Report by: Emma Stapleton, Consultant Otolaryngologist and Skull Base Surgeon, Manchester Royal Infirmary and Salford Royal Hospital, UK
I was delighted to be awarded one of the 2019 Matthew Yung and Chris Raine Travelling Scholarships, to visit John Dornhoffer in Little Rock, Arkansas, and to attend the 4th International Otology Fellows Congress and Advanced Course in Ear and Skull Base Surgery.
I began to plan my visit as soon as I heard the news. A trip to the US Embassy in London was required to acquire a B1 visa due to my contact with US-based patients, and a flu jab was surprisingly challenging to track down outwith the British flu season!
My scholarship took the form of a two-week attachment to John Dornhoffer. He is currently the only neurotologist in the state of Arkansas which has a population of three million people. He therefore has an impressive practice! He’s performed over 2000 cochlear implant operations, and the remainder of his practice largely involves chronic ear disease in adults and children.
John Dornhoffer in the operating theatre (it’s not a theatre, it’s an OR!).
I learned plenty of useful hints and hacks from watching John at work and chatting about his techniques. Many are described in his book, The Chronic Ear. I saw a number of operations for stenotic ear canals, several cartilage tympanoplasties using John’s trapdoor and T-tube techniques, retrograde approaches to cholesteatoma surgery (with stunning cartilage reconstructions of the posterior canal wall), an interesting meningoencephalocoele and several ossiculoplasties. This was a spectacular opportunity to learn new approaches to challenging surgical scenarios.
I also saw a number of cochlear implants. John is a cochlear implant user himself, and his combination of expertise and personal experience mean that he has a unique insight, especially with regard to hearing preservation and adult neuroplasticity.
A diverse faculty came from all over the US and overseas to teach on the skull base course, which is free to attend and one of the best I’ve ever attended. The three days incorporated useful lectures and round-table discussions, followed by cadaveric dissection in the Yasargil Surgical Laboratories. As a consultant with a skull base practice, I was more experienced than the other dissectors, meaning I progressed quickly to the advanced approaches, including complete mobilisation and rerouting of the facial nerve on two cadaveric specimens, and exploration of the jugular foramen supervised by Chungfu Dai, China, who has the biggest temporal bone cancer and paraganglioma practice in the world.
Faculty and delegates at the 4th International Fellows Otology Congress and Skull Base Course.
The atmosphere of the course was relaxed and I thoroughly enjoyed myself. There were social events in the evenings, one at a downtown pizza place (followed by a cocktail bar!) and another at John Dornhoffer’s home. During my trip it was a pleasure to spend time with John and Mary Dornhoffer, who were extremely generous and friendly hosts.
I’m a great proponent for travel; there is no substitute for meeting and learning from experts around the globe, and I encourage my own trainees to travel as much as possible before they settle down. The Matthew Yung and Chris Raine scholarships offer this privilege to young consultants. The value of this opportunity is far greater than the monetary value of the award, and I strongly encourage colleagues to apply for future scholarships.
Otology fellows from Mexico (left) and Slovenia (right) enjoying a game on a night out.