About

Gretchen M. Oakley, MD, specializes in Rhinology and Skull Base Surgery. Her clinical practice focuses on nasal and sinus diseases, including acute and chronic sinusitis, polyps, nasal and sinus tumors, cerebrospinal fluid leaks, endoscopic orbital surgery, nasal obstruction, and allergy. She works with a large multidisciplinary team that includes neurosurgeons, ophthalmologists, head and neck cancer surgeons, neuroradiologists, and head and neck pathologists to provide comprehensive care to patients and ensure optimal treatment outcomes. Outside of her clinical work, she is involved in Rhinology clinical research and has published several journal articles and book chapters in the field. Her research interests include cerebrospinal fluid leak diagnosis and management, genetic, biologic, and environmental factors in chronic sinusitis, and treatment outcomes of chronic sinusitis. In addition, she serves as the Medical Student Director for Otolaryngology.

Research topics

• Medicine
• Pathology
• Immunology
• Biology
• Internal medicine
• Surgery
• Microbiology
• Dermatology
• Law
• Virology
• Genetics
• Intensive care medicine
• Family medicine
• Biotechnology

Selected publications

• Characterizing air pollution exposure methodologies in rhinology: a scoping review

  International Journal of Environmental Health Research · 2025-03-13 · 1 citations

  reviewOpen access

  ABST RACTCharacterization of air pollution assessment methodologies in rhinologic disease research is lacking. A scoping review was thus conducted to survey exposure methods in studies examining common rhinologic conditions: allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Several medical databases were queried for variables relating to (1) adults with a diagnosis of CRS or AR and (2) air pollution exposure. Data was extracted for pollutants assessed, method of quantifying exposure, assessment of residential stability, inclusion of authors with expertise in environmental exposure assessment, and disease-related outcomes. Thirty-four articles were included for analysis - 16 for AR and 18 for CRS. Fifteen studies originated from East Asia, 10 from North America, and 6 from Europe. The most common pollutant studied was PM2.5 (28 studies), with most studies investigating multiple pollutants. Twenty-one studies used a nearby air monitor to quantify exposure, 9 studies reported whether subjects had residential stability for the period assessed, and 17 studies included authors with climate science background. Timeframes included both acute and chronic exposure. Current methods to quantify air pollution exposure in rhinology vary considerably and inconsistently employ expertise from environmental scientists. Future investigations may benefit from multidisciplinary collaboration, reporting of residential stability, and standardized reporting metrics.

  PublisherOA PDFDOI

• Sinonasal and Skull Base Morbidity from a Modified Nasoseptal Flap versus No Flap in Pituitary Surgery

  Journal of Neurological Surgery Part B Skull Base · 2025-10-07 · 1 citations

  article

  Abstract Durable sellar reconstruction and preserving sinonasal function are pivotal objectives in endoscopic pituitary surgery. This study aimed to investigate the postoperative skull base and sinonasal morbidity associated with a modified nasoseptal flap (NSF) in endoscopic pituitary surgery. A retrospective cohort study was conducted on patients undergoing endoscopic transsphenoidal pituitary surgery with either an NSF or non-NSF reconstruction of the sella. Patients had an obvious or suspected intraoperative cerebrospinal leak. A minimum 6-month follow-up was required. Outcome measures included postoperative skull base morbidity (cerebrospinal fluid leak, flap necrosis, pneumocephalus, meningitis, other intracranial infections, intracranial hemorrhage), sinonasal morbidity (epistaxis, crusting, sinus infection, atrophic rhinitis, persistent crusting, sinus dysfunction, mucocele formation, septal perforation), and patient-reported outcome measures (Sinonasal Outcome Test 22 [SNOT22; range 0–110], Nasal Symptom Score [NSS; range 0–30], and olfactory dysfunction score [range 0–5]). About 372 patients (age 53.8 ± 16.7 years, 53.5% female) were included. Most patients underwent NSF reconstruction (87.1%). There was no significant difference in skull base morbidity between the NSF and non-pedicle flap groups. The NSF group had fewer self-reported sinus infections (0.9% vs. 6.4%, p = 0.03) and sinus dysfunction (2.8% vs. 31.3%, p < 0.01). Postoperative SNOT22 (12.9 ± 15.3 vs. 25.2 ± 21.3, p < 0.01), NSSs (2.3 ± 3.5 vs. 5.9 ± 6.0, p < 0.01), and olfactory dysfunction score (percentage of cases ≥“moderate problem [score 3],” 6.4% vs. 26.3%, p = 0.01) were also lower in the NSF group. Utilizing a modified NSF in endoscopic transsphenoidal pituitary surgery allows for a sellar reconstruction option without detrimental impact on sinonasal function.

