3rd International Course in the Endoscopic Sinus Surgery, Kajetany, May 21-22, 2010

The third International Course in the Endoscopic Sinus Surgery, organized every year in the International Center of Hearing and Speech in Kajetany, took place on May 21-22, 2010.

Once again Kajetany center had an opportunity to play a host to a large, counting 80 persons, group of rhinologists from Poland and other countries who wanted to study the endoscopic techniques of sinus surgery. This year the group was markedly international, with doctors from the Czech Republic, Ukraine, UK and the Netherlands.

The main goal of the course was to introduce the physicians to the latest achievements in the endoscopic surgery of paranasal sinuses, as well as the opportunities of medical treatment of sinusitis. The lecturers were the eminent experts in rhinology and surgery: Prof. Paweł Stręk from the Jagiellonian University Collegium Medicum, Kraków, Poland, Prof. Dariusz Jurkiewicz from the ORL Clinic of the Military Institute of Medicine in Warsaw, Poland, Prof. Bożena Wróbel from the University of Southern California, USA, Prof. Timoleon Terzis from the Athens Rhinology Centre at Neo Athinaion Hospital, Greece, Prof. Elgan Davis from the Macclesfield District Hospital and Leighton Hospital, UK and Prof. Salil Nair from the Royal Hampshire County Hospital and Southampton University Hospitals NHS Trust, UK.

The scientific program comprised two parts: theoretical and practical. The lectures presented a wide range of topics necessary for every physician who wants to do the endoscopic surgery of sinuses, starting from the surgical anatomy of paranasal sinuses and analysis of the CT images. The radiological diagnostics is the basis of qualifying the patient for surgery and gives the patient the opportunity of thorough and self-reliant evaluation of the pathological changes, planning of the surgical approaches taking into account the anatomical characteristics of the lateral wall of the nose and skull base in each individual, previewing the most difficult stages of the surgery. Another important lecture concerned the optimization of the surgical field. Each operating surgeon understand the importance of the control of the surgical field, bleeding, suppression of the inflammation and selection of the appropriate surgical tools for the precise and fast surgery. The following lectures presented the methods of surgical treatment of diseases of paranasal sinuses and management of postsurgical complications. The topics encompassed basic surgical techniques as well as the advanced techniques such as the modified Lothrop’s procedure and the new technique ‘Ballon Sinuplasty’ in the treatment of chronic sinusitis.

An important part of the course was the round table meeting, during which the participants had an opportunity to discuss with lectures the problems related to the perioperative care. It was the unique chance for them to learn first-and from the many years of experience of our experts and to confront it with own and colleagues’ knowledge and experience. It is all the more important that even though the handbooks provide detailed information on methodology and technical details of the operation, it is not possible to learn from them all these subtle nuances that are learned only through the long experience: which patients should be referred for surgery, when is medical or surgical treatment better, how to prepare patient in order to assure the successful surgery, how frequent should be the follow-up visits, when and how re-operate in complications, which medicines are the best for preparing the patient for surgery. Replies to all these and more questions were provided during the round table, and in their own praxis they will be able to confront the methods used in different countries with their own results and experience.

On the second day of the course took place the practical training. First the lecturers performed demonstrations of the surgical approaches to the most important parts of sinuses. These demonstrations, including the image from the endoscope and surgical navigation, were transmitted to the screen in the lecture room, where all participants of the course could observe them, listening to the explanations and being able to ask questions. Then the smaller group, about 20 persons, qualified for the practical training, could perform all presented endoscopic techniques individually, on fresh frozen cadaver heads, using the latest equipment for endoscopic surgery. The practical training was performed under the supervision of the lecturers, who instructed, corrected and helped in finding the right way into each part of sinuses. Laboratory training took the entire day, but most participants would prefer it to be even longer.

The ending of the another edition of the course is a good time for its evaluation. The participants completed a special questionnaire assessing the presentations, organization, practical training. In each category the 3rd Course in Kajetany has won very good marks. All participants stressed the usefulness of such meetings, particularly the opportunity of the hands-on training, for all surgeons interested in rhinology. One of the participants said that he took part in the first, second and third course and is looking to come to the next course as well, as he was never disappointed. These words of appreciation are for the Organizers of the International Course in the Endoscopic Sinus Surgery an obligation for the future.