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Journal 2017 Journal of ENT masterclass ISSN 2047-959X Journal of ENT MASTERCLASS® Year Book 2017 Volume 10 Number 1 YEAR BOOK 2017 VOLUME 10 NUMBER 1 JOURNAL OF ENT MASTERCLASS® Volume 10 Issue 1 December 2017 Contents Free Courses for Trainees, Consultants, SAS grades, GPs & Nurses Welcome Message 3 CALENDER OF FREE RESOURCES 2018-19 Hesham Saleh Increased seats for specialist registrars & exam candidates ENT aspects of cystic fibrosis management 4 Gary J Connett ® 15th Annual International ENT Masterclass Paediatric swallowing disorders 8 Venue: Doncaster Royal Infirmary, 25-27th January 2019 Hayley Herbert and Shyan Vijayasekaran Special viva sessions for exam candidates Paediatric tongue-tie 14 Steven Frampton, Ciba Paul, Andrea Burgess and Hasnaa Ismail-Koch rd ® 3 ENT Masterclass China Paediatric oesophageal foreign bodies 20 Beijing, China, 12-13th May 2018 Emily Lowe, Jessica Chapman, Ori Ron and Michael Stanton Biofilms in paediatric otorhinolaryngology 26 3rd ENT Masterclass® Europe S Goldie, H Ismail-Koch, P.G. Harries and R J Salib Berlin, Germany, 14-15th Sept 2018 Intracranial complications of ear, nose and throat infections in childhood 34 Alice Lording, Sanjay Patel and Andrea Whitney ® ENT Masterclass Switzerland The superior canal dehiscence syndrome 41 Lausanne, 5-6th Oct 2018 Simon Richard Mackenzie Freeman Tympanosclerosis 46 ® ENT Masterclass Sri Lanka Priya Achar and Harry Powell Colombo, 16-17th Nov 2018 Endoscopic ear surgery 49 Carolina Wuesthoff, Nicholas Jufas and Nirmal Patel o Limited places, on first come basis. Early applications advised. o Masterclass lectures, Panel discussions, Clinical Grand Rounds Vestibular function testing 57 o Oncology, Plastics, Pathology, Radiology, Audiology, Medico-legal Karen Lindley and Charlie Huins Auditory brainstem implantation 63 Website: www.entmasterclass.com Harry R F Powell and Shakeel S Saeed CYBER TEXTBOOK on operative surgery, Journal of ENT Masterclass®, Surgical management of temporal bone meningo-encephalocoele and CSF leaks 69 Application forms Mr. Richard M. Irving and Mr. Raghu Nandhan Sampath Kumar A review of middle vault reconstruction techniques 75 Director: Prof. M. Shahed Quraishi, OBE, FRCS, FRCS (ORL, H&N) A Mesbahi, P P Cheang and Miss P P Cheang Consultant Otolaryngologist, Thyroid & Parathyroid surgeon The evolution of osteotomy in rhinoplasty 82 Visiting Professor Capital Medical University, Beijing, Kevin Kulendra and Shahram Anari Doncaster & Bassetlaw NHS Foundation Trust Tel: 01302 642418 E-mail: [email protected] Navigation systems in endonasal endoscopic surgery – A review 87 Abdul Nassimizadeh and Yujay Ramakrishnan ENT Masterclass® These courses are sponsored by the Faculty Members with Institutional support 1 JOURNAL OF ENT MASTERCLASS® YEAR BOOK 2017 VOLUME 10 NUMBER 1 JOURNAL OF ENT MASTERCLASS® Welcome to Volume 10 Issue 1 of Journal of ENT Masterclass® 2017 Scar revision: An overview and update 92 I very much welcome our readers to this edition of the Journal of ENT Mr Nigel KF Koo Ng and Mr Alwyn D’Souza Masterclass®. We have two events to celebrate this year. It is the 10th Endoscopic transorbital neuroendoscopic surgery (TONES) 101 birthday for the Journal which has continued to provide high quality Lubbe DE up-to-date educational material free of charge. In this 10th edition, I am Editor: very happy to present you with articles that cover a breadth of subjects Management of primary tracheal tumours 105 Mr. M S Quraishi which we have not covered before. Latest developments such as auditory Mr Thavakumar Subramaniam and Professor James Paul O’Neill OBE, FRCS, FRCS (ORL, H&N) brainstem implants and other cutting edge topics have been covered. Consultant ENT Surgeon Poorly differentiated thyroid carcinoma 109 Hon Senior Lecturer in Detailed reviews on management of known conditions are also there to Surgical Oncology update our knowledge. Jay Goswamy, Iain J. Nixon and Ricard Simo Doncaster Royal Infirmary Doncaster, UK Management of the minor salivary gland tumours in the head and neck 117 E-mail: We very much appreciate the immense efforts of our editors and authors Ashley Hay, Amit Bhojwani and Ian Ganly [email protected] to present you with such comprehensive material and are certain it would be of great benefit. Pharyngeal pouch and cricopharyngeal spasm: current indications and treatment modalities 124 We proudly celebrate our founding editor Shahed Quraishi’s Royal Gordon A G McKenzie and R James A England appointment as an Officer of the Order of the British Empire (OBE) in Giant parathyroid adenomas in the neck: A minimally-invasive recognition of his role in medical education and the NHS. In 2005, approach to 17 consecutive cases 130 Mr Quraishi started with a local revision course that was