Day 2 :
Director and Head of ENT in Dr. Anand ENT Specialty Centre, India
Time : 9:30-10:00
R Anand is the Director and Head of ENT in Dr. Anand ENT Specialty Centre, an academic training institute, Coimbatore, India. He graduated from Madurai Medical College, Madurai, Tamil Nadu, and India. He worked as Resident under Dr. Mohan Kameswaran, a world renowned ENT Surgeon from Chennai, India. He is a member of various associations’ like European Politzer Society of Otology, World Sleep Association, Cochlear Implant group of India, Founder Member of Indian Academy of Otorhinolaryngology Head & Neck surgery, Indian Association of Surgeons for Sleep Apnea. He has presented several papers in India and international conferences and conducts Cadaver hands on workshops in regular intervals. He also conducted Rhinology and Otology live surgery workshops. He is the head of cochlear implant department in PSG hospital a leading Pediatric cochlear implant center in India
Obstructive sleep apnea (OSA) is a silent nightmare. It is a rising social problem. A variety of medical and surgical solutions are available in the field but still there is no 100% cure. There are many hidden causes for the failure: Lack of proper counseling, over-weight, improper diagnosis and unaddressed areas in surgery. Hypo-pharyngeal collapse in OSA is the main cause for failure. Hypo-pharynx is the area between upper borders of epiglottis to lower border of cricoid cartilage. In failure cases, a high level of suspicion about hypo-pharyngeal collapse must be thought. Structures like huge tongue base, floppy epiglottis, lingual tonsil and laryngeal mass can be the reasons for the collapse. Apart from the routine workup Sleep Endoscopy is a very important tool to find out the cause. Surgeries like hyoid mobilization & suspension with mandible, midline glossectomy, epiglottopexy and vocal cord surgeries-posterior cordectomy are being performed to correct the failures. Proper pre-operative assessment along with Drug Induced Sleep Endoscopy (DISE) is very important for accurate diagnosis and better outcome. Multilevel surgical intervention tailored according to each individual is mandatory.
Associate Professor, Duke University Health System, USA
Keynote: Multimodality management of head and neck vascular malformations: Review of current literature
Time : 9:00-9:30
Vascular malformations of the head and neck often require multiple interventions with the use of a variety of modalities including periods of observations, systemic medical management, targeted interventional radiologic approaches and surgical debulking or excision. The literature is deficient in evidence based management protocols with the majority being small case series or retrospective reviews. The terminology for these lesions historically has been confusing and until the development of a classification system by the International Society for the Study of Vascular Anomalies (ISSVA), understanding the nature of various vascular lesions has been challenging. Use of a vascular malformation team based approach has improved the diagnosis and management of these complicated lesions. The team generally consists of interventional radiologists, vascular surgeons, dermatologists, plastic surgeons and head and neck surgeons with contributions from other specialties as the need arises. This discussion will focus on diagnosis and management options of the major categories of vascular malformations including hemangioma, venous or mixed venous malformations, lymphatic malformations and arteriovenous malformations with an emphasis on team management and review of the current literature.
Professor Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
Time : 10:00-10:30
Belayat Hossain Siddiquee is a Pioneer Head Neck Surgeon in Bangladesh. He started career as Head Neck Surgeons in 1992 after obtaining Fellowship in ORLHNS from Bangladesh . He is first person posted as Professor of Head-Neck Surgery in the University Hospital of the country. He is Founder chief of HNS Division,BSMMU, Founder president, Bangladesh Society of HN Surgeons, Governing Council Member, Asian Society Head-Neck Oncology (ASHNO), Councilor, IFHNOS, Country Coordinator, World Head-Neck Cancer Day and Editorial Board Member, Springer journal “Oral Cancer”. He is working to improve skill of HN Surgeon’s of his country to global level, make facilities for HN Surgery accessible to common people.
Advance laryngeal carcinoma with N0 neck is a condition where controversies about surgical management are still present. Clearance of the echelon groups of cervical lymph nodes in clinically and radiologically negative neck during surgery for laryngeal primary has got a positive impact on prognosis. We have treated 114 such cases over thirteen years (2001-2013). Fifty five (55) were glottic and 59 supraglottic carcinoma. Surgery was done both in primary and irradiated cases: Primary modality in 53 cases (Glottic-23 and Supraglottic-30) and 61 irradiated cases (Glottic-32 and Supraglottic-29). Two types of surgery offered were (1) Total Laryngectomy, (2) Total Laryngectomy+Bilateral Selective Neck Dissection of Level-II, III, IV lymph nodes (Bil.SND). Total laryngectomy was done in 41 cases (Glottic-20 and Supraglottic-21), Total Laryngectomy+Bil.SND in 73 cases (Glottic-35 and Supraglottic-38). Postoperative adjuvant radiotherapy was given according to demand of the postoperative histopathology. 97.37% (111 patients) were followed up for >2 years, 74.35% (85 cases) >3 years and 45.61% (52 cases) for >5 years. Recurrence detected in 15 cases of Glottic carcinoma, Laryngectomy group-11 (55%) and Laryngectomy+Bil.SND-04 cases (11.43%; p=0.001). In supraglottic carcinoma recurrence found in 20 cases, Laryngectomy group-11 (52.38%) and Laryngectomy+Bil.SND-09 cases (23, 68%; p=0.026). Most of the recurrence (68.18%) occurs in the neck if not addressed properly during surgery. Prophylactic Bilateral SND in advance carcinoma of the larynx with N0 neck has significant influence in reducing recurrence.