Hospital
(January 2001)

Pituitary Foundation
Royal Surrey County Hospital
(March 2001)

Orthopaedic Core Curriculum
Charing Cross Hospital
(6th June 2001)

The Surgical Sixty Meeting - Acoustic Neuroma
Charing Cross Hospital
(May 2001)

Gordon Holmes Study Day
Charing Cross Hospital
(December 2001)

Windsor Othopaedic Lecture Day
Wellington College
(January 2002)

Pain and Nociception Group (PANG)
Charing Cross Hospital
(14th May 2002)

Skull Base Group Meeting - ( TGN + MVD )
National Hospital for Neurology & Neurosurgery
(June 2002)

Red Cross Surgical Meeting
Chelsea & Westminster Hospital
(October 2002)

Faculty Member: Approaches to Skull Base: 6
Royal College of Surgeons of England
(8th November 2002)

Calman SpR Training (Endocrine)
Charing Cross Hospital
(25th September 2003)

Temporal Bone Dissection Course (Management of Acoustic Neuroma)
St Mary’s Hospital
(14th October 2003)

Facial Pain Symposium
Royal College of Surgeons
(18 October 2003)

Imperial Spine 2001 Course
Hammersmith Hospital
(24th October 2003)

Windsor Othopaedic Lecture Day
Wellington College
2003

Windsor Orthopaedic Lecture Day
Wellington College
2004

Imperial Spine 2003 Course
Hammersmith Hospital

Imperial Spine 2004 Course
Hammersmith Hospital

Calman Training Day (Medical) – Post Fossa Haematoma
Charing Cross Hospital
(27th October 2004)

Temporal Bone Dissection Course (Management of Acoustic Neuroma)
St Mary’s Hospital
(17th November 2004)

Windsor Orthopaedic Lecture Day
Reading Football Club
(22nd November 2004)

Imperial Spine 2005 Course
Hammersmith Hospital

BUPA: Spine Surgery
(January 2005)

Consultant Orthodontist Group Symposium
Royal College of Physicians

Imperial Spine Course 2006
Hammersmith Hospital

Trigeminal Neuralgia
(February 2006)

Intracranial and Spinal Anatomy for Neurosurgeons - Arachnoid Cisterns
Royal College of Surgeons
(February 2006)

Endocrine Symposium (Pituitary Tumour Surgery)
Hammersmith Hospital
(December 2006)

Research Experience:

During this period I was involved with both the clinical and research applications of neuromonitoring in relation to preoperative assessment and intraoperative monitoring of patients.

Transcranial magnetic stimulation for the preoperative assessment of the central motor conduction time and motor evoked potential in patients with spinal pathology.
Transcranial electrical stimulation for the intraoperative monitoring of spinal surgery.
Intraoperative assessment of somatosensory evoked potentials in the treatment of middle cerebral artery aneurysms.
Intraoperative assessment of facial nerve function for acoustic neuromas and other lesions of the cerebello-pontine angle.

Specialist Courses:

November 1988	Advanced Trauma Life Support Course Royal Free Hospital
September 1992	International Cranio-Cervical “Hands On” Workshop University College, London
April 1994	International Cavernous Sinus and Cerebello-pontine angle: "Hands On" Workshop University College, London
April 1994	Midas Rex "Hands On" Workshop University College, London
February 1995	European Neuroendoscopy Workshop University of Nottingham
April 1995	S.W.A.P: Approaches to the thoracolumbar spine. Royal College of Surgeons, London
January 2000	Interview skills and equal opportunities training course. Imperial College of Science, Technology and Medicine
May 2000	Millenium Masterclass: Thoracic Spine: advances in treatment Royal College of Surgeons, London
February 2002	IDET Course: De Puy Acromed: Basel, Switzerland
August 2002	Gamma Knife Stereotactic Radiosurgery Training Course London (16th August 2002)
October 2002	Spinal Injury Repair Workshop: Institute of Neurology
December 2004	International Microneurosurgical Skull Base Dissection Course Palm Beach, Florida, United States of America

Neurosurgical Experience:

Since March 1989 I have participated in, and completed a recognised training programme at both registrar and senior registrar grade in Neurosurgery which has allowed me to obtain the Fellowship in Surgical Neurology conducted by the Intercollegiate Speciality Assessment Board on behalf of the Royal Colleges of Surgeons and the Certificate of Accreditation.

In addition to these aspects of training I have been involved with the day to day organisation of Neurosurgical units including the management of waiting lists, junior staff rotas, clinical meetings and medical audit. I have presented tutorials on the principles of general surgery and neurosurgery to medical students, medical and nursing staff on a regular basis. I have also attended meetings of the Society of British Neurological Surgeons, the British Cervical Spine Society, and the Senior Registrars' Travelling Club.

