Vol. 29, No 3 Autumn 2019

Prof. B. Nirmal Kumar President, ENT UK

From the President’s Desk I write this after the end of summer and trust you’ve all had a good break enjoying the British sunshine, though with the incessant rain we have had in the last few weeks, sunshine seems a distant memory and we are only in October.

We had an exciting and over-subscribed annual meeting which was held on September 13th in London; the highlight in addition to the educational content was the patient concert by members of "Shout at Cancer" charity led by our very own Thomas Moore ably supported by guitarist John de Carpentier. The singers who have all had a laryngectomy drew a standing ovation from the delegates. Their performance was truly heart-warming. The concert and some of the visiting international speaker costs were sponsored by Storz who generously continue supporting us in our educational endeavours.

The SFO UK (student and foundation doctor) conference was again a great success and the programme drew a fully subscribed delegate list. The SFO UK committee ably led by Jayesh Doshi is doing exceedingly good work in keeping the interest in our specialty high in the next generation. We are blessed in having so many of our colleagues willing to offer inspiration and guidance.

We had a good number of British ENT colleagues visiting New Orleans for the American Academy meeting and as our partners for BACO 2020 we hope the Americans and Canadians will come in full force for our conference in Birmingham next year. The academic programme is taking good shape and the conference is going to be delivered by our in-house team.

We bade farewell to Lyndy Pullan as General Manager of ENT UK, and we have a new General Manager recently in post, to take up the challenge and lead ENT UK forward working with all of our staff, volunteers, executives and trustees.

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It’s a bumper issue for the Autumn 2019 Newsletter, in which ENT UK is particularly delighted to welcome a new General Manager, Julianne Ilebode-Akisanya.

ENT UK’s specialty societies have contributed plenty of updates; there must be something in the air! For trainees, Craig Murray’s SAC update is an essential read.

Finally, please consider nominating a colleague for an inaugural BACO award.

Emma StapletonEditor

The Newsletter for ENT Professionals

Contents From the President’s Desk

New ENT UK GM

GIRFT Report

Education Update

SAC Update

Patient Information

Specialty Group Updates

Obituary

BACO 2020

Vol. 29, No 3 Autumn 2019

One issue that has come up suddenly is the bright idea in some CCGs cascaded to hospitals to change the plastic tubing and bottle lining after every patient when microsuction is performed. This will have huge cost implications and there is no conceivable benefit in terms of infection control. The environmental impact of the additional waste plastic has to be considered too. Fortunately, Andrew Swift who has great experience in coming up with sensible guidance for decontamination of endoscopes has agreed, with Will Helier helping, to lead a short-life working group that will provide the evidence for us to counter this requirement.

I am very pleased to hear that the formal publication of the GIRFT ENT National report was released on 5th November, and the report is available to view on the GIRFT website. I would like to congratulate Andy Marshall and all our members who supported this important initiative for our specialty. Our aim working with all of you is to ensure that we provide high value for membership and this in turn will allow you to concentrate on the important work you do while ensuring our specialty leads from the front, both within the UK and internationally.

Ms. Julianne Ilebode-Akisanya General Manager, ENT UK

From the ENT UK General Manager

It is an absolute privilege for me to join ENT UK as your new General Manager. I look forward to working with the organisation in this period of growth and evolution! Prior to joining ENT UK, I worked as a management consultant across government and health industries with PricewaterhouseCoopers UK and most recently with General Electric Healthcare Partners. During my time as a management consultant, I worked with a wide variety of clients in healthcare from providers to commissioners, both at home and abroad. A core focus of my work over the past years has involved shaping and enabling an organisation's ability to deliver their strategic objectives; this will continue to be a priority for me in this new role, particularly as we seek to forge stronger collaborations with international colleagues.

I also currently serve on the Board of Trustees for Teach First, a leading educational charity and graduate employer working to tackle educational disadvantage across schools in the United Kingdom. This role has provided me with the opportunity to work with a charity delivering solutions to transform the lives of underserved children in our society, whilst also being a leading voice for educational reform. On a final note, I would like to say thank you to the office team who have kindly welcomed me this week and have been a great support as I settle into the role. I look forward to meeting many of you over the coming weeks and months.

