News from Gordon Tsang, Otology and Neurotology Fellow, University Health Network, Toronto, Canada
The inaugural Manchester Skull Base Surgical Dissection Course took place from 16-20 October 2017. The venue for the course was the Manchester Surgical Skills Centre, housed within the University of Manchester campus. There were 13 participants from the UK, Turkey, Sweden, Australia, Belgium, including myself, the lone Canadian.
The course emphasised the 360 degree approach to management of skull base disease with a comprehensive curriculum that included many of the common approaches to the skull base. It also included a day focused on using minimally invasive (i.e. endoscopic) approaches to the anterior and central skull base. Course instructors consisted of consultant neurosurgeons and ENT surgeons from Manchester’s Skull Base Unit. Each participant was provided with an entire formalin flushed and vessel-injected cadaveric head and neck to work with for the duration of the course.
Our mornings typically began with a briefing of the day’s dissection goals and an overview of the surgical approaches. To maximise time spent in the lab, didactic lectures were kept at a minimum, with instructors doing much of their teaching during step-by-step demonstrations of the surgical approaches in the lab. Following the demonstration, participants were then able to perform the same procedures on their own specimens as the course instructors circulated. Ample time was provided to achieve our dissection goals and occasionally there was some spare time to explore certain anatomic regions further. A supplemental dissection manual was prepared specifically for the course describing each of the surgical approaches. This served as a helpful aide throughout the course.
There was also the opportunity to socialise with other delegates and the faculty over lunches and coffee breaks. A mid-week dinner for participants took place at the nearby Chetham School of Music.
We were treated to a short tour of the school’s library, which many of us were surprised to learn is the oldest free reference library in the United Kingdom and was frequented by Karl Marx during his time in Manchester. The evening was capped off with a delicious three course dinner in the setting of a recital hall with entertainment provided by a magician.
Due to the overall breadth of the course and amount of time dedicated to dissection, this is a course suited for advanced trainees or consultants with a goal of better understanding the intricate anatomy of the skull base and the strengths and weaknesses of various surgical approaches. Given the expert instruction available during the course, I also found that there was good opportunity to refine and practise familiar surgical approaches.
"Overall, the dissection experience was excellent with much of the credit going towards the availability of equipment from course sponsors, the modern facilities of the simulation centre, along with friendly and approachable instructors. I must also extend my gratitude to my fellowship supervisor, John Rutka, University Health Network, Toronto, Canada, for providing me with the opportunity to travel overseas and participate in this course."