I have gained a wide experience of operative neurosurgical procedures in addition to which I have also been trained and taught by Neurosurgeons who have an interest in particular aspects of neurosurgery. This has included:

Surgery of the posterior fossa and skull base: I have seen different approaches to this area including a transphenoidal approach, the combined infra- and supratentorial approach, subtemporal approach and the extreme far lateral approach as well as the standard retrosigmoid craniectomy with exposure of the sigmoid sinus. The pathology treated has included acoustic neuromas, meningiomas, glomus tumours, chordomas and pituitary tumours.
Complex spinal surgery including transoral procedures and lesions of the cranio-cervical junction: I have experience of both anterior and posterior approaches to the vertebral column and different forms of spinal fixation for the treatment of congenital disorders such as Down's syndrome and osteogenesis imperfecta, and acquired disorders most commonly due to rheumatoid arthritis, cervical spondylosis and malignancy.

Aneurysm surgery: I have seen the treatment of both anterior and posterior circulation aneurysms including giant aneurysms using hypothermia and cardiac arrest as well as routine general anaesthesia.
Stereotaxy: I have performed tumour resection and biopsy using both the Leksell and CRW stereotactic frames and frameless stereotaxy.

I now have 11 years experience as an NHS Consultant Neurosurgeon working at the West London Neurosciences Unit at Charing Cross Hospital. I was Chief of Service for the previous 5 years. I have continued to consolidate my clinical practice developing specialist areas of surgical interest taking an active part in continuous personal development and continuing medical education. My particular areas of interest include spinal surgery, trigeminal neuralgia, pituitary tumours and skull base surgery.

Operative Experience:

Operation	Personal	As Assistant	Consultant Assisted
Chronic Subdural	74	3	6
Tumour Biopsy	36	5	4
External Ventricular Drain	38	5	2

Operation	Personal	As Assistant	Consultant Assisted
Extra/Subdural Haematoma	75	9	1
Malignant Tumours	71	49	7
Meningiomas	23	22	2
Aneurysms	53	71	12
Haematoma	26	5	3
Abscess/ Empyema	16	5	0

Operation	Personal	As Assistant	Consultant Assisted
Benign Tumour	10	43	4
Malignant Tumour	15	9	5

Operation	Personal	As Assistant	Consultant Assisted
Transphenoidal	10	16	4
Other	8	10	1

Operation	Personal	As Assistant	Consultant Assisted
Infants	27	5	3
Adults	97	14	2

Operation	Personal	As Assistant	Consultant Assisted
Cervical Spondylosis	85	22	4
Lumbar Surgery	76	69	20
Trauma / Fixation	28	16	6
AVM	2	8	1

Operation	Personal	As Assistant	Consultant Assisted
Extradural	22	24	2
Intradural	14	20	2
Transoral Procedure	5	10	3

Operation	Personal	As Assistant	Consultant Assisted
Biopsy	36	14	4

Operation	Personal	As Assistant	Consultant Assisted
CTD/ Ulnar Nerve	39	0	0
Cervical Rib	6	1	1

Publications:

Chapters:

Mendoza N.D, Bradford R, Middleton F. Spinal Injury. In: Neurological Rehabilitation.
Chapter 47: 545-560; Ed. Greenwood R.J, Barnes M.P, MCMillan T.M, Ward C.D. Churchill Livingstone, Edinburgh. 1993.

Mendoza N.D, Harkness W. The Spine: The Vertebral Column and Spinal Cord. In: Bailey and Love's Short Practice Of Surgery. Chapter 26:354-373; 22nd Edition. Ed. Mann C.V, Russell R.C.G,Williams N. Chapman and Hall Medical, London.1995.

Mendoza N.D, Crockard H.A. Anterior Transoral Procedures. In: An Atlas of Surgery of the Spine. Chapter 3: 55 - 69 Ed. An H.S, Riley L Martin Dunitz, London. 1998

Papers:

Beware the prolapsed disc. Mendoza N.D, Leherman O, Bradford R. British Journal of Hospital Medicine 1991: 46; 52.

Recurrent Craniopharyngioma in the posterior fossa. Tomita S, Mendoza N.D, Symon L. British Journal of Neurosurgery 1992: 6; 587-590.

Spontaneous Spinal Epidural Haematoma: A cautionary tale. Mendoza N.D, Lord G.M. Archives of Emergency Medicine 1993:10; 339-342.