 Click here to see the latest content in Clinical Otolaryngology

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Vol. 29, No 3 Autumn 2019

GETTING IT RIGHT FIRST TIME (GIRFT)

NATIONAL REPORT RECOMMENDS INCREASE IN DAY CASE SURGERY

The Getting It Right First Time (GIRFT) programme has published its national report for ENT surgery, setting out a series of 23 recommendations designed to improve the patient experience by lowering admissions and repeat visits and potentially reducing waiting times.

Author Andrew Marshall, consultant ENT surgeon at Nottingham University Hospitals NHS Trust, visited 126 units in England in his review and found that thousands more people could be treated on a day case basis rather than being admitted to hospital. Through the report’s recommendations and by sharing the good practice of units with higher-than-average day case rates, GIRFT aims to:

• ensure more patients are treated without a stay in hospital

• make ENT departments more resilient to pressures on beds

• allow trusts to free up beds for use by other specialties

As well as enabling patients to get home more qu ick ly, increas ing day case rates for tonsillectomy operations could release between £1.4m and £3.7m per year for the NHS.

This is the ninth national report from the Getting It Right First Time programme. It shows there are 330,000 admissions to ENT departments every year, with 43,000 children and adults admitted for the most common procedure of tonsillectomy. There are also 2.8 million ENT outpatient attendances, including 960,000 outpatient procedures.

The report is endorsed by ENT UK president Professor Nirmal Kumar, who said: “This report shows there is very good work being done in ENT departments across the country.”

“The findings offer great scope to build on the strong foundations of service already in place, in terms of quality of patient care and the sheer volume of savings that the NHS could invest back into patient services.”

Click here to read more about the report

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Vol. 29, No 3 Autumn 2019

Ms. Philippa Tostevin ENT UK Director of Education

Education and Training Update

Emergency Skills Course for Consultants (ESCC)

Well done to the Guildford team led by San Sunkaraneni for their delivery of a superb adult emergency skills course for consultants (ESCC) on Oct 11th 2019. Philip Clamp, the National lead for ESCC will be developing and fine-tuning the course to facilitate the delivery at other sites around the UK in the future. Our aim is to be able to deliver ESCC at reduced cost as a membership benefit to ensure that all consultants can maintain emergency safe skills in the generality of ENT when their day job has become increasingly specialised. The ESCC course provides case based discussion and hands-on cadaveric dissection to help consultants and specialty doctors on the consultant rota, to revise and update their emergency skills.

Student and Foundation Doctors (SFO)

The Student and Foundation Doctors Conference in Birmingham on Oct 12th 2019 was brilliantly organised and coordinated by Jayesh Doshi and his team. A morning of inspiring and informative lectures was followed by an afternoon of ENT skills stations. The teaching was provided by a team of kind and enthusiastic trainers covering amongst other things emergency airway, septorhinoplasty simulation and grommet insertion. The SFO group is an enormously popular and rapidly expanding group with 337 members including 160 medical students which is fantastic. Well done to Jayesh for dynamic leadership of the group.

Please encourage any students or Foundation doctors you know to join SFO as it is a source of great support and useful information for them with opportunities to hold leadership positions.

Many reports have shown that work-life balance is a key determinant of choice in the future

workforce when it comes to specialisation and so it was great for the SFO group to hear from many speakers who were able to demonstrate that it is possible to be an ENT surgeon and have other interests and a family life. The winning poster interestingly demonstrated that work-life balance is important in the decision regarding subject of training in both the UK and France. We need to show that we have a positive and attractive message in this area which may not be obvious to medical students and Foundation doctors.

CESR buddies and applications

Thank you to all who have volunteered to be a CESR buddy. We have started the process of pairing buddies with specialty doctors around the UK. If you are interested in being a buddy or are a speciality doctor who would like support in you CESR application please contact Janet.

Medical Licensing Assessment (MLA)

Please take a moment to familiarise yourself with the content of the new Medical Licensing Assessment (MLA) which will transform the way that we can ensure that all medical schools in the UK are addressing ENT teaching.

