Prof Valerie Lund caught up with friend and colleague, Prof Dr Metin Önerci, to discuss his various positions in rhinology, the FOAM programme with which he is involved, and rhinology in Turkey and the Balkan and the Central Asian region.
Prof Metin Önerci
You hold many senior positions in rhinology, notably General Secretary of IRS and Chair of the IFOS Committee for Rhinology, Allergy, Facial Plastic Surgery and Sleep for some years and you are one of the main founders of the Central and West Asian Countries ORL Association. You were also involved in relaunching the Balkan ORL Society of which you are an honorary member and wrote their byelaws in the early 2000s. What have been the most challenging issues you’ve faced during this time and how have you managed them?
The biggest challenge was to overcome the political issues, to bring people together, and have them work together. The political tensions are very easily reflected in the scientific arena but we are scientific people and nothing to do with politics. In our societies, in our board meetings, and in all other gatherings, we never talk about politics, religion etc. We are a family, and above politics. We belong to one country, which is the world. Everything we contribute to science and patient care is a contribution to the people of that world.
Some countries object to one country being a member of the society because of the conflicts between their countries. It is very difficult to overcome these conflicts. Thank goodness we succeeded in having almost all countries of the world in our society, IRS, due to the commonsense of our members. In the Balkan Society as well, even during the wartime, our colleagues from the fighting sides came together as scientists, worked for rhinology and contributed to science.
In overcoming these problems, Civil Society Organisations like the International Rhinologic Society, Balkan ORL Society, Central and West Asian ORL Society are very important. As the people come together and know each other better, they overcome these political issues and become very good friends.
During your time as General Secretary so far, what single achievement are you most proud of?
Of all my achievements, the most important has been to unite people. Now IRS covers the whole world. Only a few countries are not actively members, but they have observer status, which means they are in the society but without voting right. Briefly, IRS covers the whole world with over 40,000 members.
All the countries, irrespective of their political systems are in our society. They contribute to it, regardless of their countries’ political differences, taking part in the same panels. Travel restrictions do not prevent them from coming to the congresses to share their experiences, as long as they can get a visa. I think we became successful by keeping everybody under the rhinology umbrella. This is a wonderful example for the world.
Prof Önerci and colleagues at Central Asian ORL Congress in 2019.
Are there any specific challenges in delivering rhinology care in Turkey and the Balkan and the Central Asian region?
The most important issue is communication. We are trying to overcome language problems. The colleagues in these countries are speaking English better now, especially the younger generation. There are very smart and innovative colleagues in Balkan and Central Asian countries. We are trying to share with them our experiences on research, especially addressing the issues in their countries and providing them with scientific support. And we learn from their research as well but we need more effective ways to share our experiences.
Can you share your vision for improving rhinology worldwide and in particular in Turkey, the Balkan and the Central Asia region?
Turkey, the Balkan countries and Central Asian countries organise meetings, workshops, and courses together with the participation of other neighbouring countries. We plan to go to these countries more often with well-known international experts and researchers. These countries also need support about how to plan, organise and perform research, whether it is basic, clinical or epidemiological. We are also trying to support them in publishing their research and I am sure they will come up with very interesting studies in the future.
Can you tell us what the future holds for us in rhinology?
We live in a time of very interesting progress in rhinology. Biomarkers or other tests to predict treatment response in advance enable us to use highly-targeted therapies such as monoclonal antibodies. Allergic rhinitis will be treated and even prevented using methods without any adverse effects. Immunotherapy will treat the symptoms and prevent new sensitisation. Immunotherapy will also become the treatment of choice in head and neck malignancies such as melanoma. Treatment with monoclonal antibodies in patients with CRSwNP will reduce the number of surgeries. New drug-eluting devices to deliver high dose local corticosteroids in the ethmoid will be as effective as systemic corticosteroids and surgery for CRS with nasal polyps.
Patients with cystic fibrosis (CF) will have a normal life due to correction of their defect through gene therapy and small molecule treatment. The technical aspects of surgery will also be changing: 3D endoscopes, 3D navigation and robots will help us to overcome the technical challenges in our specialty and will enable us to perform more meticulous surgery. Nanometer-sized sensors will give a high-definition, cellular-level map of a patient allowing multiple in-vitro simulations of therapeutic responses. The augmented and virtual reality display technologies will make it possible for the surgeon to look at the operative field and see the imaging overlaid, with important anatomical areas identified and coloured differently.
Of course, in addition to all this exciting but expensive technology, I am hopeful that in the future, we will be able to provide good equality affordable rhinology care throughout the world.
L-R: Valerie Lund, David Kennedy, Anthony Papavasiliou and Metin Önerci at an IRS meeting.
Can you tell the ENT & Audiology News readership about the FOAM (Free open access medicine) programme?
The FOAM programme is one of the most important initiatives. The philosophy behind this programme is to spread knowledge and news. There are so many research activities all around the world and the knowledge is accumulating. If we can share the information and knowledge we have, the readers will not repeat the same research and have an idea about what kind of research is needed. We have fellowship programmes, and organise schools for residents and for the new specialists with hands-on training workshops. We also give scholarships for their participation in main scientific congresses. We need to share news in our specialty, informing colleagues about these activities and the new information which can be achieved by this free open access programme.
“We will be happy to share the beatiues of Istanbul with our colleagues if we have the chance”
I understand that Turkey will be bidding to host IFOS in Istanbul in 2025. Can you explain the background to this application?
Istanbul is a city of different cultures. It was the capital of three Empires. The people from different cultures are used to living together. They respect each others’ culture and beliefs. When you are in Istanbul you have so many places to visit, from the early Byzantine, Roman and Ottoman Empires, and the holy places for Jewish, Christian and Islam religions. The food is very healthy and delicious, a combination of different kitchens. It is in a place where the two continents meet; you can walk from one continent to the other over the Bosphorus bridge. Istanbul is easily reached from all over the world. There are direct flights from almost every country to Istanbul. Most importantly, entry into Turkey is very easy and only a few countries need a visa which they can obtain at Istanbul airport on arrival. And the infrastructure for holding such a prestigious meeting is excellent. We feel ourselves lucky to be one of the candidates. We will be happy to share the beatiues of Istanbul with our colleagues if we have the chance.
This interview took place before the enormity of the Covid-19 crisis became apparent. Our thoughts are with the many patients, their families and carers and all our colleagues struggling throughout the world with this monumental health challenge.