Ashraf H. Darwish, M.D.



Dr. Ashraf Darwish offers comprehensive care solutions, allowing patients to return quickly to active and healthy lifestyles.  His main interests in orthopaedics are diagnosing and treating disorders of the cervical, thoracic, and lumbar spine.

The cornerstone of Dr. Darwish’s care philosophy is to utilize surgery as the last option.  He often recommends nonsurgical solutions for the relief of neck and back pain including diagnostic procedures, pain management, physical therapy, and return to work programs.

For patients who are good surgical candidates, Dr. Darwish has had extensive training in procedures that range from common to the more complex, such as minimally invasive surgery, microsurgery, decompression and fusion, and deformity correction.  Dr. Darwish’s personal mission is to provide individualized care for each patient.

Board Certification


• Orthopaedic Surgery



Education / Training


• Fellowship, Spine Surgery, The Texas Back Institute, Dallas, TX
• Residency, Orthopaedic Surgery, The Ohio State University, Columbus, OH
• Internship, Orthopaedic Surgery, Wayne State University, Detroit, MI
• M.D., Southern Illinois University, Springfield, IL
• J.D., Southern Illinois University Law School, Carbondale, IL

Areas Of Specialty
• Adult Spinal Disorders
• Cervical, Thoracic, and Lumbar Spine Disorders
• Minimally Invasive Spine Surgery
• Spinal Decompression and Fusion
• Spinal Instrumentation

Professional Memberships
• American Academy of Orthopaedic Surgeons
• American Medical Association Physician Member
• American College of Legal Medicine Member
• North American Spine Society


Craig J. Della Valle, M.D.



Dr. Della Valle is a native of New York and received his undergraduate and medical degrees from the University of Pennsylvania in Philadelphia.  He completed his residency at the Hospital for Joint Diseases in New York City.  During his residency he spent a full year devoted to clinical and basic science research in the field of adult reconstructive surgery.  Dr. Della Valle completed a fellowship in adult reconstructive surgery at Rush University Medical Center and Central DuPage Hospital.

He is presently the Aaron G. Rosenberg Endowed Professor of Orthopaedic Surgery and Chief of the Section of Adult Reconstruction at Rush University Medical Center in Chicago, Illinois.

Dr. Della Valle is a busy clinician who specializes in primary and revision total joint arthroplasty.  A respected researcher, he has more than 200 peer reviewed publications on topics including unicompartmental, primary and revision total knee arthroplasty as well as total hip arthroplasty, hip resurfacing and revision total hip arthroplasty.

Dr Della Valle is a member of The Hip Society, The Knee Society and The International Hip Society. He currently is President for the American Association of Hip and Knee Surgeons.

Dr. Della Valle has been married to Justyna for 8 years and has a 4-year old son named Dominic.



Find Out More
http://dellavalleortho.com/
https://www.rushortho.com/
  
Office Locations
1611 West Harrison, Suite 300
Chicago, IL 60612
Phone: 312-432-2350
John M. Diveris, M.D.



Dr. John Diveris has been in private practice since 1986. He specializes in sports injuries, torn ACLs, meniscus, and rotator cuffs, and joint replacements.

Dr. Diveris is a fellow of the American Academy of Orthopedic Surgeons, and an active member of the American Orthopedic Society for Sports Medicine and the Arthroscopy Association of North America. He is also a member of the Indiana Orthopedic Society, Clinical Orthopedic Society, American Medical Association, Indiana State Medical Society, and the Lake County Medical Society.

Board Certification


• American Board of Orthopedic Surgery, Diplomate, 1988



Education & Training
• Residency, Orthopedic Surgery, Northwestern University, Chicago, IL, 1982-86
• Fellowship, Orthopedic Sports Medicine, Knoxville Orthopedic Clinic, Knoxville, TN, 1991-92
• Internship, General Surgery and Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, 1981
• Medical Degree, Northwestern University Medical School, Chicago, IL, 1980
• Undergraduate, B.A. Biology, Northwestern University, Chicago, IL, 1974-77

Office Locations
333 W 89th Ave Ste. W5
Merrillville, IN 46410
Phone: 219-755-4448
Benjamin G. Domb, M.D.



