ENT Trainee Research Articles

ENT trainee papers presented at the ENT Scotland Winter Meeting, 8 November 2019, Stirling, Scotland, UK

ENT trainee papers presented at the ENT Scotland Winter Meeting, 8 November 2019, Stirling, Scotland, UK

P62 Impact of the Covid-19 pandemic on the SeaSHeL study

IntroductionThe SeaSHeL Study is an ongoing national, multi-centre, cohort study investigating Sudden Sensorineural Hearing Loss (SSNHL). The study is supported by the INTEGRATE ENT Trainee Research Network and the Audiology NIHR Champions, as well as being adopted onto the NIHR Clinical Research Network. It aims to map the pathway of patients with SSNHL, develop a prognostic model to predict recovery of patients with idiopathic SSNHL and establish the impact on patients’ quality of life. Here we summarise the impact of the Covid-19 pandemic on the study and highlight methods employed to improve data collection.MethodsData collection commenced in October 2019 and as of August 2020, 227 patients have been recruited from 66 registered sites across England. This interim data was analysed. The primary outcome was the change in monthly patient recruitment and site registration. The secondary outcome was the completeness of the dataset.ResultsInitially, monthly site registration increased to a peak of 31 in December 2019 and monthly patient recruitment increased to a peak of 34 in February 2020. Both levels decreased during the first wave of Covid-19 with 11 patients recruited and 0 sites registered in April 2020. Both levels have been increasing since, with 21 patients recruited and 5 sites registered in August 2020. The dataset of 227 patients has 113 (49.7%) completed records.ConclusionsThis study represents the largest national cohort study into SSNHL. Despite the Covid-19 pandemic, data collection continued during the first wave and rates are now recovering to pre-Covid-19 levels. Key factors in this recovery are a collaborative research approach involving motivated trainees, an ethics amendment for follow-up data to be collected by telephone and continued engagement of collaborators through regular email correspondence and fortnightly newsletters.

12 Tips to Improve ENT Training During the Covid-19 Pandemic.

This article was migrated. The article was marked as recommended. Background: The Covid-19 pandemic has resulted in significant change to ENT practice, as it a high-risk speciality in terms of SARS-Cov-2 virus transmission. The reduction in theatre time, loss of face to face outpatient appointments and redeployment has contributed to significant loss of training opportunities for current ENT trainees. Aim: This paper provides twelve easy and simple tips for current ENT trainees to follow. Methods: Relevant literature was reviewed and the first named author's personal experiences were drawn upon. Results: The twelve tips are (1) Try run a telephone clinic, (2) Evaluate face to face patients independently and make a management plan, (3) Gain formative feedback, (4) Make the ward round a learning opportunity, (5) Organise formal consultant led teaching, (6) Learn from the interprofessional team, (7) Attend online courses and webinars, (8) Take pictures when performing flexible nasoendoscopy , (9) Organise simulation sessions, (10) Gain surgical knowledge and exposure outside of the theatre setting, (11) Undertake an audit or quality improvement project and (12) Look after yourself and make mental health a priority Conclusion: These twelve tips should help the ENT trainee to maximise their learning opportunities and improve their training.

A multi-centre analysis of a decade of endoscopic pharyngeal pouch surgery in Cheshire and Merseyside.

There are sparse data on the outcomes of endoscopic stapling of pharyngeal pouches. The Mersey ENT Trainee Collaborative compared regional practice against published benchmarks. A 10-year retrospective analysis of endoscopic pharyngeal pouch surgery was conducted and practice was assessed against eight standards. Comparisons were made between results from the tertiary centre and other sites. A total of 225 procedures were performed (range of 1.2-9.2 cases per centre per year). All centres achieved 90 per cent resumption of oral intake within 2 days. All centres achieved less than 2-day hospital stays. Primary success (84 per cent (i.e. abandonment of endoscopic stapling in 16 per cent)), symptom resolution (83 per cent) and recurrence rates (13 per cent) failed to meet the standard across the non-tertiary centres. Endoscopic pharyngeal pouch stapling is a procedure with a low mortality and brief in-patient stay. There was significant variance in outcomes across the region. This raises the question of whether this service should become centralised and the preserve of either tertiary centres or sub-specialist practitioners.

The role of allied healthcare professionals in head and neck cancer surveillance: A systematic review.