Isolated Cervical nerve root injury successfully treated by operative decompression. Kitchen N, Mendoza N.D, Bradford R. Injury 1993: 24; 341-342.

An unusual complication of glomus jugulare tumour resection: a case report and review of the literature. Vowles R, Mendoza N.D, Cheeseman A, Symon L. Journal of Laryngology and Otology 194: 108; 776-778.

Glomus Jugulare Tumours: a review of 61 cases. Watkins L, Mendoza N.D, Cheeseman A.D, Symon L. Acta Neurochirugica 1994: 130; 66-70.

Trigeminal neuralgia treated by microvascular decompression: A long term follow-up study. Mendoza N.D, Illingworth R. British Journal of Neurosurgery 1995: 9; 13-19.

Posterior fossa arteriovenous malformations: Long term follow up and review of the literature. Tacconi L, Mendoza N.D, Symon L. British Journal of Nuerosurgery 1995: 9; 721-732.

Dysphagia and deformity following after odontoid fracture in the elderly. Ishaque M, Mendoza N.D, Crockard. Journal of Accident and Emergency Medicine. 1995: 12; 293-295

Magnetic resonance imaging – compatible posterior cervical implant for occiptocervical stabilization. Crockard H.A, Tammam A, Mendoza N.D. Journal of Neurosurgery 1998: 89; 852 – 856.

Motor evoked potential monitoring during spinal surgery: responses of distal limb muscles to transcranial cortical stimulation with pulse trains. Jones S J, Harrison R, Koh K, Mendoza N, Crockard A. Electroencephalography and clinical neurophysiology. 1996: 100; 375-383.

Late relapse of metastatic teratoma invading a vertebral body: a combined surgical approach. Elkabir J, Christmas T, Ellamushi H, Mendoza N. British Journal of Urology. 1997: 79; 999 - 1000.

Trigeminal neuralgia. Stacey R, Mendoza N. Neurology and Neurosurgery. 1997: 13; 87 - 90.

Loss of chromosome 10 is an independent prognostic factor in high – grade gliomas.. Balesaria S, Brock C, Bower M, Clark J, Nicholson SK, Lewis P, de Sanctis S, Evans H, Peterson D, Mendoza N, Glaser MG, Newlands ES, Fisher RA.

Pneumatic drill through the foramen magnum . McEvoy AW, Mendoza N. Journal of Neurol Neurosurg Psychiatry. 1998 65 (4); 511

Primary Non-Hodgkin's Lymphoma of the Cranial Vault Presenting with Unilateral Proptosis. Pardhanani K, Ashkan K, Mendoza N, Acta Neurochirugica 2000 142: 597 - 598

Cortisol Binding Globulin is important in the interpretation of the hypothalamic - pituitary - adrenal axis . Dhillo W, Kong W, Zadem J, Carter G, Mendoza N, Meeran K, O’Shea D . European Journal of Endocrinology 2002 146: 231 - 235

Collecting Duct Carcinoma of the Renal Medulla Presenting with paraplegia. Ockrim J, Rees H, Mendoza N, Christmas T.(In preperation)

Case report re Dysphagia and Cervico - medullary meningioma : BMJ ( Minerva ) April 2002

Expression, Subcellular localisation and phosphorylation statu of annexins 1 and 5 in Human pituitary adenomas and a growth hormone secreting carcinoma : Mulla A, Solito E, Mendoza N, Morris J, Christian H, Buckingham J. Submitted for publication : Journal of Clinical Endocrinology

The operative learning curve for Vestibular Schwannoma Surgery via the Retrosigmoid approach : Elsmore A, Mendoza N. British Journal of Neurosurgery 2002 ; 16: 448 – 455

Measurement of pulse pressure profiles in patients with Trigeminal Neuralgia : Turner C.L, Mendoza N , Illingworth R, Kirkpatrick P. Journal of Neurology, Neurosurgery and Pyschiatry. 2003 ; 74 : 533 0 535.

Posterior Fossa Meningioma presenting as hypnic headache. Peatfield R, Mendoza N. Headache. 2003; 43 : 1007 – 1008.

