Dr Axel Sahovaler : University College London Hospitals NHS Foundation Trust

Professional background

Dr Axel Sahovaler is a head and neck surgeon who subspecialises in treating complex head and neck malignancies including microvascular facial reconstruction. He also has a special interest in minimally invasive salivary gland surgery and management of facial paralysis.

Dr Sahovaler completed his undergraduate training and residency in Buenos Aires, Argentina. This was followed by a three-year head and neck surgery fellowship at the busiest referral centre in the country, which provided training in endocrine surgery and extensive experience in treating an array of complex head and neck cancer patients. His educational experience was broadened by time spent at Harvard-affiliated Massachusetts Eye and Ear Hospital, New York University Langone Health, University of Brescia in Italy and the Sydney Head and Neck Cancer Institute in Australia.

Subsequently, he consolidated his training with a formal 18-month fellowship in Advanced Head and Neck Oncology & Reconstructive Microvascular Surgery at Western University Canada, which included facial nerve reanimation and robotic surgery. Then, with a second formal Fellowship at the University of Toronto, where he spent two years. The Toronto Head and Neck unit is world renowned, and affiliated to the American Head and Neck Society (AHNS). During this appointment he had the opportunity to join cutting edge translational research at the Guided Therapeutics (GTx) Laboratory.

Academically, Dr Sahovaler has participated in the following research grants:

First-in-Human Porphysome Nanotechnology for Precision Tumor Ablation and Surgical Guidance. The Agnico Eagle Beyond Chemotherapy Grand Challenge. $500,000 CAD. PIs: A Oza, J Irish, B Wilson.
First-in-Human Porphysome Nanotechnology for Precision Tumour Ablation and Surgical Guidance, OICR Clinical Acceleration Team Awards. Ontario Institute for Cancer Research. $1,130,803 CAD PI: G Zhang.
Pre-CTA/protocol design for the first-in-human porphysome clinical trial. Princess Margaret Research Stimulus Grant. $75,000.00 CAD PI: G Zhang.
Princess Margaret Cancer Foundation. Grant: Surgical Oncology Innovations in Translational and Basic Science Research. Title: "Assessment and translation of nanoparticle mediated photo-therapy in spontaneously occurring head and neck tumours in a clinical veterinary population". PI: Jonathan Irish MD.
Princess Margaret Cancer Centre Catalyst Grants/Invest in Research Grants. "Nanotechnology-enabled photodynamic therapy in translational veterinary models: treatment parameter optimization for in-human studies". PI: Jonathan Irish MD.
Canadian Institutes of Health Research - CIHR project Grant. "Nanoparticle mediated fluorescence imaging and photodynamic therapy in veterinary animals with spontaneous oral cavity carcinomas". PI: Jonathan Irish MD.
Nanoparticle enabled photodynamic therapy and fluorescence guided surgery for treatment of oral cavity cancer. Canadian Cancer Society Challenge Grant. Co-PI: Zheng Co-applicants/collaborators: M Oblak, R Foster, B Wilson, N Muhanna, R Weersink. $401,700 (CAD) PI: J Irish.

He has 40 peer-reviewed PubMed-indexed publications covering clinical outcomes research, reconstruction, navigation, thyroid surgery among others. He is actively involved in international head and neck cancer meetings presenting in numerous occasions.

Dr Sahovaler joined the UCLH head and neck department in December 2022. This is one of the busiest oncology units in London, and he has quickly formed an integrated team to manage head and neck advanced diseases using techniques learnt during his international experiences. He is also active in teaching as the head and neck surgery fellowship coordinator, and continues to be actively involved in research.

Specialties

Head and Neck Centre

Research interests

Sentinel Node Biopsy, Clinical outcomes research, introduction of augmented reality/surgical navigation to surgery, photodynamic therapy applications.