Dr. Benjamin Domb has been in private practice in the Chicago area since 2007. He is a nationally recognized orthopaedic surgeon specializing in sports medicine and arthroscopic surgery of the hip, shoulder and knee.

Dr. Domb is a member of Hinsdale Orthopaedic Associates, S.C. and Sports Medicine, Hip Preservation and Restoration.  He is the Assistant Clinical Professor at Loyola University Stritch School of Medicine.  He is the Founder and Medical Director of the American Hip Institute in Chicago and the Medical Director of Hip Center of Excellence, Adventist Hinsdale Hospital. He is also the head team physician for the Chicago Sky, WNBA.

Board Certification


• American Board of Orthopedic Surgery, 2010



Education & Training
• Residency, Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 2002-2006
• Fellowship, Hip Arthroscopy and Joint Preservation, Traveling Fellowship, 2007
• Fellowship, Sports Medicine, Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, 2006-2007
• Fellowship, Orthopedic Trauma, Hadassah Hospital, Jerusalem, Israel, 2005
• Internship, General Surgery, New York Presbyterian Hospital, New York, NY, 2001-2002
• Medical Degree, Johns Hopkins University School of Medicine, Baltimore, MD, 2001
• Undergraduate, B.A. Biology, Cum Laude, Princeton University, Princeton, NJ, 1997

Office Locations
1010 Executive Court Ste. 250
Westmont, IL  60559
Phone: 630-920-2350
Brian Forsythe, M.D.



Dr. Forsythe is a board certified orthopedic surgeon specializing in minimally invasive techniques in sports medicine, arthroscopic shoulder, knee and elbow surgery, as well as shoulder replacement surgery. His patient care philosophy centers on communication and accessibility. He believes that patients come first in the patient-doctor relationship, and that clinical problem-solving begins with careful listening, observation, and examination. Ultimately, the goal is to return patients and athletes to the highest levels of activity and competition through specialized treatments or surgery.

His practice includes advanced techniques in arthroscopic shoulder instability, rotator cuff repair, and shoulder replacement surgery. He also focuses on knee ligament reconstruction (ACL/PCL), articular cartilage reconstruction, meniscal transplantation, joint-preserving osteotomies, and patella-femoral realignment and resurfacing procedures. Dr. Forsythe performs elbow ligament reconstruction, as well as proximal hamstring tendon repairs.

After graduating from medical school at the University of Pennsylvania, Dr. Forsythe pursued his surgical training at the Harvard Combined Orthopedic Surgical Residency Program. He then completed subspecialty training in shoulder and sports medicine surgery at the world-renowned University of Pittsburgh Medical Center, Center for Sports Medicine. Dr. Forsythe has since been actively involved in education and surgical training of surgical residents, fellows, and practicing orthopedic surgeons.

Dr. Forsythe is currently a team physician for the Chicago White Sox (MLB) and Chicago Bulls (NBA). He is also a team physician for U.S. Soccer, which involves international competitions and travel. His former team coverage includes the Pittsburgh Steelers (NFL), Chicago Bears training camp, Pittsburgh Penguins (NHL) and the New England Revolution Soccer (MLS). He has provided game coverage for numerous high schools and universities.

In addition to his clinical interests, Dr. Forsythe is actively involved in research. He is an assistant professor of orthopedic surgery at Rush and he has authored dozens of scientific publications, book chapters, and abstracts. Furthermore, his work has been presented at national and international meetings and his manuscripts have been published in the most highly regarded orthopedic journals.

He serves as a reviewer for the American Journal of Sports Medicine and the Orthopedic Journal, Arthroscopy. He is a Fellow of the American Academy of Orthopaedic Surgeons, and a member of the American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine.

Dr. Forsythe's athletic interests have helped define his career goals. He played Division 1 soccer at Brown University and he still enjoys playing, when not spending time with his wife and growing family.


Education & Training
• Medical School - University of Pennsylvania
• Residency - Harvard Combined Orthopedic Surgical Residency Program
• Fellowship - University of Pittsburgh Medical Center, Center for Sports Medicine

Find Out More
https://www.brianforsythemd.com/
https://www.rushortho.com/

Office Locations
Orthopedic Building at Rush University Medical Center
1611 West Harrison Street
Chicago, Illinois 60612
Phone: 708-236-2782

Central DuPage Hospital
25 North Winfield Road
Winfield, IL 60190
David Garras, M.D.