  PublisherDOI

• An eosinophil peroxidase activity assay predicts acute exacerbations in post‐operative chronic rhinosinusitis

  International Forum of Allergy & Rhinology · 2024-05-20 · 3 citations

  articleOpen access

  KEY POINTS: EPX activity has been correlated with eCRS diagnosis and baseline disease severity. Herein, EPX activity is shown to correlate with post-operative antibiotic and steroid use in CRS. EPX activity has potential to act as a prognostic biomarker of CRS disease severity and control.

  PublisherOA PDFDOI

• Chemokine CCL19 and Its Receptors CCR7 and CCRL1 in Chronic Rhinosinusitis

  Journal of Inflammation Research · 2024-05-01 · 1 citations

  articleOpen access

  Background: CCL19 has been shown to predict disease severity in COVID-19 and treatment response in rheumatoid arthritis. CCL19 can exert both pro- and anti-inflammatory effects and is elevated in chronic rhinosinusitis (CRS). However, its role in CRS remains unknown. This study sought to determine the transcriptional changes in CCL19, its receptors, and associated cytokines and their association with disease severity in CRS. Methods: A clinical database of control subjects and patients with CRS was examined. Lund-Kennedy, Lund-Mackay, Sinonasal Outcomes Test 22 (SNOT-22), and rhinosinusitis disability index (RSDI) scores were collected at enrollment. mRNA was extracted from sinonasal tissues and subjected to multiplex gene expression analysis. Gene transcript differences between patients with CRS and controls were compared and correlated with disease severity metrics. Immunohistochemical analyses of CCL19, CCR7, and CCRL1 were conducted to compare differences in protein expression between cohorts. A subgroup analysis was performed to compare transcriptional and protein expression difference between patients with (CRSwNP) and without (CRSsNP) nasal polyps and controls. Results: Thirty-eight subjects (control group, n=7; CRS group, n=31) were included in this study. CCRL1 ( p =0.0093) and CCR7 ( p =0.017) levels were significantly elevated in CRS compared to those in controls. CCL19 ( p =0.038) and CCR7 ( p =0.0097) levels were elevated in CRSwNP and CCRL1 was elevated in CRSsNP ( p =0.0004). CCR7 expression was significantly elevated in sinonasal epithelial cells in CRSwNP ( p =0.04). CCL19 expression was positively correlated with TNFA expression ( p < 0.0002). CCL19 and CCR7 expression was positively correlated with SNOT-22 and RSDI scores ( p < 0.05). Conclusion: CCL19 and CCR7 may modulate TNF-α-driven pro-inflammatory signaling and contribute to increased disease severity in CRS. Mechanistic studies are required to further elucidate the role of CCRL1 in CRS. Keywords: chronic rhinosinusitis with nasal polyps, chemokines, cytokines, gene expression, protein expression

  PublisherOA PDFDOI

• Response to the editor regarding “An eosinophil peroxidase activity assay predicts acute exacerbations in post‐operative chronic rhinosinusitis”

