The first combined meeting of the British Association of Oral and Maxillofacial Surgeons and ENT UK was held on 6 September at the Royal College of Surgeons of England
A combined meeting between maxillofacial surgery and ENT surgery was long overdue given the significant overlap between the two specialties.
The event’s keynote speaker, Professor Maura Gillison, from Ohio State University, discussed “the clinical implications of a diagnosis of HPV16 positive head and neck cancer”. It has become apparent that this disease is a new variant of squamous cancer, affecting a younger age group, due to a different aetiology and risk behaviour and responding to treatment in a different way. Professor Gillison gave a highly informed lecture, clarifying many aspects of this emerging disease and raising highly pertinent questions as to how it should be managed, both from a public health and treatment point of view.
‘There is no doubt that within the NHS, surgical treatment for snoring will come under increasing pressure’Following Professor Gillison, three speakers addressed the topic of resection margins in conventional resections for squamous carcinoma, in laser resections and in parotid surgery. The debate on safe margins will never be totally solved, but there is no doubt that physical margins remain only one aspect of how we predict the risk of local tumour recurrence. There are some time-honoured surgical practices by ENT and OMF surgeons which probably do not stand up to scrutiny. An example was the resection margins recommended for parotid tumours. In practice, these are often very fine indeed, given the surgical imperative of preserving facial nerve function, even in the presence of malignant lesions. The counter argument is the recognised risk of local recurrence in pleomorphic adenoma and yet the evidence points to very low risks of local recurrence in careful resections even with very close resection margins.
The session on advances in anterior skull base surgery reflected the long-term interest ENT has developed in the use of the rigid endoscope for sinus surgery. Here, otolaryngologists interface with neurosurgeons, particularly where intracranial surgery is undertaken through the nose. However, it is obvious that there are limits as to what can be done endoscopically.
The conference also addressed surgery for snoring, a controversial field in all respects. Finding hard evidence of effect for any surgical intervention in snoring is difficult, but in a field where patient and partner intolerance of the condition cause serious social and domestic issues, there is persistent pressure on doctors to “cure” snoring.
There is no doubt that within the NHS, surgical treatment for snoring will come under increasing pressure and the vote at the end of the session on “This house believes that surgery is the key to treating snoring” received an overwhelming ‘no’.
The final session was on cross-cover between ENT and OMF departments – a highly topical issue in the era of shift pattern working, hospital at night and WTR, and given that many OMF and ENT units share inpatient facilities and nursing staff.
The poster exhibition was well supported with William Scotton taking the prize for “The use of a modified assessment tool to analyse the impact of radical and selective neck dissection on shoulder function”. The meetings were well supported by our combined sponsors and very efficiently organised by the staff of ENTUK and BAOMS.
Professor Robert Woodwards, President, BAOMS
Alan Johnson, President, ENT UK
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