Languages spoken

Italian, Spanish

Publications

Ultrasound-guided wire localisation: a GPS for hidden head and neck tumours? A case series. Laxague F, Gualtieri T, Brahm G, Yoo J, MacNeil SD, Fung K, Mendez A, Sahovaler A, Nichols AC. Acta Otorhinolaryngol Ital. 2023 Jul 28. doi: 10.14639/0392-100X-N2280. Online ahead of print.PMID: 37519136

The impact of surgical resection margins on outcomes for adults with head and neck osteosarcomas: A Canadian sarcoma research and Clinical Collaboration (CanSaRCC) study. Tzelnick S, Soroka HP, Tasnim N, Gilbert RW, Irish JC, Goldstein DP, Brown D, Gullane P, Chepeha DB, Yao CMKL, Sahovaler A, Witterick IJ, Monteiro E, Davies J, Huang SH, O'Sullivan B, Hahn E, Hosni A, Razak AA, Gupta AA, de Almeida JR. Oral Oncol. 2023 Jul 19;145:106495. doi: 10.1016/j.oraloncology.2023.106495. Online ahead of print.PMID: 37478572

The Ansa Hypoglossi: Quantifying Axonal Density of a Donor Nerve for Facial Reinnervation. Sahovaler A, Laxague F, Fnais N, Tran C, Wehrli B, Matic D, Nichols A, Mendez A, Gill R, Yoo J. Facial Plast Surg Aesthet Med. 2023 May 16. doi: 10.1089/fpsam.2022.0405. Online ahead of print.PMID: 37192498

Skull-Base Surgery -A Narrative Review on Current Approaches and Future Developments in Surgical Navigation. Tzelnick S, Rampinelli V, Sahovaler A, Franz L, Chan HHL, Daly MJ, Irish JC.J Clin Med. 2023 Apr 4;12(7):2706. doi: 10.3390/jcm12072706.PMID: 37048788

Cigarette smoking cessation, duration of smoking abstinence, and head and neck squamous cell carcinoma prognosis. Lee JJW, Kunaratnam V, Kim CJH, Pienkowski M, Hueniken K, Sahovaler A, Lam ACL, Davies JC, Brown CM, De Almeida JR, Huang SH, Waldron JN, Spreafico A, Hung RJ, Xu W, Goldstein DP, Liu G. Cancer. 2023 Mar 15;129(6):867-877. doi: 10.1002/cncr.34620. Epub 2023 Jan 18.PMID: 36653915

Automatic Registration and Error Color Maps to Improve Accuracy for Navigated Bone Tumor Surgery Using Intraoperative Cone-Beam CT. Sahovaler A, Daly MJ, Chan HHL, Nayak P, Tzelnick S, Arkhangorodsky M, Qiu J, Weersink R, Irish JC, Ferguson P, Wunder JS. JB JS Open Access. 2022 May 5;7(2):e21.00140. doi: 10.2106/JBJS.OA.21.00140. eCollection 2022 Apr-Jun.PMID: 35540727

Transoral robotic surgery for the identification of unknown primary head and neck squamous cell carcinomas: Its effect on the wait and the weight. Alzahrani F, Sahovaler A, Mundi N, Rammal A, Fnais N, MacNeil SD, Mendez A, Yoo J, Fung K, Laxague F, Warner A, Palma DA, Nichols A. Head Neck. 2022 May;44(5):1206-1212. doi: 10.1002/hed.27023. Epub 2022 Feb 27.PMID: 35224796

Projected cutting guides using an augmented reality system to improve surgical margins in maxillectomies: A preclinical study. Sahovaler A, H L Chan H, Daly MJ, Ferrari M, Franz L, Gualtieri T, Tzelnick S, Eu D, Manojlovic-Kolarski M, Berania I, Orzell S, de Almeida JR, Goldstein DP, Nicolai P, Gilbert RW, Irish JC. Oral Oncol. 2022 Apr;127:105775. doi: 10.1016/j.oraloncology.2022.105775. Epub 2022 Feb 21.PMID: 35203002

Variations of the thoracodorsal axis: application for scapular tip free flap harvesting. Sahovaler A, Low H, Laxague F, Chung EJ, Fung K, Mac Neil SD, Nichols AC, Yoo J.Oral Maxillofac Surg. 2022 Dec;26(4):619-623. doi: 10.1007/s10006-021-01037-8. Epub 2022 Jan 4.PMID: 34982293

Contralateral nodal failures in oropharyngeal cancers after TORS and unilateral neck management: a retrospective study. Sahovaler A, Lee JJW, Xu W, Su S, Hosni A, Bayley A, Goldstein DP, de Almeida JR. J Otolaryngol Head Neck Surg. 2021 Dec 23;50(1):71. doi: 10.1186/s40463-021-00551-9.PMID: 34949220