David N. Garras is a board certified orthopedist who specializes in foot and ankle surgery, with an emphasis on total ankle replacement, occupational and sports injuries, ligament and tendon repairs and reconstruction, minimally invasive and arthroscopic techniques, deformity correction and reconstructive surgery, as well as foot and ankle fracture care. He has a strong interest in Achilles ruptures, sports injuries, and foot and ankle arthritis.

Although Dr. Garras grew up in Southern California, he was born in Egypt and is fortunate to be fluent in Arabic. He developed his passion for orthopedics while serving as a medic in the U.S. Navy.

After his honorable discharge, he attended the University of California where he graduated, not only summa cum laude, but also at the top of his class. He went on to complete his medical degree at Duke University School of Medicine in Durham, N.C. There, he was privileged to work with Dr. James Nunley and Dr. Mark Easley. He completed his residency at Thomas Jefferson University Hospital, Rothman Institute, in Philadelphia, P.A., and worked with Dr. Steven Raikin. Under the direction of the world-renowned foot and ankle surgeon, Dr. Robert Anderson, as well as Drs. Hodges Davis, Bruce Cohen, and Carroll Jones, he completed his fellowship at OrthoCarolina in Charlotte, N.C.  He is a member of the American Academy of Orthopedic Surgeons and the American Orthopedic Foot and Ankle Society.

Dr. Garras is committed to research, having written numerous articles for publication in textbooks and medical journals. He received multiple awards for his research, including the prestigious Howard Hughes Medical Institute Fellowship and the Alpha Omega Alpha research award.

Dr. Garras is on the faculty at the University of Illinois Chicago.  He enjoys teaching and interacting with the orthopedic at both UIC and Midwestern University. He is also a consultant for several orthopedic companies and has developed numerous innovative foot and ankle implants.

No biography of Dr. Garras would be complete without noting his dedication to medical and surgical humanitarian causes.  Along with the Community Empowerment Group, he founded the orthopedic surgical mission work in the Auza and Peralta provinces of the Dominican Republic.  He leads week-long trips that provide surgical care to the underprivileged populations there and also works countless hours raising funds and obtaining donations for this important program.

When he’s not working, Dr. Garras enjoys spending time with his wife and son.  He is an avid Duke basketball fan, but will treat Carolina fans as well. He enjoys country music, traveling, and eating spicy food. His greatest satisfaction comes from his family and from being able to help so many people.


Board Certification
• American Board of Orthopedic Surgery

Education & Training
• Duke University School of Medicine, Durham, NC
• Fellowship, OrthoCarolina, Charlotte, NC

Specialty
• Total ankle replacement
• Work and sports injuries
• Ligament and tendon repairs/ reconstruction
• Minimally invasive and arthroscopic techniques
• Deformity correction and reconstructive surgery
• Foot and ankle fracture care

Research Interest
• Achilles ruptures
• Tendon and ligament injuries
• Toe deformities
• Foot and ankle arthritis

Office Locations
Midwest Orthopedic Consultants
10719 W 160th Street
Orland Park, IL 60467
4220 W 95th St. Ste. 100
Oak Lawn, IL 60453
Phone: 708-226-3300

Prairie Medical Center of Westchester
2450 S. Wolf Road, Suite F, 2nd Floor
Westchester, IL 60154
Toll free: 877-632-6637
Fax: 708-409-5179

Media
Facebook
Instagram
Zeshan Hyder, D.O.



Dr. Zeshan Hyder has been in private practice in Northwest Indiana since 2011. He is fellowship trained in Spine Surgery and specializes in Minimally Surgery of the Spine. His goals are to return his patients to productive and pain-free activity using the most advanced minimally invasive and motion-preserving techniques, holding surgery as a last option.

Dr. Hyder is a member of the American Osteopathic Academy of Orthopedic Surgeons, the American Academy of Orthopedic Surgery, and the North American Spine Society.