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Clinical skills at the 2019 SFO UK conference

Vol. 29, No 3 Autumn 2019

Mr. Craig Murray Chair, Specialist Advisory Committee in Otolaryngology

SAC Update

My last few updates have been full of information overload, unsurprising given the changes ahead. Rather than focus upon details I thought I should try and summarise where we are and deal with feedback received. Firstly, let us remember why the curriculum is changing. This is not for change’s sake but has followed on from the “Shape of Training” document from several years ago and taken forward with “Excellence by Design” which is the new GMC standards that all post graduate medical curricula must meet. The aim is to develop medical training with generic professional transferable skills as well as training someone in the broader aspects of their job (outpatient management, emergency take etc). When I speak with trainees, their primary concern is anxiety regarding the defined Special Interest areas. It is worth remembering that this was always the case and people would develop these areas, and be expected to show evidence of this, by time of certification.

The new Multiple Consultant Report (MCR) assessment tool has been significantly improved since the first version. I would hope that trainers have accessed ISCP and trialled this new version which is a useful tool to define trainees’ needs. I would stress the importance of using the MCR pilot tool available on the ISCP website as now is the time to give feedback rather than after it goes

live. Your input will be invaluable to the developers who will take note of what you say.

The new development of JCST Post Certification Fellowships has started to become a reality. We, along with General Surgery and Cardiothoracic Surgery are the chosen pilot specialties, subject to it being possible to ensure the necessary arrangements. A curriculum for lateral skull base has been drafted and will possibly be the first area of training to pilot in ENT. If all goes well I would hope other advanced areas such as trans-oral robotic surgery, cochlear implantation, pituitary surgery, and others will follow in time. These fellowships would train to a standard above that expected at certification, and would be driven by service need. On that basis, specific fellowships would not necessarily be available every year. It is very early days.

National Selection will be held 23-24th March 2020. After the smooth process last year this will again be in Hull. Those wishing to interview should fill in the application which will be available shortly through the Yorkshire and Humber Local Office and Deanery. The venue, whilst being more awkward to travel to, proved to work well and I hope those that attended last year found it worthwhile and will consider coming back again.

Miss May Yaneza Second Assistant Honorary Secretary, ENT UK

Patient Information

We are practicing in an age where information is freely available to the public via the Internet and social media. The information that they access may not be accurate, may not be relevant to the

population in the United Kingdom or may originate from sources without a medical background. Updating and overhauling Patient Information is

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Vol. 29, No 3 Autumn 2019

a momentous task. I have been leading the team involved since March 2019. The team includes Nashreen Oozeer, the Sub-specialty Leads, the ENT UK Executive, John and Davide at ENT UK, and the authors who have submitted revised or new patient information leaflets. Leaflets once received undergo an initial editorial review by myself, Nashreen and John before Executive review, Patient group review then Sub-Specialty review. The majority of the leaflets we receive or that have been revised originate from the sub-specialty groups. The Sub-specialty leads are Sanjai Sood (Head and Neck), Attila Dezso and Arun Iyer (Otology), Sean Carrie (Rhinology), Hesham Saleh (Facial Plastics) and Michael Kuo (Paediatrics). There are currently 40 different patient information topics and we are actively working on 50% of them to be able to edit and respond to queries in a timely fashion.

Patient information includes the Patient Information Leaflets and the website content. We have been focusing on the Patient Information Leaflets as a priority but we will be asking our surgeons of the future at the SFO conference their thoughts regarding the website.

The content and the appearance of the leaflet are important as unfortunately the book is often judged by its cover therefore if the leaflet does not look easy to read or appealing, the patient may not read its content. The act of giving the leaflet to the patient does not mean that patient has read and understood its content. An author guide has been created to assist authors, and summarises the ethos, language and expected areas of content to cover for each topic or procedure. Language should conform to the recommendations made by the Plain English Campaign (think sentences should be short and sweet!) and should be Patient-Centred (substitute “the patient” for “you”). Risks should be quantified where the information is available. Risks that may have been quoted as “rare” become “infrequent” when we review the latest literature!

We can no longer squeeze the information required for a procedure on two sides of A4 therefore the paper leaflets will be longer. We are

developing a new format for the Patient Information Leaflets (paper and online) to make the leaflets visually appealing, easy to read, and easy for the patient to refer back to each section. We are also developing visual “infographics” so that important information can be displayed on one page with the supporting text. John and Davide are working on graphics and layout.