Development of a cadaveric head and neck cancer model and three-dimensional analysis of margins in surgical navigation-aided ablations. Ferrari M, Taboni S, Carobbio ALC, Buffoli B, Rampinelli V, Mattavelli D, Schreiber A, Verzeletti V, Ravanelli M, Daly MJ, Chan HHL, Sahovaler A, Franz L, Gualtieri T, Rezzani R, Maroldi R, Signoroni A, Deganello A, Irish JC, Nicolai P. Eur J Surg Oncol. 2022 Jun;48(6):1235-1242. doi: 10.1016/j.ejso.2021.12.012. Epub 2021 Dec 11.PMID: 34916084

Navigation-Guided Transnasal Endoscopic Delineation of the Posterior Margin for Maxillary Sinus Cancers: A Preclinical Study. Taboni S, Ferrari M, Daly MJ, Chan HHL, Eu D, Gualtieri T, Jethwa AR, Sahovaler A, Sewell A, Hasan W, Berania I, Qiu J, de Almeida J, Nicolai P, Gilbert RW, Irish JC. Front Oncol. 2021 Nov 11;11:747227. doi: 10.3389/fonc.2021.747227. eCollection 2021.PMID: 34858824

Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study. Sahovaler A, Chan HHL, Gualtieri T, Daly M, Ferrari M, Vannelli C, Eu D, Manojlovic-Kolarski M, Orzell S, Taboni S, de Almeida JR, Goldstein DP, Deganello A, Nicolai P, Gilbert RW, Irish JC. Front Oncol. 2021 Nov 1;11:723509. doi: 10.3389/fonc.2021.723509. eCollection 2021.PMID: 34790568

Applications of intraoperative angiography in head and neck reconstruction. Sahovaler A, Gualtieri T, Lee JJW, Eskander A, Deutsch K, Rashid S, Orsini M, Deganello A, Davies J, Enepekides D, Higgins K. Acta Otorhinolaryngol Ital. 2021 Jun;41(3):215-220. doi: 10.14639/0392-100X-N1161.PMID: 34264914

Rapid standardized operating rooms (RAPSTOR) in thyroid and parathyroid surgery. Ernst H, Sowerby L, Sahovaler A, Macneil D, Nichols A, Yoo J, Hilsden R, Strychowsky J, Fung K. J Otolaryngol Head Neck Surg. 2021 Jul 8;50(1):44. doi: 10.1186/s40463-021-00525-x.PMID: 34238389

A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study. Sahovaler A, Eskander A, Shin J, Deutsch K, Crowson M, Goyal N, Witsell DL, Schulz K, Gross ND, Weber R, Khariwala SS, Cohen S, CyrLee DW, Mehta V.BMC Oral Health. 2021 May 17;21(1):270. doi: 10.1186/s12903-021-01616-x.PMID: 34001080

Investigating the Sources of Heterogeneity in Systematic Review of Recurrence Rate after Hemithyroidectomy for Low-Risk Well-Differentiated Thyroid Cancer. Sahovaler A, Ferrari M, Athayde J, Mendez A, Fung K, Yoo J, Nichols AC, MacNeil SD. Eur Thyroid J. 2021 Apr;10(2):179-182. doi: 10.1159/000511870. Epub 2020 Nov 25.PMID: 33981623

Importance of Margins, Radiotherapy, and Systemic Therapy in Mucosal Melanoma of the Head and Neck. Sahovaler A, Ziai H, Cardemil F, Huang SH, Su J, Goldstein DP, Gilbert R, Hosni A, Hope A, Waldron J, Spreafico A, Monteiro E, Witterick I, Irish J, Gullane P, Xu W, O'Sullivan B, de Almeida JR. Laryngoscope. 2021 Oct;131(10):2269-2276. doi: 10.1002/lary.29555. Epub 2021 Apr 15.PMID: 33856051

Objective evaluation of orbito-zygomatic reconstruction with scapular tip free flaps to restore facial projection and orbital volume. Sahovaler A, Chan HHL, Ferrari M, Gualtieri T, Zhang C, Taboni S, Irish JC, Gilbert RW. Oral Oncol. 2021 Jun;117:105268. doi: 10.1016/j.oraloncology.2021.105268. Epub 2021 Apr 10.PMID: 33848724

