HEAD & NECK RECONSTRUCTIVE SURGICAL CONFERENCE
Friday 4th March 2011
@
St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

The first Head and Neck Reconstructive Surgical Conference was organised on Friday 4th of March 2011 by Professor Aongus Curran at St. Vincent’s University Hospital, Elm Park, Dublin 4.

This one-day event brought together experts from different specialties to speak on the current state of the art in this regard. The session was attended not just by staff and members of the hospital itself but also by Otolaryngologists, Plastic Surgeons, Maxillofacial Surgeons and countrywide trainees from different strands of surgery. Representatives from the nursing and dental professions were well represented as were other related specialties.

Professor Curran and Mr. Enda McDermott, Consultant Surgeon, opened the proceedings shortly after 9 am with a brief introduction, followed by a detailed assessment of nasal and sinonasal malignancies by Mr. Mark Rafferty, Consultant Otolaryngologist. He outlined staging systems for various pathologies of this region and discussed in some detail the treatment options available. This group of cancers poses an especially difficult problem in that presentation is often late and extirpation (open or endoscopic) does provide challenges in terms of clearance given the intricate anatomy involved.

Professor John Crown, a well renowned Oncologist and speaker in his field of expertise then followed with novel treatment modalities for the head and neck cancer patients. His talk was a broad-based fascinating exposition of current advances in this regard and was of interest, not just to head and neck surgeons but to a much wider audience.

Mr. Tadhg O’Dwyer, Consultant Otolaryngologist from the Mater Hospital then concluded the pre-break session with a discussion on oral cavity carcinoma and the various reconstructive options available. He brought to the meeting a wealth of knowledge from his previous experience in this regard.

The morning break was followed by a talk delivered by the Guest Speaker, Professor Peter Neligan, Professor of Surgery at the University of Washington. Professor Neligan who is of Irish origin explained briefly how he came to find himself in the States and then delivered a superb talk on the various flaps and their evolution within the head and neck region. He also emphasised the role of teamwork - a topic which is of exceptional importance at the present time.

The next speaker was Ms. Emer Hanrahan, Consultant Oncologist who continued where Professor John Crown had left off with a more focussed discourse on chemotherapeutic options in head and neck oncology. The last talk of the morning session was given by Mr. Patrick Sheahan, Consultant Otolaryngologist, Cork, on the dilemmas posed both in early and late stage laryngeal cancer with special emphasis on the often confounding role of nodal metastases, which are generally unusual in this type of tumour.

The afternoon session was chaired by Professor Aongus Curran and Ms. Orla Young, Consultant Otolaryngologist. The session began with Dr. Tom Crotty, Consultant Pathologist who discussed the type of standardising pathology parameters in head and neck oncology highlighting various pathologists interpretation of positive margins and advances in staining techniques which are standard at St. Vincent’s University Hospital.

Professor Armstrong, Consultant Radiation Oncologist, gave an excellent overview of the role of current radiotherapy including IMRT in the management of laryngeal cancer. The role of concomitant chemo-xrt in preserving the larynx was discussed with the latest evidence based on trials supporting this approach.

Mr. Eamon Beausang, Consultant Plastic Surgeon at St. James’s Hospital discussed the challenging topic of pharyngeal reconstruction. He outlined the advantages and disadvantages of tubed flaps versus free jejunal interposition flaps and emphasised technical tips to ensuring good swallowing and voice restoration with this type of reconstruction.

Mr. Sean Carroll, Consultant Plastic Surgeon at St. Vincent’s University Hospital, Head of the Plastic and Reconstructive team, discussed the great value of muscle flaps in head and neck reconstruction and pointed out their advantages with restoring function. The latter part of his talk discussed the topic of assessing trainees’ technical capabilities at the RCSI and attempts to develop this internationally.

Professor Leo Stassen, Consultant Maxillofacial Surgeon at St. James’s Hospital gave an interesting overview of the role of maxillofacial surgery in head & neck oncology bringing the strengths of his experience to disorders of the maxilla and mandible.

Professor Michael Walsh, Professor of Otolaryngology at Beaumont Hospital gave a talk on skull base surgery presenting his extensive experience over the past three decades dealing with this area which presents a constant challenge both oncologically and from a reconstructive perspective.

Professor Curran and Ms. Young then closed most enjoyable and informative meeting and thanked Professor Neligan for his invaluable contribution to the conference.

Report by - Professor Aongus Curran / Mr. Nash Patil

Left to right:
Prof Leo Stassen, Professor of Maxillofacial surgeon, St.James’s & Dental Hospital.
Prof Aongus Curran, Professor of Otolaryngology / Head and Neck Surgery, UCD, St.Vincent’s University Hospital.
Dr Edward Cotter, Consultant Dentist, Irish Dental Association.

Left to right:
Prof Peter Neligan, Professor of Surgery, University of Washington.
Prof Aongus Curran, Professor of Otolaryngology / Head and Neck Surgery, UCD, St.Vincent’s Hospital.
Ms Caitriona Lawler, Consultant Plastic Surgeon, St.Vincent’s University Hospital.

Left to right:
Mr David Charles, Consultant Otolaryngology / Head and Neck Surgery, St.Vincent’s University Hospital.
Dr Anne O'Donoghue, Consultant Dentist, Irish Dental Association.
Mr. O'Dwyer, Consultant Otolaryngology / Head and Neck Surgery, Mater Miseriocordiae University Hospital.

Left to right:
Mr Patrick Sheahan, Consultant Otolaryngology / Head and Neck Surgery, South Infirmary University Hospital, Cork
Ms. Orla Young, Consultant Otolaryngology / Head and Neck Surgery, University College Hospital, Galway
Mr Nash Patil, Consultant Otolaryngology / Head and Neck Surgery, Sligo General Hospital, Sligo

Left to right:
Wael Hasan, Special Lecturer in Otolaryngology / Head and Neck Surgery, UCD, St.Vincent’s University Hospital.
Ms Eileen Corridan, Senior Executive Assistant, UCD, School of Medicine.

Photographs by Mr. Wael Hassan