Much discussion has been had in the ENT UK office about the format of the paper leaflets: DL (existing format) versus A5. We contacted the main users of the printed-paper leaflets and polled delegates at the ENT UK EGM (13th September 2019). The DL format was a clearer winner (68%). We are also an environmentally conscious charity and asked the delegates at the EGM whether paper leaflets would be beneficial in their hospital. 92% said that paper leaflets are beneficial in their hospital. A completely electronic system would also exclude our most vulnerable patients (for example, the elderly without internet access or those in lower socioeconomic groups) and it is also much quicker and easier to adapt (that is cross out, circle, highlight or write additional information) on to a paper leaflet than an electronic version.

We were fortunate to receive a suite of revised leaflets from the Head and Neck Society plus leaflets from other subspecialties. They were received before the release of the author guide and enabled the team to have up-to-date content to put in to the new leaflet formats. We are currently sourcing graphics and images, creating the infographics and hope to have the leaflets ready for review by a patient group soon.

Patient information is an important aspect of ENT UK’s work. We know that you are all waiting in anticipation for the new leaflets but as you have read it has not been just a simple case of updating text. The information and the way that it is presented require an extensive overhaul so that we do not have to revisit this area in such depth in the near future. We have developed clear guidance and an editorial process so that future revisions should be quicker. Please contact John at ENT UK regarding Patient Information.

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Vol. 29, No 3 Autumn 2019

Professor Claire Hopkins President, British Rhinological Society

BRS Update

Autumn has been a busy time for the BRS, so it is a good opportunity to update you on our plans. As I write, we have just awarded the first BRS Olympus Advanced Rhinology Tra in ing Fellowships to eight senior trainees and associate specialists. This is a fantastic scheme and we are enormously grateful for Olympus for their very generous sponsorship; our Fellows will have the opportunity to attend a study day, cadaveric dissection course and undertake a clinical observership with a member of the faculty. We hope that this will act as a strong foundation to allow trainees compete for global fellowships as well as providing targeted training. We hope to be able to offer this scheme on an annual basis. Sean Carrie has been instrumental in designing the programme, and we have a very strong faculty who help deliver the programme.

The BRS Juniors group, under the leadership of Richard Green and Abi Walker, have formed a full committee and are planning a number of educational and audit based activities. Please see their update below. The Juniors’ BRS Study day will be free of charge, whilst the main BRS meeting will be heavily discounted for trainees. All trainees can join for free, just contact Lidija.

Given the surplus from the ERS meeting in 2018, we are also in the fortunate position of being able to freeze membership fees and meeting costs for the next year , and all members will

continue to have ERS membership included and have online access to Rhinology. Being a member of the BRS has never been better value!

Meanwhile Showkat Mirza and Matthew Oluwole are already putting the finishing touches to the programme for next year’s annual meeting, to be held on May 15th 2020 in Sheffield. We will be hosting two brilliant international speakers; Isam Alobid, from Barcelona, sharing his technique to make closure of septal perforation easy (I can vouch that it really works too!) and Gwijde Adriansen from Amsterdam, speaking on functional rhinoplasty and the difficult caudal septum; so hopefully helping to avoid a septal perforation in the first place! In addition there will be sessions on Eustachian tube dilatation, panels on difficult to treat CRS and a discussion regarding what role biologics will likely play in the management of CRS in the NHS.

On the last point, the results of the dupilumab trial have now been published in the Lancet and show significant improvements in quality of life, with a 70% response rate. NICE are currently considering indications, but given the cost this is likely to be an option only for patients with severe disease who have failed current treatment pathways. We must avoid the situation encountered in the US where allergists appear to be prescribing for all patients with polyps, regardless of disease severity or prior treatment – we will surely not be allowed to do so in the NHS!

Finally, please make sure that you save the dates for the ERS Congress being held in Thessaloniki next year. June 21 – 25th 2020 will see a fully packed programme in a magnificent setting. We hope to see you all there.

Very best wishes on behalf of the BRS Exec.

