Peter Costantino, ’84 MD, ’90 GME, credits Northwestern University with paving the road for him to become a surgeon. “I look at medical schools in general now, and though they do anatomy, they do not do it to nearly the degree they did when I was a student,” he says. Not only did Dr. Costantino take anatomy as a first-year medical student, but he also continued dissecting cadavers for the next three years as a technical assistant. “This allowed me to gain an enormous amount of anatomic experience,” he says.
Dr. Costantino’s exposure to anatomy—coupled with dynamic faculty in head and neck surgery, neurosurgery and plastic surgery—convinced him of his desire to enter the field of surgery. “I really never considered any other specialty,” he confesses.
After medical school, he performed two years of general surgery and then four years of otolaryngology, both at the McGaw Medical Center of Northwestern University. In 1990, he went to the University of Pittsburgh, where he completed a one-year fellowship in cranial-based surgery, which at the time was a brand-new field.
“It was kind of an amalgamation between head and neck surgery, neurosurgery and plastic surgery, whereby we were removing tumors behind the eye sockets at the base of the brain,” he explains. Often, this required disassembling the facial skeleton before excising the tumors, then piecing it all back together.
Afterward, as repayment for medical school, Dr. Costantino served four years in the Air Force at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, as director of medical education in otolaryngology. He then returned to Chicago to become chief of head and neck cancer at what was then the new Cardinal Bernardin Cancer Center at Loyola University. In 1997, he was recruited to Mount Sinai Hospital in New York as co-director of the microsurgery training program.
Three years later, Costantino left to run a medical device company, but he found that he was “utterly miserable doing it.” In fact, he sometimes called friends to ask if he could scrub in on surgical cases because he missed the operating room.
He returned to Mount Sinai for a year before he transitioned to St. Luke’s-Roosevelt Hospital Center (affiliated with Columbia University), where he spent a decade as director of cranial-based surgery.
“Everything that I am as a surgeon came from my training process. I was very fortunate to have some amazing mentors and instructors at Northwestern and afterward,” says Costantino, 56, who since November 2010 has served as executive director and senior vice president of the New York Head & Neck Institute of North Shore-Long Island Jewish Health System.
Training future surgeons
Since 2000, Dr. Costantino has created several training programs, including three fellowships for fully trained head and neck surgeons: two at St. Luke’s-Roosevelt Hospital Center (facial plastic surgery and cranial-based surgery) and the third at Mount Sinai (reconstructive microvascular surgery).
He is in the process of developing a new residency in otolaryngology for the medical school at Hofstra University on Long Island. He and others are also spearheading the second—and the largest—residency for physician assistants and nurse practitioners in this specialty, which will be housed at both Hofstra and New York Head & Neck Institute.
“The highest calling, of course, is taking care of patients. But it is a step beyond that when you can help train other surgeons and caregivers,” Dr. Costantino explains. “There is a genuine level of satisfaction knowing that someone you have helped train is making a difference in a patient’s life.”
His primary surgical expertise is in all forms of cranial-based surgery, especially removing recurrent nasopharyngeal cancer. It occurs in the back of the nasal cavity, and early on often invades the base of the skull. The Asian population is particularly susceptible.
“Previously, this cancer has been considered either surgically untreatable or the surgery was extremely disfiguring and morbid,” Dr. Costantino says. “However, we have developed surgical methods for recurrent tumors, using telescopes inserted through the nostrils. Our success rate is comparable to open procedures, but with much lower complication rates and no facial disfigurement.”
He also performs endoscopic pituitary tumor removal, facial nerve construction with microneurosurgery, and cranial reconstruction. In 2006, he successfully replaced half the skull of ABC television journalist Bob Woodruff, who sustained a traumatic brain injury while covering the war in Iraq. Likewise, last year, Dr. Costantino removed a recurrent sinus cancer from former Buffalo Bills quarterback and Pro Football Hall of Famer Jim Kelly, with no subsequent evidence of any cancer.
Through the decades, Dr. Costantino has developed and commercialized several new biomaterials, spurred by an abstract he stumbled upon in the library while in medical school. The paper described a cement invented by the American Dental Association that could convert into hydroxylapatite, the form that calcium takes in the body to make bone hard. “The researchers were using the cement to glue in fillings,” he recalls.
Over the ensuing years, Costantino and his colleagues conducted a series of animal studies on the material, altering it for use in the reconstruction of the craniofacial skeleton. Human clinical trials followed. Today, BoneSource is offered by Stryker Corporation. “Since 1996, the cement has been used in many thousands of patients, if not more,” Dr. Costantino explains. In fact, one of those patients is his wife, Laurie, whom he met in 1995, the year after another surgeon employed BoneSource to reconstruct her skull following a brain tumor removal.
Furthermore, Dr. Costantino helped develop a sheeting material called AlloDerm, constituted from the skin of deceased donors, from LifeCell Corporation. He was the first to use AlloDerm to reline the surface of the brain case (dura).
Outside medicine, Costantino focuses on his wife and four children, ranging in age from seven to 23, and enjoys playing baseball and tennis.