Michaella Cameron, ST6 (OOPE), North Thames Deanery, United Kingdom
The 30th ERS Congress welcomed 1,850 participants from around the world to a warm and collegial environment – perfect for newcomers like myself. Set in the vibrant city of Budapest, the event was not only academically rich but also beautifully hosted, with a well-curated social programme that brought the international rhinology community together beyond the lecture theatres.
Poignantly, there were moving tributes throughout the congress to the late Peter Tomazic – a respected and much-loved figure in our field.
One of my personal highlights was speaking with Professor Claire Hopkins, who shared that the most impactful sessions for her focused on surgeon wellbeing and resilience. These included Raewyn Campbell’s ‘First do no harm (to ourselves): ergonomics and a long surgical career’ and Kevin Turner’s compelling session on complications and catastrophes in surgery. He posed powerful questions: Why do surgeons need support when things go wrong? How can we better prepare them? And how should we support them afterwards? His insights reminded us that beyond personality traits such as extraversion or conscientiousness, it is psychological flexibility that helps surgeons manage challenges like stress and burnout. Olivia Donnelly also presented powerfully, stating that ‘resilience is between us, not within us’. She reminded us that as leaders, we shape the culture and tone that influence how others respond in pressured environments.
Professor Siow Jin Keat chaired an engaging, candid panel on sinonasal complications with characteristic humour. The ‘Difficult Septum – How I Do It’ sessions were a popular draw, offering practical insights, including Professor Hesham Salem’s approach to anterior deviations.
I also had the privilege of delivering an oral presentation on ‘Septo-Collumelloplasty – The Parachute Graft’. Academic engagement was impressive across the board. I would like to congratulate the 15 clinicians who received ERS travel grants, as well as the winners of the Dragons' Den competition.
The first-ever ERS dissection labs proved invaluable, offering hands-on learning. Highlights included Professor Wormald’s Draf III and Catherine Rennie’s optic nerve decompression demonstration.
Looking ahead, I’m eager to follow developments from the TORNADO trial, which compares Dupilumab and Mepolizumab in treating CRSwNP – paving the way for more personalised treatment.
A final word for the young woman who said she was “just a medical student”: congratulations on your presentation – you belong here too.
The next ERS Congress will be held in Seville in 2027, and I wholeheartedly encourage colleagues from all corners of the globe to attend:
www.ers-isian2027.com
Report on Symposium on Analysis and Management of Chronic Facial Pain in Rhinology
Held at ERS Wednesday 25 June, Budapest
By the Chair, Adrian Agius
Professor Ju Jang (Seoul, Korea) presented some unusual but difficult cases of paranasal facial pain that commenced after rhinoplasty in Eastern populations, bearing in mind that these are usually augmentation rather than reduction rhinoplasty as seen in Western practice.
Prof Larry Kalish (Sydney, Australia) confirmed that pain is a significant burden on the healthcare providers in the rhinology clinic. He presented evidence that facial pain seen in patients with CRS is overwhelmingly due to neurological causes. It is important to be objective and evidence-based in order to plan treatment and he stressed the importance of not rushing into surgery and weighing decisions based on endoscopic and radiologic findings.
Dr Vlad Budu from Romania spoke on differentiation of facial pain into sinogenic and neurologic origin. There have been several instances of facial pain improving after endoscopic sinus surgery however long term follow-up is necessary to verify these results. Small osteomas discovered incidentally do not need to be removed unless causing complications due to obstruction and are rarely a cause of pain.
Dr Rory O’Neill (Dublin, Ireland) neatly summarised the state of the art regarding medical treatment of facial pain. Patients often attend the clinic with a firm belief that that their sinuses need to be drained. Exacerbation of pain by direct pressure on the sinus is a very weak and unreliable sign. Amitriptyline has been shown to be a cheap and very effective treatment for tension type pain and migraine, however as one goes up the ladder costs for headache medication increase significantly.
The chair summarised that, in accordance with international classification of headache disorders in pain of sinugenic origin, there is a temporal relationship between facial pain and the commencement and resolution of the underlying sinus condition.