Haemangioblastoma : a rare cause of a cerebellar mass in the elderly. Gnanalingham K, Apostolopoulos V, Chopra I, Mendoza N, Peterson D. British Journal of Neurosurgery . 2003 ; 17 : 461 - 464

The time course of visual field recovery following transphenoidal surgery for pituitary adenomas: predictive factors for a good outcome.
Kanna K Gnanalingham, Sumon Bhattacharjee, Richard Pennington, James Ng, and Nigel Mendoza

Journal of Neurology, Neurosurgery and Psychiatry 2005; 76: 415 - 419
Back pain and disability following lumbar laminectomy – Is there a relationship to muscle retraction? Gorav Datta, Kanna K Gnanalingham, David Peterson, Nigel Mendoza , Kevin O’Neill, James Van Dellen, Alison McGregor, Sean PF Hughes Neurosurgery 2004 : 54 : 1413 – 1420

Intradural metastatic spinal cord compression from ACTH – secreting Pituitary Carcinoma. Case report and review of literature. Tysome J, Gnanalinghma KK, Chopra I, Mendoza N. Acta Neurochirugica ( in press ) 2004
Morganstein, D, Mendoza, N, Strickland, N, Meeran, K
Low TSH in a patient with primary hypothyroidism
J R Soc Med 2005 98: 417-418

Abstracts & Letters:

Management of patients with head injuries. Schieff C, Bradford R, Mendoza N.D. British Medical Journal 1990: 300; 1195.

Management of thoracolumbar spinal trauma with incomplete neurological injury. Mendoza N.D, Bradford R, Lehousky J. Journal of Neurology, Neurosurgery and Pyschiatry 1992: 55;82.

Manipulative therapy and physiotherapy for persistant back and neck complaints. Lehermann O.J, Mendoza N.D. British Medical Journal 1992: 304; 1309

Trigeminal neuralgia treated by microvascular decompression: A long term follow-up study.
Mendoza N.D, Illingworth R. Journal of Neurology, Neurosurgery and Psychiatry 1993: 56; 82

Pituitary Surgery for Cushing’s should be carried out by a specialised neurosurgeon. Collier K, Mendoza N, Barakat M, Todd J, Meeran K. Endocrine abstracts ( 2002 ) 4 : 49

Management of thoracolumbar trauma with incomplete neurological injury. Society of British Neurological Surgeons. London, April 1991.

Trigeminal neuralgia treated by microvascular decompression: A long term follow-up study. Society of British Neurological Surgeons. Hull, September 1992.

Intracranial complications of chronic otitis media. Royal Society of Medicine. London, December 1993.

Postoperative MRI in patients with titanium frame fixation. British Cervical Spine Society. Birmingham, November 1994.

Extended vertebrectomy and reconstruction for treatment of teratoma. Royal Society of Medicine, London, June 1996.

Intraoperative MEP to transcranial electrical stimuli. 6th International Symposium on Spinal Cord Monitoring. New York, USA. May 1995.

Arteriovenous malformations of the posterior fossa: A report on 28 cases. 10th European Congress of Neurosurgery. Berlin, May 1995.

Facial nerve preservation and function following surgery for Acoustic neuroma. Society of British Neurological Surgeons. Hanover, September 1996.

Facial nerve preservation and function following surgery for Acoustic neuroma. 3rd European Skull Base Congress. London, April 1997.

Reconstruction of the skull base. 3rd European Skull Base Congress. London, April 1997.

Neurocystosarcosis presenting in the United Kingdom: Management of a single enhancing lesion causing epilepsy. Society of British Neurological Surgeons, Cambridge, April 1997.

Facial nerve preservation and function following surgery for Acoustic Neuroma . Society of British Neurological Surgeons, Glasgow , April 2000.

Solitary infraorbital schwannoma arising from the supraorbital nerve. World Federation of Neurosurgeons, Australia, September 2001

Percutaneous retrogasserian glycerol rhizotomy for TGN. The experience of one surgeon. SBNS Middlesborough Sep 2002
Determining the causes of delayed surgical intervention for sciatica. SBNS Middlesborough Sep 2002

Returning summaries of emergency referrals improves accountability. SBNS Middlesborough Sep 2002

Quantative assesment of the time course of visual recovery following trasphenoidal surgery for pituitary adenomas : British Skull Base Meeting : London Dec 2002

Quantative assesment of the time course of visual recovery following trasphenoidal surgery for pituitary adenomas :
European Skull Base meeting : Barcelona March 2003

Pituitary case presentations : Clinicopathological conference on Pituitary disease : RCP London Feb 2004

Long term outcome following Microvascular decompression for Trigeminal Neuralgia : SBNS Manchester September 2004

Pituitary case presentations : Clinicopathological conference on Pituitary disease : RCP London Feb 2005

Pituitary case presentations : Clinicopathological conference on Pituitary disease : RCP London Feb 2006

Imperial College Medical School :

An audit of the diagnosis, treatment and surgical outcome of patients with pituitary tumours : Kathleen Collier