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Vol. 29, No 3 Autumn 2019

Richard Green and Abi Walker On behalf of BRS Juniors

BRS Juniors Update

The British Rhinological Society has a long history of engagement with junior doctors, through provision of travelling fellowships and encouraging participation in meetings. The BRS committee is excited to launch a Juniors section with the specific aim of providing education and opportunities for the benefit of the next generation of rhinologists. In May the inaugural BRS Juniors educational meeting was held and attracted a stellar international faculty, and the day received extremely positive feedback from delegates. The BRS Juniors section committee is composed of doctors in training and has set out their stated aims: providing high quality education aimed specifically at juniors; to act as a repository of information about rhinology training; and to raise the profile of rhinology amongst their peers. Planned activities include online journal clubs, updated website and social media profiles, and a directory of international fellowships. We are also delighted to announce the second BRS Juniors educational day which will be held on 14th May 2020 in Sheffield and will attract another world class line up of speakers. This event will again be provided free courtesy of the generous support of Medtronic and the BRS.

Mr. Hesham Saleh President, British Society of Facial Plastic Surgeons

BSFPS Update

The British Society of Facial Plastic Surgery (BSFPS) is pleased to announce that the nominations and election process for the updated structure of its council have started. We invite our members to participate in the process which will mark a new era in the development of the society and facial plastic surgery in the UK.

The BSFPS council will consist of:

Executive Officers President President Elect

Immediate Past President Secretary Treasurer Media and newsletter officer Education officer

AOT representative

Regional representatives

1. North 2. Yorkshire 3. Midlands 4. East of England 5. South West 6. North Thames 7. South Thames 8. Wales 9. Scotland 10. Northern Ireland

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Vol. 29, No 3 Autumn 2019

Mr. Jayesh Doshi Chair, Student and Foundation Doctors in Otolaryngology

SFO Update

The SFO membership continues to grow, currently standing at 337 with an approximately equal split between medical students and doctors.

The 2019 undergraduate elective prize had six high quality entries this year; marking was extremely close but the winner was Ben Talks from Birmingham University about his elective in Melbourne, Australia.

The Annual SFO conference was held in Birmingham on 12th October 2019 and had an attendance of 86 medical students & foundation doctors (plus a waiting list of 25!). Thank you to all the speakers and faculty members who gave up their Saturday to help deliver another fantastic day which was well received by the delegates. Particular thanks to Ameera Abdelrahim, Nina Mistry and Dheeraj Karamchandani who helped organise the event as well as Jessica Leigh in the ENT UK office. Prizewinners included Kiran Joshi (JLO best oral presentation for his talk on Topical e ffect o f Otr iv ine on Eustachian Tube Dysfunction), Sarah McBrinn and William Tsang (Grant Bates Poster prize for her poster on How to Boost ENT Recruitment: International

Comparison) and Fangyue Chen (People’s Poster Prize for her poster on Outcome of Mastoid Obliteration using Bioactive Glass).

The next SFO event will be Thursday 9th July 2020 at BACO 2020. Confirmed simulation skills stations will include 3D temporal bone drilling, paediatric bronchoscopy, grommet insertion and bone-anchored hearing aid surgery. Spaces will be limited! There is also a separate SFO abstract stream so please encourage your medical student and juniors to submit work and register early! Also don’t forget to remind them about the SFO E-book that is available to download from Amazon. Its content has been mapped to the published SFO undergraduate curriculum.

Finally, I am indebted to all those who are involved in promoting and supporting SFO activities. It is clear to see that our specialty is in safe hands!

SFO website SFO Facebook

SFO Twitter SFO Instagram

Delegates at the 2019 SFO Conference

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ENT UK’s Jess and Christy at the 2019

SFO UK conference

Vol. 29, No 3 Autumn 2019

Mr. Michael Wareing British Society of Otology

BSO Update

The BSO have been very active, working on the upcoming BSO Annual meeting and AGM which is taking place at The Great Hall and Morris Lecture Theatre, St Bartholomew’s Hospital, London on Thursday 6th February 2020. The meeting is themed ‘All about the ear’ and has four distinct sessions dealing with issues that the Otologist currently faces and will face in the future.

