SCIENTIFIC
PROGRAM
62nd ANNUAL MEETING
Fairmont Jasper Park Lodge, JASPER, AB
OVERALL MEETING OBJECTIVES
This meeting offers our delegates the unique opportunity to learn from experts and share their own
professional experience in various areas of otolaryngology-head & neck surgery. Participants are also
encouraged and challenged to expand their knowledge and ideas beyond the boundaries of health care.
The overall objective of this meeting is to provide community and academic otolaryngologists with
relevant and up-to-date information in all otolaryngology sub-specialty areas.
Upon completion of this CME activity, the otolaryngologist should be able to acquire the current
approach to formulating differential diagnoses, diagnostic, therapeutic and preventive management of
common otolaryngological conditions in the fields of pediatric, laryngology, head and neck cancer,
rhinology and facial plastics.
Participants will be cognizant of the latest research undertaken across Canadian universities.
Participants will identify common post-operative complications and learn technical aspects to avoid or
minimize such complications.
WEDNESDAY, JUNE 4, 2008
MORNING
Mary Schaffer Ballroom (AB)
CPD Credits – 1.0 hours
SATELLITE SYMPOSIUM
07:00-08:00
Salivary Gland Obstruction: Assessment and Management, including Endoscopic Techniques
CHAIR:
R. Irvine, VANCOUVER, BC
PANEL:
D. Sommer, HAMILTON, ON, J. Kolenda, S. Daniel, MONTREAL, QC
LEARNING OBJECTIVES:
1. Review the epidemiology and etiology of salivary gland calculi.
2. Compare the diagnostic imaging options for the assessment of salivary gland obstruction.
3. Gain familiarity with the management options for salivary gland calculi according to size and location, including
endoscopic management.
4. Discuss the diagnosis and management of pediatric salivary gland obstruction.
Sialolithiasis is a clinical problem often encoured by otolaryngologists, with an incidence of 1 case per 15,000-30,000 people
per year. The presentation can vary from episodes of salivary obstruction triggered by meals, to infections of the gland and
associated deep neck spaces. In some patients, stones can grow to a considerable size, yet remain asymptomatic. Several
imaging modalities for the assessment of obstructive salivary gland disease are available, including ultrasound, sialography,
CT and MRI. The relative indications for these imaging modalities will be reviewed. The management of submadibular
salivary stones has been unsatisfactory for many patients, as the main option for hilar stones has been gland excision.
Likewise, parotid stones have been difficult to manage as neither patients or surgeons are enthusiastic about parotidectomy in
this situation. Salivary gland endoscopy has become a reliable technique for the diagnosis and management of many salivary
stones. This procedure will be reviewed, including the equipment and technical issues involved, a discussion of the
indications, procedure and outcomes. Salivary stones as well as ductal strictures can also occur in the pediatric population,
and the role of endoscopy in the management of these problems will be reviewed.
This symposium is supported by NYCOMED through a non-restricted educational grant.
CPD Credits – 1.0 hours
WORKSHOP
08:00-09:00
Upper Lid Blepharoplasty for the Otolaryngologist-Head & Neck Surgery
CHAIR:
M. Taylor, HALIFAX, NS
LEARNING OBJECTIVES:
1)
2)
3)
4)
To discuss preoperative assessment of patients seeking upper lid blepharoplasty
To outline the relevant anatomy of the upper eyelid, orbit and periorbital region
To discuss in detail the surgical technique for upper lid blepharoplasty
To review postoperative care and potential complications of the procedure
OBJECTIVE: To outline the approach to upper lid blepharoplasty for the practising otolaryngologist-head and neck surgeon.
METHODS: The workshop will address pre-operative assessment, proper patient selection, operative technique, and
postoperative care.
CPD Credits – 3.0 hours
WORKSHOP
09:00-12:00
Non-Melanoma Skin Cancer
CHAIR:
M. Hier, MONTREAL, QC
PANEL:
J. Chaplin, R. Gilbert, J. Harris, N. Jha, C. Keeling, C. Moore, R. Taylor, H. Seikaly,
M. Sepejasco, J. Yoo
LEARNING OBJECTIVES:
1) Review Epidemiology , Etiology of skin cancer
2) Consolidate our understanding of the technique and application of Moh’s surgery in the head and neck
3) Explore the role of the head and neck surgeon, radiation oncologist and medical oncologist in this patient population
4) Develop an approach to reconstruction of the various defects encountered in the management of these cancers
Non-melanoma skin cancer is the most common type of cancer that we encounter in oncology. 20% of North Americans will
develop it in their lifetimes and approximately 70-80% will appear in the head and neck region. As head and neck surgeons,
we are being consulted to participate in the care of these patients with increasing frequency. The cases are often recurrent,
advanced and the disease itself along with the treatment can lead to substantial morbidity and sometimes mortality. Various
treatment options exist for the management of these patients. The treatment decision-making as well as the execution of the
treatment must be well thought out and multi-disciplinary. This seminar will address the complexities encountered with this
interesting patient population and provide an update on novel treatment approaches.
