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Matt Howard in the operating room.
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MATTHEW HOWARD Whether inventing new devices, honing procedures, or training the next generation of neurosurgeons, a physician and his colleagues focus on finding a better way.

Matthew Howard entered medical school with a strong background in the sciences and little understanding of medical applications. This combination fostered an idea for improving surgical techniques—an idea that became the Stereotaxis Magnetic Navigation System, which today is used at more than 100 sites worldwide.

“I was a physics major in college, so I was familiar with basic principles of magnetism,” says Howard, today head of neurosurgery at the University of Iowa Carver College of Medicine and UI Hospitals and Clinics. “As a medical student, I had a fresh look at medical problems. Seeing some significant limitations to existing surgical methods, it popped into my head that we could come up with a different way of doing this.”

Howard’s system allows physicians to direct catheter-based cardiac procedures with magnetic forces, eliminating the need for control wires or conduits that extend outside the patient’s body. Two magnets on pivoting arms guide the flexible catheter and gently push its soft tip against blood vessel walls or heart chambers. Compared to manual methods, the system dramatically reduces the risk of puncturing delicate tissues.

It also lets physicians direct procedures from far beyond the operating room. “One procedure was performed across the Atlantic Ocean,” Howard says. “The cardiologist was in a control suite in Boston and he performed a cardiac procedure in a patient who was in the magnetic suite in Italy.”

Howard is quick to credit the work of his collaborators when he recounts seeing his idea become a reality.

“Every step of the way, this project depended on teamwork,” Howard says. “I had multiple co-inventors for all applications of the scientific and business ideas, and many important recent developments were the ideas of others. It’s a classic example of creative, driven people coming together to make something happen.”

Howard’s interest in this sort of collaboration brought him to The University of Iowa in 1993. He was named head of neurosurgery in 2001, and has a joint appointment in neurology. His current research explores how the human brain processes sound information, and how the brain allows people to experience emotions.

“We have investigators coming from all over the world to work with us on this,” Howard says. “The hearing research community here is so strong, and the key leaders, including Dr. Bruce Gantz, were incredibly supportive of this research.”

Howard also applies innovative techniques and technologies to epilepsy surgery, which offers an alternative for patients who do not respond to antiseizure drugs. EEG monitoring and biomedical imaging locate a patient’s epileptic focus, and presurgery testing identifies “eloquent” areas of the brain—portions responsible for speech—to avoid during surgery. Howard and his team then remove the epileptic focus area.

“Over the years we have improved our ability to identify patients who will benefit from the surgical treatment, and the tools and techniques that we’ve developed allow us to do it more safely,” Howard says. “The key to success is the team approach with our colleagues in neurology, particularly Drs. Mark Granner and Erik St. Louis.”

Howard now helps develop the next generation of neurosurgeons, a role he finds rewarding. His department, which annually accepts two medical residents from an applicant pool of about 130, has a structured mentoring process to help young physicians achieve their goal of becoming surgeons and scientists.

“This is the perfect job: I get the tremendous rewards of taking care of patients, and helping patients’ families through a very scary and stressful time,” Howard says. “Also, we’re discovering things, creating new things, and all the while working with young people and trying to give them the opportunities that I had when I was in training. That’s immensely rewarding—the whole combination makes it a real pleasure to come to work at The University of Iowa.”

Story by Christopher Clair; Photo by Tim Schoon

Feb. 18, 2008