2nd African Head and Neck Society (AfHNS) Annual Scientific Conference in association with the 5th Otorhinolaryngology Society of Ghana meeting and Joint Meeting with the American Academy of Otolaryngology, Head and Neck Surgery (AAOHNS)
Report by: Anna Konney, Consultant Otolaryngology, Head and Neck Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
In 2005 there were no specialist head and neck surgeons in Sub-Saharan Africa, north of South Africa. By 2018 there were 14 fully trained head and neck surgeons in 11 Sub-Saharan African countries who had completed a full year of training through the University of Cape Town Karl Storz Head and Neck Fellowship (12) and the PAACS/Hopkins Head and Neck Fellowship in Cameroon (2). This group of head and neck surgeons established the African Head and Neck Society (AfHNS) in Rwanda in 2016. The 1st AfHNS conference was held in Mombasa, Kenya in 2017. The 2nd was held in association with the 5th Otorhinolaryngology Society of Ghana Meeting and was a Joint Meeting with the American Academy of Otolaryngology, Head and Neck Surgery (AAOHNS). The 3rd AfHNS conference is planned to be held in Harare, Zimbabwe in 2019.
A preconference head and neck dissection course was held at the anatomy department of the Korle Bu Teaching Hospital with objectives to teach trainees and young specialists surgical anatomy of the head and neck; and to demonstrate and practise basic head and neck surgeries, as well as to acquire practical tips on the management of head and neck surgical patients. Twelve otolaryngology residents from Ghana and Kenya participated in the course. It was exciting for all of us to have among us Prof Johan Fagan from University of Cape Town, South Africa, as the main facilitator and our mentor, who worked tirelessly and made all lectures comprehensive and yet simple. His lectures with demonstrations using videos of his surgeries were invaluable to understand even the most difficult areas e.g. the parapharyngeal spaces. We had varied lectures on salivary glands, the thyroid gland, laryngectomy, neck dissections, and some flaps for reconstruction. Practical sessions on cadavers were the most exciting for all and were facilitated by all African Head and Neck Fellows as well as facilitators from the American Head and Neck Society, namely Dr Mark Prince and Dr Jeff Moyer from University of Michigan, Dr Douglas B Chepeha from the University of Toronto, Canada, and Dr Mark Zafereo from MD Anderson Cancer Center. They made practical sessions and demonstrations on cadavers so easy by giving valuable tips to approaches, especially in a low resource environment where improvisations are often necessary to make all surgeries possible and successful. A preconference hands-on ultrasound course was facilitated by Dr Mark Zafereo, with Dr Merry Sebelik of Emory University also partnering in the organisation of the course. Twenty participants enjoyed interactive ultrasound lectures followed by hands-on training with volunteer patients. The participants developed a good understanding of basic ultrasound principles and neck anatomy, with plans to build on this knowledge base with a more advanced ultrasound course in association with future meetings.
During the two-day scientific meeting, we shared work and research results with participants. It was noted that since the head and neck surgeons had returned to their hospitals after their fellowships, there had been much improvement in managing head and neck cancer cases. It became evident that we have to improvise to achieve good results in head and neck cancer. It was also noted that it is difficult to apply international cancer guidelines in low-resourced centres, mainly due to patients being unable to afford expensive investigations and treatment, and a lack of diagnostic and therapeutic equipment. Most patients present with advanced stage disease and may not have access to multidisciplinary treatment regimens including radiation and chemotherapy, further complicating treatment planning.
We hope this is only the beginning of a strong collaboration between the AfHNS and international organisations such as the AHNS and AAOHNS with regard to exchanging ideas and research about head and neck cancers in Africa.