‘Difficult to deal with dizziness’ includes insights i n t o Ve s t i b u l a r M i g r a i n e , P P P D a n d hyperventilation with contributions from Audiovestibular medicine, Neurology and ENT.

‘Technology and the future’ is a very exciting session that will look at advances in hearing aid technology as well as the role of Artificial Intelligence and new technologies to promote ear care and ear health.

The after lunch session looks at two areas of increasing prevalence, pulsatile tinnitus and necrotizing otitis externa with an update from the ‘UK NOE collaborative’ which is a new, national multi-specialty collaborative group led by colleagues in ENT (Emma Stapleton), infection and microbiology (Monique Andersson) and radiology (Pieter Pretorius).

The academic day finishes with a research session with anatomical insights into the middle ear and an overview of the developing field of inner ear medicine. Before the meeting closes the BSO AGM is held with election of new committee members. New members for the committee are always needed as there is a three year rotation policy so if anyone is interested then firstly make sure you attend the meeting! And then contact any BSO council member to discuss the role.

Early bird registration has already opened at a phenomenally good value price of £79 for ENT UK members

The meeting ties in well with the following day’s Laryngology and Otology meeting at the RSM for people travelling from outside London.

The meeting is preceded by the renowned BSO Balance course on Wednesday 5th February 2020.

Always oversubscribed, this course gives a superb one day instruction on practical management of balance disorders.

The issue of data lodged with PHIN continues: They feel unable to clean the data and as such individually we should put a disclaimer on our page to say that whilst NHS data will give a reflection of our overall practice, we are aware that there are significant errors which cannot be corrected and therefore patients should take care interpreting the data.

We very much look forward to seeing as many people as possible in London on the 6th February next year!

The Great Hall at St. Bartholomew’s Hospital

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Vol. 29, No 3 Autumn 2019

Mr. Matthew Smith Chair, INTEGRATE

INTEGRATE Update

I would like to start by once again thanking trainees for their contributions to INTEGRATE projects, and by providing an update on where the data has gone. For those trainees submitting data to the epistaxis audit, I’m pleased to say that three papers have been published under collaborative authorship, with a fourth under peer review. We are also delighted that in May of this year the Journal of Laryngology and Otology awarded our epistaxis and mortality work the “Best Original Paper” award for 2018, building on INTEGRATE’s 2017 success in the same award.

The head and neck follow up audit data, collected from 5,700 patients, was presented at the BAHNO conference in May 2019, winning “Best Oral Presentation.” The publication containing the results of this work is under peer review, and we hope that the interesting findings will provide impetus to explore alternative regimens of more patient-driven follow-up for head and neck cancer.

Currently the INTEGRATE otology group has the DECODE project underway: DEveloping a Core Outcome set and Diagnostic criteria for acute otitis Externa. This project involves over 100 patient and professionals, and aims to pave the way for future studies of acute otitis externa, including, we hope, a multi-site trial run by INTEGRATE.

As well as our own national projects, one of our more recent aims has been to develop a varied portfolio of projects which are supported by INTEGRATE, but remain externally led and funded. These will benefit from access to a national network of trainees, and our increasing experience coordinating national collaborative projects.

Once the scheme is established, it is hoped that trainees will be able to browse a list of studies, and pick and choose which they become involved with according to their interests. Our first INTEGRATE-supported project, the SeaSHeL study investigating sudden onset sensorineural hearing loss, is currently recruiting site leads across the UK. We’re still looking for a few additional regional leads for the SeaSHeL study in the South Western, North East/Northern and Wessex Deaneries, please get in touch if interested. All involved will gain collaborative authorship in resulting publications.

We are pleased to have had further approaches from teams with studies at various stages of development, and hope to add to the INTEGRATE portfolio soon. If you have a project you think may benefit from more widespread trainee involvement, I would be very happy to discuss how INTEGRATE might be able to help.

Finally, INTEGRATE ran a two-day Research Competencies and Development courses in January 2018 and 2019, providing ENT trainees with Good Clinical Practice (GCP) training and an overview of critical appraisal and research skills. The course imparts basic skills for participation in systematic reviews and research studies, and will run again in April 2020. This year we will be including a session on statistics, hopefully making the course even more useful for those interested in developing a research proposal, and for those taking the FRCS Part 1 exam.