Head and neck cancer patients declining curative treatment: a case series and literature review. Sahovaler A, Gualtieri T, Palma D, Fung K, MacNeil SD, Yoo J, Nichols A. Acta Otorhinolaryngol Ital. 2021 Feb;41(1):18-23. doi: 10.14639/0392-100X-N1099.PMID: 33746218

Association of the Implementation of a Standardized Thyroid Ultrasonography Reporting Program With Documentation of Nodule Characteristics. Hamour AF, Yang W, Lee JJW, Wu V, Ziai H, Singh P, Eskander A, Sahovaler A, Higgins K, Witterick IJ, Vescan A, Freeman J, de Almeida JR, Goldstein D, Gilbert R, Chepeha D, Irish J, Enepekides D, Monteiro E. JAMA Otolaryngol Head Neck Surg. 2021 Apr 1;147(4):343-349. doi: 10.1001/jamaoto.2020.5233.PMID: 33570552

Comparing Contour Restoration of Mandibular Body Defects With Fibula, Iliac Crest, and Scapular Tip Flaps: A Conformance Virtual Study. Sahovaler A, Ferrari M, Chan H, Ziai H, Gilbert R, Irish J. J Oral Maxillofac Surg. 2021 Jun;79(6):1345-1354. doi: 10.1016/j.joms.2020.12.031. Epub 2020 Dec 29.PMID: 33508237

Temporal Artery Posterior Auricular Skin Free Flap for Secondary Oral Cavity Reconstruction. Sahovaler A, Berania I, Ferrari M, Ziai H, Jethwa A, Goldstein DP, de Almeida JR, Gilbert R. Laryngoscope. 2021 Jun;131(6):1297-1300. doi: 10.1002/lary.29250. Epub 2020 Dec 15.PMID: 33320348

Delay in diagnosis of patients with head-and-neck cancer in Canada: impact of patient and provider delay. Kassirian S, Dzioba A, Hamel S, Patel K, Sahovaler A, Palma DA, Read N, Venkatesan V, Nichols AC, Yoo J, Fung K, Mendez A, MacNeil SD. Curr Oncol. 2020 Oct;27(5):e467-e477. doi: 10.3747/co.27.6547. Epub 2020 Oct 1.PMID: 33173386

Survival Outcomes in Human Papillomavirus-Associated Nonoropharyngeal Squamous Cell Carcinomas: A Systematic Review and Meta-analysis. Sahovaler A, Kim MH, Mendez A, Palma D, Fung K, Yoo J, Nichols AC, MacNeil SD.JAMA Otolaryngol Head Neck Surg. 2020 Dec 1;146(12):1158-1166. doi: 10.1001/jamaoto.2020.3382.PMID: 33057610

Scapular tip-thoracodorsal artery perforator free flap for total/subtotal glossectomy defects: Case series and conformance study. Ferrari M, Sahovaler A, Chan HHL, Nicolai P, Irish JC, Gilbert RW. Oral Oncol. 2020 Jun;105:104660. doi: 10.1016/j.oraloncology.2020.104660. Epub 2020 Mar 31.PMID: 32240930

Genomic and human papillomavirus profiling of an oral cancer cohort identifies TP53 as a predictor of overall survival. Mundi N, Prokopec SD, Ghasemi F, Warner A, Patel K, MacNeil D, Howlett C, Stecho W, Plantinga P, Pinto N, Ruicci KM, Khan MI, Han MW, Yoo J, Fung K, Sahovaler A, Palma DA, Winquist E, Mymryk JS, Barrett JW, Boutros PC, Nichols AC. Cancers Head Neck. 2019 Dec 5;4:5. doi: 10.1186/s41199-019-0045-0. eCollection 2019.PMID: 31844556

Navigation-guided osteotomies improve margin delineation in tumors involving the sinonasal area: A preclinical study. Ferrari M, Daly MJ, Douglas CM, Chan HHL, Qiu J, Deganello A, Taboni S, Thomas CM, Sahovaler A, Jethwa AR, Hasan W, Nicolai P, Gilbert RW, Irish JC. Oral Oncol. 2019 Dec;99:104463. doi: 10.1016/j.oraloncology.2019.104463. Epub 2019 Nov 1.PMID: 31683173