  International Forum of Allergy & Rhinology · 2024-07-25 · 1 citations

  letterOpen access

  To the Editor, The authors are appreciative of Dr. Yadav's comments on our recently published study.1 We are grateful for the suggestions to expand research in this area, providing support for our ongoing investigations that seek to ascertain the clinical significance of sinonasal eosinophil peroxidase (EPX) activity as a diagnostic and prognostic biomarker for detecting active eosinophilic type 2 (T2) inflammation and predicting treatment response in chronic rhinosinusitis (CRS).1, 2 Our research team has similarly identified the salient points raised as essential next steps to validate our prior findings.1, 2 Several investigations are currently underway and include peroxidase assay optimization to achieve peroxidase specificity for EPX versus myeloperoxidase activity as a marker of active eosinophilic versus neutrophilic inflammation in clinical samples.3 This will enable detection of dominant or mixed endotypes and prompt further evaluation of associated biomarkers.4 A clinical study to evaluate the reliability of sample collection and EPX activity analysis through the use of a novel nasal swab device is also underway. This will allow for reproducibility in biomarker sampling and quantification and ensure accuracy in endotyping. A longitudinal study to correlate pre- and post-operative sinonasal tissue levels of EPX activity to T1-, T2-, and T3-associated cytokine levels, quantify how those levels change in response to surgical and medical interventions in patients with CRS, and correlate these changes to CRS-specific outcomes is ongoing.5-7 These data will support future multi-center studies to evaluate the sinonasal sampling and analysis methodologies in diverse patient populations. We look forward to continuing this research and disseminating our translational findings to the community. Sincerely, University of Utah Rhinology Research Team

  PublisherOA PDFDOI

• Investigation of the Genetic Determinants of Telangiectasia and Solid Organ Arteriovenous Malformation Formation in Hereditary Hemorrhagic Telangiectasia (HHT)

  International Journal of Molecular Sciences · 2024 · 15 citations

  • Pathology
  • Medicine
  • Biology

  in one brain AVM sample, in which the germline mutation occurred in a different allele than a nearby somatic mutation (both are loss-of-function mutations). Eight of nine (88.9%) patients in whom telangiectasia tissues were evaluated had a somatic mutation ranging from 0.68 to 1.96% in the same gene with the germline mutation. Six of fifteen (40%) nasal and two of four (50%) dermal telangiectasia had a detectable somatic second hit. Additional low-level somatic mutations in other genes were identified in several telangiectasias. This is the first report that nasal telangiectasias and solid organ AVMs in HHT are caused by very-low-level somatic biallelic second-hit mutations.

  PublisherOA PDFDOI

• International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

  UNC Libraries · 2024-10-16

  articleOpen access

  BACKGROUND: Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. METHODS: In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. RESULTS: The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. CONCLUSION: As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.

  PublisherDOI

• Other Complications Following Skull Base Reconstruction

  2023-01-01

  book-chapterSenior author
  PublisherDOI

• An eosinophil peroxidase activity assay accurately predicts eosinophilic chronic rhinosinusitis

  Journal of Allergy and Clinical Immunology · 2023 · 18 citations

  • Medicine
  • Pathology
  • Immunology
  PublisherOA PDFDOI

• International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

  International Forum of Allergy & Rhinology · 2023 · 121 citations

  • Medicine
  • Dermatology
  • Immunology

  BACKGROUND: Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. METHODS: In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. RESULTS: The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. CONCLUSION: As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.

  PublisherOA PDFDOI

Frequent coauthors

• Richard J. Harvey

  St Vincent's Health

  49 shared

• Raymond Sacks

  University of Sydney

  37 shared

• Jeremiah A. Alt

  University of Utah

  24 shared

• Richard R. Orlandi

  University of Utah

  21 shared

• Kristine A. Smith

  University of Utah

  17 shared

• Janet Rimmer

  Woolcock Institute of Medical Research

  16 shared

• Karen Curtin

  University of Utah

  14 shared

• Larry Kalish

  Concord Repatriation General Hospital

  10 shared

Education

• B.A.

  Georgetown University

• M.D.

  Saint Louis University School of Medicine

• Other, Otolaryngology

  University of Utah

• Other, Rhinology and Skull Base Surgery

  Sydney, Australia