INTRODUCTION – Dr. Michael Hier
SECTION 1
Dr. Mario Sepejasco - Epidemiology, etiology, diagnosis / Moh’s Surgery – Indications, techniques, cases
SECTION 2
Dr. Michael Hier - Surgical Indications
Dr. Naresh Jha - Indications for XRT
Dr. Chris Keeling - Role for chemo and novel medical therapeutics
Drs. Corey Moore / Ansari - Local flaps for head and neck Moh’s defects
SECTION 3
MODERATORS – Drs. Hadi Seikaly / John Yoo
PANELISTS – Drs. John Chaplin, Ralph Gilbert, Rick Taylor and Jeff Harris - Reconstruction of large head and neck skin defects
10:00-10:15
COFFEE BREAK
12:00-13:00
LUNCH BREAK
WEDNESDAY, JUNE 4, 2008 - AFTERNOON
Mary Schaffer Ballroom (AB)
CPD Credits – 3.0 hours
SPECIAL MINI-WORKSHOP
13:00-16:00
Transoral Laser Microsurgery in the Upper Aerodigestive Tract: Early to Advanced Tumors
CHAIR:
W. Steiner, GOTTENGEN, GERMANY
PANEL:
D. Brown, TORONTO, ON, J. Harris, EDMONTON, AB, P. Kerr, WINNIPEG, MB,
M. Taylor, HALIFAX, NS
This symposium is supported by KARL STORZ ENDOSCOPY through a non-restricted educational grant.
WEDNESDAY, JUNE 4, 2008 - MORNING
Mary Schaffer Ballroom (C)
CPD Credits – 1.0 hours
WORKSHOP
08:15-09:15
A Brief History of Epistaxis: From Salt Pork to Surgicel
CHAIR:
I. Dempsey, HALIFAX, NS
LEARNING OBJECTIVES:
The objectives for this workshop are:
1.
To provide the participant with a current protocol for coagulopathy assessment
2.
To provide clinical criteria for selection of existing nasal packing materials
3.
To introduce and discuss indications for use of new thrombin based packing materials.
4.
To discuss a protocol for epistaxis management in the ER.
Epistaxis continues to be one of the most common reasons for urgent otolaryngology consultation. Presentation can vary
from a minor nuisance to life threatening hemorrhage. Epistaxis patients frequently have other medical conditions or take
multiple medications that impair normal coagulation. Successful management of these patients often requires a combination
of medical and surgical treatments and a variety of nasal packing techniques. This one hour workshop will review the
evolution of epistaxis management from home remedies to current practice. Coagulation workup and indications for
coagulopathy reversal will be discussed. A review of current nasal packing materials and indications for new thrombin based
packing materials will follow. Case presentations with discussion will conclude the workshop.
CPD Credits – 1.0 hours
WORKSHOP
09:15-10:15
Current Trends in Cochlear Implantation: A Panel Discussion
CHAIR:
D. Schramm, OTTAWA, ON
LEARNING OBJECTIVES:
To familiarize the clinician with the recent advances in cochlear implantation, in particular:
1. the expanded audiologic criteria for implantation
2. the trend toward consideration of bilateral cochlear implantation for children
3. current meningitis prophylaxis for cochlear implant recipients.
Recent advances in cochlear implant technology include:
•
Expanded audiologic criteria for implantation
•
Bilateral cochlear implantation for children and adults
•
Electro-acoustic stimulation
•
Bimodal stimulation
•
Meningitis prophylaxis for implant recipients
•
Cochlear implant reliability monitoring
Format: This panel will discuss aspects of cochlear implantation that are potentially relevant to all otolaryngologists.
Surgeons from various cochlear implant centers will describe their current approach to the evaluation and management of
patients for cochlear implantation.
10:15-10:30
COFFEE BREAK
CPD Credits – 1.0 hours
WORKSHOP
10:30-11:30
Maximizing Quality in Your OR: Can it be Done?
CHAIR:
K. Kost, MONTREAL, QC, D. Eibling, PITTSBURGH, PA
LEARNING OBJECTIVES:
1. To appreciate the impact of teamwork in the OR on outcomes.
2. To identify the major causes of dysfunctional operating rooms.
3. To undestand how to translate workshop suggestions into concrete action.
METHODS:
1. The history of Crew Resource Management (CRM) training in aviation will be presented.
2. Evidence from the aviation industry that supports the importance of team training will be reviewed.
3. Research that identifies the most frequent causes of OR team malfunction will be discussed.
4. Initiatives currently employed to remedy dysfunctional OR teams will be presented along with pecific suggestions for
problem-targeted interventions.
RESULTS: Evidence from non-medical and medical disciplines illustrates the impact of dysfunction within the OR on
outcomes. The importance of collaborative teamwork, a facilitative approach by the team leader, and effective
communication of a clear 'game plan' are all key elements in maximizing OR quality and efficiency. Conclusions:Suboptimal
collaborative teamwork negatively impacts OR quality and efficiency. Missing instruments may lead to frustration and
unnecessary delays, a poor or non-existent game plan may result in distracted, disinterested personnel, unable to positively
contribute to the task at hand. Proactive planning, interactive discussion and formulation of a concrete game plan serve to
reduce the possibility of errors and promote a highly functional and efficient OR team.
11:30-13:00
LUNCH BREAK