The roles of Allied Health Care Professionals (AHPs) in Head and Neck Cancer (HNC) are wide ranging but not clearly defined. Inter-regional variability in practice results from a lack of standardisation in approaches to the Multidisciplinary Team (MDT) make-up and structure. Traditionally, the follow-up of HNC patients is clinician led with multiple scheduled follow-up appointments. The increasing population of HNC patients provides logistical, monetary and efficiency challenges. This systematic review presents the roles of the multiple AHP sub-groups in HNC with the aim of presenting how their differing skill sets can be integrated to modernise our approach in follow-up. We searched MEDLINE, Embase, the Cochrane Library, NIHR Dissemination Centre, The Kings Fund Library, Clinical Evidence, National Health Service Evidence and the National Institute of Clinical Excellence to identify multiple subgroups of AHPs (Dentists, Speech and Language Therapists, Dieticians, Physiotherapists, Psychologists, Clinical Nurse Specialists) and evidence of their role in HNC follow-up. Evidence not directly relating to HNC follow-up was excluded. This Systematic Review was undertaken online by the Integrate (UK ENT Trainee National Collaborative) Head and Neck Subcommittee. Most evidence was of low-quality, and the broad nature of the protocol provided a wide variety of study models. Two authors screened the articles for relevance to the topic before final analysis. The main role identified was improvement in Quality of Life and symptom control rather than detecting recurrence. We also demonstrate that it is possible to stratify HNC follow-up patients using their received treatment modality and Distress Thermometers to identify groups who will require more intensive AHP input. HNC follow-up covers a broad group of patients with differing needs. As such, a blanket approach to this phase of treatment is likely to be less effective than a patient-led model where the group of AHPs are employed on a needs basis rather than at set time points. This will likely lead to greater patient satisfaction, earlier detection of recurrence and efficiency savings.

ENT trainee papers presented at the ENT Scotland Winter Meeting, 18 November 2016, Sterling, Scotland, UK

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ENT trainee papers presented at the ENT Scotland Summer Meeting, 12 May 2017, Dunblane, Scotland, UK

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ENT trainee papers presented at the Association of Otolaryngologists in Training Conference, 7–8 July 2016, Glasgow, Scotland, UK

ENT trainee papers presented at the Association of Otolaryngologists in Training Conference, 7–8 July 2016, Glasgow, Scotland, UK

ENT trainee papers presented at the ENT Scotland Summer Meeting, 13 May 2016, Dunblane, Scotland, UK

ENT trainee papers presented at the ENT Scotland Summer Meeting, 13 May 2016, Dunblane, Scotland, UK

ENT trainee papers presented at the ENT Scotland Winter Meeting, 20 November 2015, Sterling, Scotland, UK

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ENT trainee papers presented at the ENT Scotland Summer Meeting, 7 May 2015, Dunblane, Scotland, UK

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ENT trainee papers presented at the ENT Scotland Winter Meeting, 21 November 2014, Sterling, Scotland, UK

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Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th edn

This new edition has been fully updated and almost entirely rewritten by an international team of editors and contributors. Much of the credit must go to the editorial team for maintaining its format and excellent content throughout. The aim is ‘to be used as the definitive reference for trainee and specialist ENT surgeons, audiologists and trainee head and neck surgeons.’ It easily achieves this aim. The previous six-volume text has been condensed into three. The number of chapters has been increased, with a total of 20 sections and 260 chapters, highly illustrated in colour throughout. Each section has standard format with key points and best-practice summaries, which aid the reader to focus on the main teaching points. The text is accompanied by a fully searchable electronic edition, containing the same content as the print edition, with references linked to MEDLINE®. This gives the reader requiring more information an excellent starting point. It costs slightly more than alternative texts of similar breadth and depth but it does represent value for money given its broad coverage. The first volume covers basic science and paediatrics. The chapters on management of congenital deformities of the external and middle ear, laryngeal stenosis, and paedatric tracheostomy and craniofacial anomalies are excellent. The second volume covers rhinology and head and neck oncology. The chapters on anatomy of the nose, paranasal sinuses, surgical management of rhinosinusitis, abnormalities of smell, frontal sinus and diagnosis of facial pain are highly recommended reading for all ENT practitioners. In the head and neck section the chapters on objective evaluation of the voice, parapharyngeal space, hypopharynx, metastatic neck disease, and quality of life for head and neck cancer and palliative care are excellent. Of specific note in the third volume are two chapters focusing on prosthetics and reconstruction. David Gault’s chapter on ear reconstruction is superb. The chapters on anatomy of the skull base and infratemporal fossa, physiology of hearing and balance, and clinical neuroanatomy are also excellent.

ENT trainee papers presented at the Summer Meeting of ENT Scotland (Scottish Otolaryngological Society), 8–9 May 2014, Dunblane, Scotland, UK

ENT trainee papers presented at the Summer Meeting of ENT Scotland (Scottish Otolaryngological Society), 8–9 May 2014, Dunblane, Scotland, UK

ENT trainee papers presented at the summer meeting of ENT Scotland (Scottish Otolaryngological Society), 9 May 2013, Dunblane, Scotland, UK

ENT trainee papers presented at the summer meeting of ENT Scotland (Scottish Otolaryngological Society), 9 May 2013, Dunblane, Scotland, UK

ENT trainee papers presented at the Summer Meeting of ENT Scotland (Scottish Otolaryngological Society), 12 May 2012, Dublane, Scotland, UK

ENT trainee papers presented at the Summer Meeting of ENT Scotland (Scottish Otolaryngological Society), 12 May 2012, Dublane, Scotland, UK

The portable temporal bone lab – a useful training adjunct for the ENT trainee

The portable temporal bone lab – a useful training adjunct for the ENT trainee