Education & Training
• Residency, Orthopedic Surgery, Midwestern University, Chicago, IL, 2006-10
• Fellowship, Orthopedic Spine Surgery, Texas Back Institute, Plano, TX, 2010-11
• Medical Degree, Midwestern University, Downers Grove, IL, 2005
• Undergraduate, B.S. Biochemistry, University of Illinois, Champaign, IL, 1996-2001

Office Locations
801 MacArthur Blvd., Ste. 302
Munster, IN 46321

9001 S. Broadway Ave.
Merrillville, IN 46410

3800 St Mary Dr.
Valparaiso, IN 46383

1354 S. Lake Park Ave.
Hobart, IN 46342

Website: true-mis.com
Jason G. Hurbanek, M.D.



During his residency at Henry Ford Hospital in Detroit, Michigan, Dr. Hurbanek received comprehensive training in orthopaedic trauma and joint replacement.  While completing his fellowship at The Ohio State University, Dr. Hurbanek was selected to assist in the care of all Ohio State athletes, specifically the football, hockey, and baseball teams.  Dr. Hurbanek is a co-founder of the Big 10 Fellows Sports Society, and is active as a reviewer and former member of the social media task force for Arthroscopy Journal.

​Dr. Hurbanek joined Hinsdale Orthopaedics in September 2009. He is active in research and is repeatedly invited as a guest speaker at national and regional orthopaedic meetings.  He is the author of multiple scientific publications in orthopaedic journals and is a designated leader within the American Academy of Orthopaedic Surgeons (AAOS).

Board Certifications


Orthopaedic Surgery (ABOS)

Certificate of Added Qualification (CAQ) Orthopaedic Sports Medicine

Certified Independent Medical Examiner (ABIME)

Participating in ABOS Maintenance of Certification (MOC)

Areas Of Specialty


Arthroscopy of Knee, Shoulder, and Elbow

Shoulder and Knee Reconstruction/Replacement

Sports Medicine

Education & Training


Fellowship, Orthopaedic Sports Medicine, Ohio State University, Columbus, OH

Residency, Henry Ford Hospital, Detroit, MI

Internship, Henry Ford Hospital, Detroit, MI

M.D., Ohio State University College of Medicine, Columbus, OH

Office Locations


550 West Ogden Avenue
Hinsdale, IL 60521

Phone:

630-323-6116


Ronak M. Patel, M.D.



Dr. Ronak M. Patel is a fellowship-trained Sports Medicine Orthopaedic Surgeon with an interest in minimally invasive procedures and joint preservation of the knee and shoulder. He treats all sports injuries with a particular interest in cartilage restoration, patellar stabilization and ligament reconstruction of the knee.

He completed his training in Sports Medicine at the world-renowned Cleveland Clinic, learning the most advanced and innovative surgical procedures, tending to professional athletes from the Cavaliers (NBA), Browns (NFL) and the Indians (MLB), and most importantly, helping patients function without pain. At Hinsdale Orthopaedics, Dr. Patel brings world-renown care back to Chicago and Northwest Indiana.

Dr. Patel’s approach to patient care is individualized, based on each patient’s injury and their level of function. He believes in practicing evidence-based Orthopaedic Surgery, giving the patient the best chance for success. Dr. Patel has published over 40 publications and book chapters and has presented his research over 70 times nationally and internationally. He is actively involved in research and academic meetings to provide the most current care to his patients.

Dr. Patel is among a small number of physicians in Chicago and Northwest Indiana performing advanced cartilage restoration and meniscal transplantation procedures. He also performs anatomic ACL reconstructions enabling optimal performance as well as partial knee replacements. He is extensively trained in arthroscopic management of shoulder problems including impingement, rotator cuff and shoulder instability, including labral tears and bone loss.

Dr. Patel believes that in sports medicine, it is essential to know when ‘not to operate’. His focus is on prolonging the life of the native joint as long as possible. To that end, he uses cartilage restoration, osteotomies to reduce stress on the joint, platelet rich plasma (PRP) injection therapy and other orthobiologic techniques to promote tissue healing and joint longevity. Favoring non-surgical rehab therapy whenever appropriate, Dr. Patel works closely with therapists to help restore patients to maximal function.