Management of aneurysmal subarachnoid haemorrhage at Charing Cross Hospital and consequent effects upon patient outcome : The impact of ISAT : Katharine Fraser

Predictive factors for surgical outcome following microdiscectomy for sciatica : David Deman

Clinical Service Developments:

Management and Proffessional Activities:

Trust:

February 1999 – April 2006	Chief of Neurosurgery
1999 – 2000	Directorate lead clinician for Clinical Risk Management
1999 – 2000	Clinical Risk Management Committee: Committee member
January/February 1998	Critical Care Users Working Group Committee
1999 – 2000	Private Patients Development Steering Group
January 2000	Steering Group Committee Member: CXH Operating Department Outline Business Case Steering Group
2000	Theatre Redevelopment Project: Member of Local Steering Group
2000	NHS Clinical Governance Support Team: Trust Representative
October 2000	Consultant Appraisal Workshop: Hammersmith Hospital
January 2001	Steering Group: Trauma centre and management of multiple injuries
18th April 2001	Representative for Clinical Director meeting to assess the 1st year of Appraisal
16th May 2001	Critical Care Users Group: Committee member
June 2001	Shortlisting panel member for LAT in Neurosurgery
December 2001	Member: Theatre Board HHNT
January 2001 - March 2002	Assessor for Consultant Appraisal
November 2002	Critical care providers group: Member committee
June 2003	Strategic development meeting: Neurosciences
26th February 2004	Steering group meeting: NCEPOD
2006	Directorate Lead for NICE Guidelines
2006	Neurosurgery representative for Clinical Risk in Directorate of Neuroscience

Regional Level:

National Level:

October 2000	Neurosurgical advisor to Clinical Risk Incident Investigation: Ealing Hospital
21st March 2001	Panel member for Step 2 appeal against a RITA for a neurosurgical trainee: NHSE, Millman Street, London Faculty member: Neurological Anatomy for Neurosurgeons at Hill Surgical Workshop: Royal College of Surgeons of England
2003 / 2004	Faculty member: Skull Base Surgery for Neurosurgeons at Hill Surgical Workshop: Royal College of Surgeons of England. Member of Spontaneous Intracerebral Haemorrhage Group: This meets four times a year, for a full day meeting, advising relevant groups on the advisability and feasibility of relevant research in this area. Medical advisor to British Acoustic Neuroma Association Member of Pituitary Foundation
Autumn 2001	Member of Trigeminal Neuralgia Association (UK) Medical Advisory Board
July 2002	Assessed abstracts for SBNS meeting 2002 in Middlesborough
June 2003	Lecture to Annual General meeting of Trigeminal Neuralgia Association: Surgery for TDN: London Lecture to Annual General Meeting of British Acoustic Neuroma Association
March 2004	Lecture to ATLA (Association of teachers of lip reading): RNIB: London
26th June 2004	AGM TNA: Focus group patient discussion: London
March 2005	Advisor to NICE: Request for Specialist Advice for Intracranial pressure monitoring (288)
22nd March 2006	Lecture to TNA Local West London Patient Group – Charing Cross Hospital
26th November 2006	Lecture to patients – London branch of BANA: Charing Cross Hospital

Continuing Proffessional Development:

Audit:

1. Theatre instrument failure : 2001, 2002, 2003
2. Delayed discharge : 2002
3. Outpatient satisfaction : 2003

Educational Meetings:

Courses Attended:

Clinical Governance:

Meetings Attended:

June 2003	‘Safe Neurosurgery 2003’ Conference: RCS, London
April 2004	SBNS: Oxford
September 2004	SBNS: Manchester
January 2006	BRITISH SKULL BASE MEETING: Bristol
February 2005	Clinico-pathological conference on Pituitary disease: RCP London
March 2006	Clinico-pathological conference on Pituitary disease: RCP London
March 2006	European Basic Instrumentation Course in Spine Surgery – (Zimmer) Windsor
7th April 2006	SBNS: Royal Free Hospital: RCS of England, London
January 2007	British Skull Base Meeting; Birmingham

Education:

Degrees and Diplomas:

Academic Awards:

Memberships:

Current Appointments:

Previous Appointments:

Teaching Experience:

Undergraduate Teaching:

Postgraduate Teaching:

Research Experience:

Specialist Courses:

Neurosurgical Experience:

Operative Experience:

Publications:

Chapters:

Papers:

Abstracts & Letters:

Imperial College Medical School :

Clinical Service Developments:

Management and Proffessional Activities:

Trust:

Regional Level:

National Level:

Continuing Proffessional Development:

Audit:

Educational Meetings:

Courses Attended:

Clinical Governance:

Meetings Attended: