ent 2002 advances in paediatric ent - david albert€¦ · - scurvy •navigation . r-t-w: sailing...

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ENT 2002 Advances in Paediatric ENT Dave Albert

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Page 1: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

ENT 2002

Advances in Paediatric ENT

Dave Albert

Page 2: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

How do we advance in surgery?

• Great minds?

• Luck?

• Years of patient research?

Page 3: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

R-T-W: Sailing advances since Magellan

•Skill in sailing?

•Innovation

•Equipment

- carbon fibre/Kevlar

•General health

- scurvy

•Navigation

Page 4: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

R-T-W: Sailing advances since Magellan

Page 5: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Advances in Paediatric ENT

• Surgical practice -

– Old ideas revisited

• Surgical excision of subglottic haemangioma

• cricotracheal resection

Page 6: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Advances in Paediatric ENT

• Surgical practice

• Equipment

– Endoscopy

Page 7: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Advances in Paediatric ENT

• Surgical practice

• Equipment

– Endoscopy

– Imaging

Page 8: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Advances in Paediatric ENT

• Surgical practice

• Equipment

– Endoscopy

– Imaging

– LASER

Page 9: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Advances in Paediatric ENT

• Surgical practice

• Equipment

• Drugs

– Mitomycin (antineoplastic agent prevents fibrin activation)

– Cidofovir (antiviral)

Page 10: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

• Support services

– Anaesthesia

– ITU

Advances in Paediatric ENT

• Surgical practice

• Equipment

• Drugs

Page 11: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Paediatric ENT

• Laryngology

• Otology

• Head and neck

• Rhinology

Page 12: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Stenosis surgery

– Prevention

– Cricotracheal resection

– Tracheal homografts

– Tracheal stents/balloon dilatation

Page 13: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Preventing subglottic stenosis

• Progression without

stenting effect of ET

Page 14: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Preventing subglottic stenosis

• Laryngeal Rest

Page 15: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Laryngeal

Stenosis

– Prevention

– Cricotracheal

resection

Page 16: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Tracheal stenosis

– Prevention

– Cricotracheal resection

– Tracheal homografts

Page 17: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Tracheal stenosis

– Prevention

– Cricotracheal resection

– Tracheal homografts

– Tracheal stents/balloon dilatation

Page 18: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Tracheal stenosis

– Prevention

– Cricotracheal resection

– Tracheal homografts

– Tracheal stents/balloon dilatation

Page 19: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Haemangioma

– Injection

– Resection

Page 20: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Haemangioma

• Vocal cord palsy

– early cordotomy?

Page 21: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Laryngology

• Haemangioma

• Vocal cord palsy

• Papillomatosis Microdebrider

Intralesional cidofovir

KTP laser

Page 22: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Rhinology

• Adenoidectomy

• Choanal atresia

– KTP

– Mitomycin

– navigation systems

Page 23: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Otology

• Cochlear implant

– age

– incision

– electrode

Page 24: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

Otology

• Microtia

– osseo integration

– rib reconstruction

Page 25: ENT 2002 Advances in Paediatric ENT - David Albert€¦ · - scurvy •Navigation . R-T-W: Sailing advances since Magellan . Advances in Paediatric ENT •Surgical practice -

The future

• Continued expansion of paediatric ENT as a speciality

• further advance thanks to

– equipment

– drugs

– genetic engineering

– surgical practice