Irene Benaran (left), ENT CDF and Noah Evans Harding (right), ENT ST4, University Hospital Monklands, Lanarkshire, UK.
The theme of this year's British Society of Otology (BSO) annual meeting was ‘The Past, Present and Future of Otology’. To introduce aspiring ENT trainees to otology surgery, the BSO team were delighted to launch the first BSO Juniors’ Day. Sponsored jointly by NHS Lanarkshire and Tunnock’s bakery, it took place in the Kirkland’s Hospital Medical Education Simulation labs at Bothwell, near Glasgow. The educational sessions were aimed at junior trainees and medical students interested in a career in otology.
The exciting programme included a morning session devoted to the latest technology in otology simulation to develop surgical skills and expand on anatomy knowledge. It included the Voxel-Mann virtual reality simulator, 3D-printed bone for middle ear implants and hands-on experience in the wet labs with lambs' heads for both microscopic and endoscopic dissection.
The afternoon session comprised a round-table discussion between otology consultants, a fellowships talk, and excellent oral presentations from the best-submitted abstracts. The oral presenters were Dr Fiona Penny on ‘Applying autoethnography to learning how to perform a cortical mastoidectomy on augmented reality’; Miss Talisa Ross on ‘Convolutional neural networks for automated image segmentation of CT temporal bones: a scoping review’; Dr Emily Heywood on ‘Outcomes of operative management of cholesteatoma in the elderly: a 15-year retrospective study’; and Miss Jessica Ball on ‘Evaluation of the NHS R67 monogenic hearing loss panel in a tertiary unit’. Miss Talisa Ross was the winner. The event was a great success with positive feedback received from all in attendance.
Juniors then joined senior and consultant otologists for the main event on Friday in Glasgow. The mysterious history of otology was explored through a Scottish lens – Mr Iyer (Lanarkshire) revealed how Mary Queen of Scots' husband died of complications of mastoiditis and how if this had not occurred, we might well have been conducting the conference in French!
Further historical lectures explored the roles of Wilde, Bell, Dix and Hallpike in pioneering the practice of otology. Though later talks explored the cutting edge of exoscopes and robotics, historical photos of 100-year-old instrument sets showed us that some things really don’t change at all. However, some change in practice was surely inspired in all of us when Professor Bhutta gave his talk about the carbon and humanitarian costs of otology. Single-use instruments were highlighted as the ecological ‘public enemy number one’.
It was not Guy Fawkes night, but oohs and aahs could be heard from the audience when Professor Marco Caversaccio of Bern showed video footage of his latest robot. Armed with a huge masonry-style drill-bit, he was able to reach the round window, blind, in a matter of seconds with margins of only 0.5mm to the facial nerve.
Closer to home, Professor Manohar Bance of Cambridge presented preliminary data of world-first gene therapy for monogenetic congenital sensorineural hearing loss, with some astonishing improvements in hearing thresholds in just a few months post-transcochlear infusion.
These were just a few of the highlights from an excellent day that also included uses of artificial intelligence in otology (Professor Alex Huber, Zurich), updates on current vestibular schwannoma management (Professor Simon Lloyd), implantable hearing aids, exoscopes, robot scopes, endoscopes and more. There were also roundtables on simulation training and practical otology dilemmas. Finally, the Glasgow college provided a fabulous venue, plenty of good food and, of course, plenty of rain.