Utility of clinical features with fine needle aspiration biopsy for diagnosis of Warthin tumor. So T, Sahovaler A, Nichols A, Fung K, Yoo J, Weir MM, MacNeil SD. J Otolaryngol Head Neck Surg. 2019 Aug 29;48(1):41. doi: 10.1186/s40463-019-0366-3.PMID: 31464652

Outcomes of Cutaneous Squamous Cell Carcinoma in the Head and Neck Region With Regional Lymph Node Metastasis: A Systematic Review and Meta-analysis. Sahovaler A, Krishnan RJ, Yeh DH, Zhou Q, Palma D, Fung K, Yoo J, Nichols A, MacNeil SD. JAMA Otolaryngol Head Neck Surg. 2019 Apr 1;145(4):352-360. doi: 10.1001/jamaoto.2018.4515.PMID: 30844021

Innovative insertion of the palmaris major tendon after lower lip reconstruction. Sahovaler A, Higgins K, Deutsch K, Eskander A, Enepekides D. Laryngoscope. 2019 Nov;129(11):2479-2481. doi: 10.1002/lary.27825. Epub 2019 Feb 6.PMID: 30724365

Novel minimally invasive transoral surgery bleeding model implemented in a nationwide otolaryngology emergencies bootcamp. Sahovaler A, Eibling DE, Bruni I, Duvvuri U, MacNeil SD, Nichols AC, Yoo J, Fung K, Roth K. J Robot Surg. 2019 Dec;13(6):773-778. doi: 10.1007/s11701-019-00920-7. Epub 2019 Jan 23.PMID: 30673979

Mutational analysis of head and neck squamous cell carcinoma stratified by smoking status. Ghasemi F, Prokopec SD, MacNeil D, Mundi N, Gameiro SF, Howlett C, Stecho W, Plantinga P, Pinto N, Ruicci KM, Khan MI, Yoo J, Fung K, Sahovaler A, Palma DA, Winquist E, Mymryk JS, Barrett JW, Boutros PC, Nichols AC. JCI Insight. 2019 Jan 10;4(1):e123443. doi: 10.1172/jci.insight.123443.PMID: 30626742

Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap. Yeh DH, Lee DJ, Sahovaler A, Fung K, MacNeil D, Nichols AC, Yoo J. Head Neck. 2019 Jan;41(1):30-36. doi: 10.1002/hed.25342. Epub 2018 Dec 4.PMID: 30511790

Advances in computer-aided design for bony free-flap reconstruction. Sahovaler A, Fung K.Curr Opin Otolaryngol Head Neck Surg. 2018 Oct;26(5):319-325. doi: 10.1097/MOO.0000000000000472.PMID: 30028747

Predictors of plate extrusion in oromandibular free flap reconstruction. Prasad J, Sahovaler A, Theurer J, Yeh DH, Fung K, MacNeil SD, Yoo J, Nichols AC. Microsurgery. 2018 Sep;38(6):682-689. doi: 10.1002/micr.30349. Epub 2018 Jun 29.PMID: 29956850

Reconstruction after salvage laryngectomy. Yeh DH, Sahovaler A, Fung K. Oral Oncol. 2017 Dec;75:22-27. doi: 10.1016/j.oraloncology.2017.10.009. Epub 2017 Oct 21.PMID: 29224818

The incidence and management of non-head and neck incidentalomas for the head and neck surgeon. Sahovaler A, Yeh DH, Morrison D, de Ribaupierre S, Izawa J, Power A, Inculet R, Parry N, Palma DA, Landis M, Leung A, Fung K, MacNeil SD, Yoo J, Nichols AC. Oral Oncol. 2017 Nov;74:98-104. doi: 10.1016/j.oraloncology.2017.09.004. Epub 2017 Oct 2.PMID: 29103759

Primary facial reanimation in head and neck cancer. Sahovaler A, Yeh D, Yoo J. Oral Oncol. 2017 Nov;74:171-180. doi: 10.1016/j.oraloncology.2017.08.013. Epub 2017 Sep 12.PMID: 28916260

Management Issues in the Treatment of an Ameloblastoma with an Atypical Presentation. Larrañaga JJ, Sahovaler A, Picco PI, Mazzaro EL, Figari MF. Craniomaxillofac Trauma Reconstr. 2015 Sep;8(3):257-61. doi: 10.1055/s-0035-1549012. Epub 2015 Mar 19. PMID: 26269737

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Dr Axel Sahovaler