held in Mahmoud Daoud, Omar Mulla and Shahed Quraishi Chairman Editorial Board: Doncaster. The course was named “ENT Masterclass” and there was Mr Hesham Saleh (UK) something special about it. It was the first ever full course to be provided Abstracts: ENT Masterclass Trainees’ Gold Medal 2017 137 Sub-Editors: to trainees free of charge. Paediatrics: Disclaimer: The individual authors have responsibility for the integrity of the content of the manuscripts. Ms A Burgess & Ms H Ismail Years have gone by and not even in our wildest dreams we would have Otology: expected it to be what it is today. Not only that the main course continued Mr R Irving & Mr C Huins Rhinology: to date but other courses on the same theme were created. Now we run a Mr S Ahmed & Mr A D’Souza Consultants’ Masterclass, GP Masterclass, Nurses Masterclass, Thyroid Head & Neck: Masterclass…and more. More so, the course has been picked up Mr R Simo & Mr I Nixon internationally and we have run it in Sydney, Delhi, Mumbai, Jeddah, Cape Editorial Board: Town, Hong Kong, Berlin and Beijing. Next editions are planned in Prof S S Musheer Hussain (UK) Karachi, Lausanne, Paris…and more to come. Prof Deepak Mehta (USA) Prof Anthony Narula (UK) Prof Shakeel R Saeed (UK) I would specially like to express my sincere gratitude to our editors and Prof Mumtaz Khan (USA) authors who selflessly continued to support the journal for all these years Mr James England (UK) and got it to its 10th anniversary. The journal was officially accredited by Prof Alok Thakar (India) Mr Faruque Riffat (Aust) ENTUK in 2016 and is now distributed free of charge to all members of Prof Carsten Palme (Aust) ENUK. I am confident that the Masterclass platform is there to stay as an Prof Shu Sheng Gong (China) Prof Zhiqiang Gao (China) outstanding unique venture that will continue to support doctors in all Prof Oliver Kaschke (Germany) corners of our planet. Prof Nirmal Kumar (ENT-UK) Mr Amit Prasai (UK) Mr Hesham Saleh, FRCS (ORL, H&N) Emeritus Editor: Consultant Rhinologist/Facial Plastic Surgeon Prof Patrick Bradley (UK) Charing Cross and Royal Brompton Hospitals, London. Chairman, Editorial Board, Journal of ENT Masterclass®. ENT Masterclass®, 106 Nottingham Road, Ravenshead,Nottingham December 2017. NG15 9HL England www.entmasterclass.com 2 3 JOURNAL OF ENT MASTERCLASS® YEAR BOOK 2017 VOLUME 10 NUMBER 1 Diagnosis as an additional cause of airways obstruction although this ENT aspects of cystic fibrosis management The gold standard diagnostic test for CF is the sweat test is no more common amongst CF patients. Patients with and a sweat chloride of >60mmol/L is diagnostic with few Primary Ciliary Dyskinesia typically have chronic Gary J Connett MD FRCPCH UK National Institute for Health Research Southampton Respiratory Biomedical Research Unit, reasons for a false positive result. Unfortunately some secretory otitis media with dilated blood vessels overlying Southampton Children’s Hospital and University Hospital Southampton NHS Foundation Trust, individuals and in particular older patients will have their tympanic membranes but in general CF patients have Tremona Road, Southampton, Hampshire SO16 6YD, UK equivocal results between 30-60mmol/L that are best little in the way of middle ear problems6. referred to CF services for clinical interpretation and Correspondence: Gary Connett further investigation to determine whether the patient has Imaging studies Department of Paediatrics CF related pathology. Curiously, CF database analyses Plain sinus X-Rays invariably show extensive opacification Southampton Children’s Hospital have shown that the presence of nasal polyps as reported and are of little value in directing management. Although Tremona Road, Southampton SO16 6YD in registry data is associated with better lung function there are legitimate concerns about radiation exposure, a E-mail: [email protected] although the reasons for this are unclear. Paradoxically it CT scan provides more useful detail about the extent and has also been reported that the presence of polyps is also nature of the disease process and is the radiological associated with a higher frequency of infection with investigation of choice (Figure 2)7. Whilst not recommended Pseudomonas aeruginosa3. as a routine investigation for all patients, CTs are a Abstract Presenting features necessary prerequisite to surgery in those individuals with Cystic Fibrosis occurs in approximately 1 in 2,500 births Although many parts of the world now have newborn Airway examination significant symptoms despite medical management. although the incidence varies between countries screening for CF, the effectiveness of these programmes It is quite common to see swollen turbinates on initial Characteristic features less commonly
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