Areas Of Specialty


Sports Medicine - Adult & Adolescent

Pediatric Injuries of the Knee

Arthroscopy

Minimally Invasive Surgery

Shoulder

Knee

Elbow

Education & Training


Fellowship, Sports Medicine, Cleveland Clinic, Cleveland, OH

Residency, Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL

M.D., Northwestern University Feinberg School of Medicine, Chicago, IL

B.A., Economics, Northwestern University, Evanston, IL

Office Locations

8141 S. Calumet Ave.
Munster, IN 46321


550 West Ogden Avenue
Hinsdale, IL 60521

Phone:

630-323-6116



1010 Executive Court
Suite 250
Westmont, IL 60559
Ralph W. Richter, M.D.



Dr. Ralph

Richter

has been in private practice in Northwest Indiana since 1992. He specializes in surgery of the hand, wrist, and forearm.

Dr. Richter is a member of the American Society for Surgery of the Hand and a fellow of the American College of Surgeons.

Board Certification


American Board of Surgery, 1993

Surgery of the Hand, 1995, 2005

Education & Training


Residency, General Surgery, Meridia Huron Hospital, Cleveland, OH, 1987-1991

Fellowship, Hand and Microvascular Surgery, Detroit Medical Center, Wayne State University, Detroit, MI, 1991-1992

Medical Degree, University of Cincinnati College of Medicine, Cincinnati, OH, 1986

Undergraduate, B.S. Natural Science Summa Cum Laude, Xavier University, Cincinnati, OH, 1982

Office Locations


4320 Fir St ,Suite 303
East Chicago, IN 46312

Phone:

219-392-1215


Joseph P. Spott, D.O.



As an local Indiana native, Dr Joseph Spott has been in private practice in Northwest Indiana since 1998. He specializes in minimally invasive spine surgery of the lower back and neck, as well as shoulder, carpal tunnel release, fracture repair, and total joint replacements of the hip and knee.

Dr. Spott is a member of the American Osteopathic Association, American Medical Association, Indiana Osteopathic Association, Indiana State Medical Society, and Lake County Medical Society. 

Board Certification


American Osteopathic Academy of Orthopedic Surgery, 2013

Education & Training


Residency, Orthopedic Surgery, Oakland General Hospital, Madison Heights, MI, 1994-1998
• Fellowship, Spine Surgery, Indianapolis Neurological Group, Indianapolis, IN, 1999 and
   Spine Surgery, PSC, Louisville, KY, 1998
• Medical Degree, University of Osteopathic Medicine and Health Services, Des Moines, IA, 1993
• Undergraduate, B.A. Biology, Indiana University, Gary, IN, 1982-1989

Office Locations


9430 Wicker Ave/Highway 41
Saint John, IN 46373

Phone:

219-558-8068

929 Ridge Rd #7
Munster, IN 46321
Phone: 219-558-8068

2020 E Columbus Drive, Suite B
East Chicago, IN 46312
Phone: 219-397-8648


Matthew W. Colman, M.D.



Dr. Matthew Colman specializes in spine surgery and musculoskeletal oncology.

Dr. Colman completed his undergraduate training cum laude with honors from Dartmouth College, earned his medical degree with honors from the University of Chicago Pritzker School of Medicine, Chicago, IL, and went on to complete his residency in orthopedic surgery at the University of Pittsburgh Medical Center, Pittsburgh, PA.

He has been fellowship trained in pediatric and adult musculoskeletal oncology at Harvard University and orthopedic and neurosurgical spine surgery at the University of Utah.

Dr. Colman has an interest in treating bone and soft tissue tumors wherever they occur, including the spine. He also treats a comprehensive set of non-tumor-related spinal problems, including degenerative disease, deformity, and trauma.

He is a member of the American Academy of Orthopaedic Surgeons (AAOS), AOSpine, the North American Spine Society, and Alpha Omega Alpha, University of Chicago Chapter.

Board Certification


Orthopaedic Surgery

Education / Training


Medical School, University of Chicago Pritzker School of Medicine, Chicago, IL
Fellowships

Musculoskeletal Oncology, Harvard University / Massachusetts General Hospital / Children's Hospital Boston, Boston, MA

Orthopedic and Neurosurgical Spine Surgery

University of Utah, Salt Lake City, UT

Residency, University of Pittsburgh Medical Center, Pittsburgh, PA

Media


Amazing rotationplasty on young boy: Dr. Matthew Colman on WGN TV

Office Locations


Rush University Medical Center
1611 West Harrison St.
Chicago, IL 60612

Phone:

224-236-4023

Munster Indiana Office
9200 Calumet Avenue, Suite 300
Munster, IN 36321

Phone:

​877-875-5460

Richard A. Berger, M.D.



