PGI Department of Otolaryngology To organise 3rd ENT Surgical Workshop – An Update

By 1 2 1 News Reporter

Chandigarh 18^th September:-- The Department of Otolaryngology, Head and Neck surgery, PGIMER is conducting the third ENT surgical Workshop – An Update. Receiving tremendous response and invaluable feedback from the academics who attended the workshop for the last two years, the organizers are upbeat conducting the surgical extravaganza this year.  Last year nearly 1000 delegates from national and international institutes of repute perched in this very institute inorder to view the masters of surgery at work and learn and let learn. Learning from the surge of delegates last year and their queries, this year the organizers are well prepared to receive not less than 1000 delegates. This may be a dream which even the great founders of this institute like Dr Tulsi Das, Dr Chuttani, Dr Anand would have never envisaged. 

"REHABILITATION OF HEARING, VISION AND VOICE HANDICAP", is the mission and motto of the conference. According to the data published by the census of India 2001, about 4 million of our population are visually impaired, 3.2 million have hearing impairment and 1.9 million have speech disabilities. Based on "A Report on Disabled Persons" published by the National Sample Survey Organization , speech and hearing constitute 27.70 percent and visual impairment contribute 24.79 percent. 78.3 percent persons with disabilities live in rural areas. In case of visual impairment, 83.27 percent people with visual impairment live in the rural areas. Visual and hearing impairments are more prominent in the higher age-groups, whereas speech and locomotor impairments are the phenomenon of the younger age groups.  This urged us to take up the responsibility of playing our part in rehabilitation of these unfortunate souls. Our primary aim of conducting this live surgical workshop is to address these disabilities by treating the diseases causing them and if not curable, rehabilitating them.

 

The workshop starts with cadaveric dissection workshop. As knowledge is the foundation of sound clinical practice, skill is the basis of surgical expertise. The Chinese philosopher Confucius has rightly said,"I hear, I know. I see, I remember. I do, I understand". It is the realization of this truth which prompted us to start the hands on Cadaveric dissection on basic endoscopic procedures last year. Seeing the tremendous enthusiasm of young aspiring surgeons we have decided to include a hands on Advanced Cadaveric dissection which would include most of the advanced skull base surgeries like Optic nerve decompression and fenestration, transphenoidal hypophysectomy etc. This is the only venue where young ENT surgeons from all over the country can get training in such complex and skillful surgeries. The value of such hands on cadaveric dissection courses is usually under estimated. However, the anatomic and surgical knowledge these expired souls teach us is extremely important. It is a norm in western institutes that one must complete certain prescribed hours of dissection with the cadavers before the surgeon tries his skills on a live patient. The seats for the basic and advanced cadaveric dissection course got filled in the first week of announcement of the event. This shows the credibility of the workshop in the minds of the surgeons and the scarcity of such events where both academic wealth and surgical valor meet. As sound theoretical knowledge forms the basis for practical success, we have also included short lecture sessions and topics pertaining to endoscopic sinus surgery like anatomy, radiology, anaesthesia etc which would be dealt by faculty of the corresponding departments of the institute.

 

Voice is an expression of the character of human being. A person is identified by his or her voice. Advancement in the field of phonosurgery (any surgical procedure done to improve voice) has made it possible to even make minute changes in human voice. The different thyroplasty techniques are safe and provide patients who thrive with voice like teachers and singers with desired quality of voice. Nowadays , even the common man who do not much need a perfect voice are conscious about the minute variations in the pitch and timbre of their voice that they seek immediate medical attention. Male adolescents with an elevated pitch in their voice and female adolescents with a low pitch are subjected to peer ridicule and is a major cause for depression among the age group. Thyroplasty provides them with a rescue rope to regain their pride and identity.

 

        Increased watering from the eyes may seem a relatively harmless complaint. But very often it is very distressful and can cause social ridicule at times. The major cause is the obstruction of the duct which connects the eyes with the nose. This can be easily cured by an endoscopic dacryocystorhinostomy which is a surgical procedure which has replaced the earlier external approach which gave much less surgical success nevertheless left the patient with an ugly scar. This procedure is completely safe and is done in our institute on a day care basis under both general and even local anaesthesia.

 

        Just like a watering from the eyes, watering from the nose may seem like a harmless complaint. But many times the cause is a condition called the CSF rhinorrhea where the fluid from the brain flows into the nose through defects in the bone which protect the brain. The defects came be either congenital or due to trauma of road traffic accidents or surgery. Some of the cases may even have a the brain and its covering herniating through the defect. The earlier technique was performing a craniotomy ie opening the skull bone and retracting the brain inorder to identify the leak and repair them from above. This left the patient with a life-long possibility of giddiness and other neurological deficits. With the advent of endoscopes, endoscopic CSF rhinorrhea repair has become the treatment of choice. By this technique these defect are done in a safe and simple method from the nasal cavity and the paranasal sinuses.

 

 

        Snoring and mouth breathing are relatively common complaints from mothers with children of around the age of 5 years. The major cause for this symptom is the hypertrophy of the adenoid tissue behind the nose which is obstructing the nose. Even though it is regarded as a  non lethal disease, it has the potential to cause many social and intellectual implication on the child. First and foremost, a hypertrophied adenoids can cause fluid to accumulate in the child's ears and is the most common treatable cause of childhood deafness. This ultimately would lead to a reduced intellectual development in the child. It can also cause changes in the appearances in the child due to persistent mouth breathing like pinched nose, malar hypoplasia and high arched palate. A fatal complication of this condition is obstructive sleep apnea and pulmonary hypertension. The conventional treatment for this disease was adenoidectomy (removal of adenoids) using a curette which is a blind technique and often associated with residual disease and injury. Endoscopic powered adenoidectomy is a more scientifically sound and safe procedure which involved removal of the adenoid tissue obstructing the nasal passage using endoscopes and powered instruments. In our institute powered adenoidectomy is being done as a day care surgery.