Theme 1: Helping Babies Breathe
Craniofacial skeletal conditions (including small/absent jaw), head and neck mass, congenital high airway obstruction syndrome, thoracic/mediastinal mass, and multiple others can prevent adequate breathing and cause brain injury from low oxygen or suffocation at birth. Fortunately, with in-utero diagnosis, we are able to make modifications during delivery that support more rapid onset of treatment or permit intervention on the fetus’s airway during a partial delivery, while oxygen and carbon dioxide exchange continue to occur through the placenta (called an EXIT).
This potentially life-saving and function-preserving treatment for newborns requires balancing concern for the infant’s well-being with the obligation to do no harm to those giving birth. It also requires us to consider just distribution of scarce resources.
Due to the rarity of these interventions, there are few systematic data available, and a survey of fetal treatment centers shows high variation in selection criteria as well as cases of over- or under-utilization of these techniques.
To address this gap, the Puricelli Research Group is gathering data on the frequency and types of interventions required immediately following birth, according to diagnosis, to help guide candidate selection and appropriate procedural preparation. Along with Dr. Lobeck, Dr. Puricelli co-leads a collaboration with over 50 colleagues in maternal fetal medicine, fetal surgery, pediatric surgery, pediatric otolaryngology, and neonatology to improve predication of treatment needs and patient selection. This will improve outcomes and empower pregnant persons to make more informed treatment decisions.
Theme 2: Supporting Hearing and Ear Function
As one of a few surgeons in the United States who completed fellowship training in advanced ear surgery and complex pediatric otolaryngology, Dr. Puricelli’s research aims to better understand and treat chronic ear disease (including cholesteatoma) as well as conditions that cause loss of hearing in children.
His work on comprehensive management of pediatric ear disease is among the first to focus on patient-centric outcomes and how to deliver ideal care to pediatric patients with chronic ear conditions and has led to inquiries about what constitutes complex pediatric otology as well as efforts to better understand the impact of chronic ear conditions on children and how treatment can improve these.
In addition, communication development in children is an area of great interest to Dr. Puricelli’s research group. Early detection, diagnosis, and intervention for newborn hearing loss leads to improved long-term outcomes. The Puricelli Research Group works to better understand limitations in current hearing screening and diagnostic testing to support earlier intervention and better outcomes.
Finally, the Puricelli research group is working to improve surgical safety. Basic science techniques in otopathology are utilized by the group to better understand the anatomy of the inner ear and how conditions affecting these structures might be ideally treated. Further, characterization of how surgical landmarks change with age will support improved surgical training while mitigating procedural risk.

Theme 3: Innovation and Device Development
Dr. Puricelli is the co-recipient of a Wallace H. Coulter Foundation grant to develop a new surgical instrument used for minimally invasive as well as traditional eardrum reconstruction, as well as a UI Ventures Technology Enhancement Grant to improve airway foreign body removal capacity and endoscopic laser delivery. The Puricelli Research Group developed a novel testing model to examine the benefits and limitations of current airway surgical energy delivery systems such as lasers.
In addition, Dr. Puricelli has intellectual property and innovative ideas in the design of tympanostomy tubes, tympanic membrane repair, and breathing tube placement (intubation) in neonates.