Dr. Berger has pioneered minimally invasive hip and knee replacement, allowing patients to recover faster with less pain than with traditional hip and knee replacement surgery. His degree in mechanical engineering from MIT has helped him design specialized instruments which allow the surgery to be done without cutting any muscle, tendons, or ligaments. These advances allow most of Dr. Berger's patients to walk independently and leave the hospital the day of surgery. His mechanical engineering background has also helped him to design gender-specific implants that fit and perform better for active patients.

Dr. Berger was fellowship trained in adult reconstruction at Rush University Medical Center. Dr. Berger also conducts research on hip and knee replacements.

Dr. Berger, as part of his pioneering role in minimally invasive surgery, has developed specialized instruments, techniques for surgery, as well as knee and hip implants. As the developer, Dr. Berger receives royalties and payments from the manufacturers of these devices.

Board Certification


• Orthopaedic Surgery



Education / Training


• Residency, University of Pittsburgh, Pittsburgh, PA - Orthopaedic Surgery
• Fellowship, Rush University Medical Center, Chicago, IL - Joint Replacement
• Medical Degree, Tufts University School of Medicine

Office Locations
Orthopedic Building at Rush University Medical Center
1611 West Harrison Street
Chicago, Illinois 60612
Toll free: 877-632-6637
Phone: 312-243-4244
Fax: 708-409-5179



George Branovacki, M.D.



Dr. George Branovacki has been in private practice in the Chicago area since 2005. He specializes in adult reconstructive surgery and sports medicine. Dr. Branovacki has interest in cartilage preservation, restoration surgery and total joint revisions.

Dr. Branovacki is a member of the American Academy of Orthopaedic Surgeons, American Academy of Hip and Knee Surgeons, and International Society for Technology in Arthroplasty.

Board Certification


• American Board of Orthopedic Surgery, 2007



Education / Training


• Fellowship, Adult Lower Extremity Reconstruction, Scripps Clinic, La Jolla, CA, 2004-200
• Residency, Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, 1999-2004
• Medical Degree, Northwestern University Medical School, Chicago, IL, 1999
• Undergraduate, B.A., Biology, Northwestern University, Evanston, IL, 1995

Office Locations
10710 W. 160th St., Orland Park, IL  
4220 W 95th St Ste 100, Oak Lawn, IL       
Phone: 708-226-3300



Jack Patel, M.D.



Dr. Jack Patel is a fellowship trained and board certified surgeon currently practicing in Northwest Indiana.

Upon completion of medical school at Midwestern University, Dr. Patel completed a surgical internship at Michigan State University and remained there to continue his advanced surgical training in otolaryngology/head and neck surgery/facial plastic surgery.  In 2010, he completed a one-year full body cosmetic surgery fellowship program, which is accredited by the American Academy of Cosmetic Surgery. Dr. Patel is a native of Indiana, and after completing his fellowship training, he came to northwest Indiana to be near his family.

With offices in both Munster, Indiana and Hinsdale, Illinois, Dr. Patel has an outstanding reputation for providing exceptional care to all of his patients in Indiana and Illinois. Patient safety is an utmost priority, and he maintains staff privileges exclusively at hospitals and accredited surgery centers that share his standard of care.

Education


Michigan State University

 

Otolaryngology/Head and Neck Surgery/Facial Plastic Surgery Residency

Midwestern University
   Medical School

University of Illinois
   BS Biology

Board Certification & Licensure


Facial Plastic Surgery

Otolaryngology/Head and Neck Surgery
  

Board Certification



Publications


Rush Presbyterian Hospital / Midwestern University
Development of Osteoradionecrosis of the Mandible Following Radiation Therapy

Metro Health Hospital


Correlation Between Tobacco Use and Papillary Thyroid Cancer
Management of Carcinoma Ex-pleomorphic Adenoma in a 90 Year-old Female
The Effects of Monteleukast In Patients With Otitis Media With Effusion