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Vol. 29, No 3 Autumn 2019

OBITUARY: Professor Leslie Michaels

Emeritus Professor of Pathology, University of London, UK.Formerly Consultant Pathologist, Royal National Nose Throat & Ear Hospital, London.

After leaving school, Leslie Michaels had to leave academic education and found a job as an assistant laboratory technician in a pharmaceutical company. After several years he was able to get a scholarship and went to Westminster Hospital Medical School. Thereafter, he took training positions in Clinical Pathology, Microbiology and Histopathology in Bristol, Manchester and London.

However, in post Second World War Britain, Pathology jobs were scarce. So he emigrated to North America and after some two years in New York and then Toronto eventually settled in Northern Ontario. One of his publications of this period was a report on nasopharyngeal carcinoma arising in aviators.

Although well settled for eleven years in North America, National Health Service scouts came to Canada to report that pathologists were now scarce in the UK. So in 1970 he took up a vacancy in the Royal National Nose and Throat and Ear Hospital in London with which he was associated for the next 45 years.

During his early years at the Royal National he investigated "non-healing midline granuloma" providing evidence that lesions with such changes often represent a malignant neoplasm of histiocytic lymphoma type. He also researched in detail inner ear changes relating to age and middle ear tumours and the origins of cholesteatoma.

After retirement, he continued his research into temporal bone specimens. He described presence of an epidermoid formation seen in most foetal ears in the mucosa of the antero-superior quadrant of the lateral wall of the developing middle ear in 1986. This formation is now accepted as precursor of congenital primary cholesteatoma of the ear in children. This epidermoid formation is now named Michael’s structure.

In recent years he contributed particularly in the field of Meniere’s disease and believed otosclerosis to be a neoplasm. He died on 28 December 2018 and is survived by his second wife Dr Sava Michaels-Soucek.

Tony Narula FRCS

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Vol. 29, No 3 Autumn 2019

WELCOME TO BACO 2020 ICC Birmingham 8-10 July 2020

BACO 2020 awards

At BACO 2020 we will celebrate the achievements of the ENT UK membership with a series of prestigious awards in the categories of ‘Rising star’, ‘Outstanding trainer’, ‘Global health’, ‘Innovation in Otolaryngology’ and ‘ENT allied professionals.’ Nominations opened on Thursday 24 October 2019, and close on Monday 2 March 2020. Winners will be determined by an online ballot open to all ENT UK members, taking place between 23 March and 20 April. You can nominate a colleague here.

BACO 2020 abstract submission

Why not be an active participant at BACO? Submissions are open for oral and poster presentations and instructional sessions until 11 December 2019. There will be no extensions! This is a unique opportunity to gain exposure for your research, get feedback from your peers, network with colleagues and experts, potentially win a prestigious prize, and stand out among a very impressive cohort of colleagues. You can submit your abstract or proposal here.

BACO 2020 Travelling fellowships

Applications are open for the Mrs Prakash Narula Travelling BACO fellowships programme, until 2 December 2019. This programme was established to help ease the financial burden of attendance for those delegates who most need it. Successful applicants will receive free registration plus £750 towards travel and expenses. Please pass this information on to any potential delegate or organisation you think might be interested. You can find full details here.

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Vol. 29, No 3 Autumn 2019

BACO 2020 registration and key dates

Early bird registration for BACO 2020 will be opening very soon. In the meantime, you can visit the website to find information, including an overview of the many keynote lectures, symposia, instructional courses, panels, video presentations and live cadaveric sessions, as well as the many other features. You will also be able to find a list of our excit ing roster of speakers and distinguished professors from all over the world, giving a series of interesting and insightful talks on issues affecting the field of contemporary ENT. A full and detailed programme will be available soon.

Key dates:

Registration open: November 2019

Award nominations open: OPEN

Fellowship applications close: 2nd Dec 2019

Abstract deadline: 11th Dec 2019

Abstract outcomes: February 2020

Award nominations close: 2nd Mar 2020

Awards voting commences: 23rd Mar 2020

Awards voting closes: 20 Apr 2020

Early bird registration closes: 17th Apr 2020

BACO 2020

8 -10 July 2020

ENT UK Newsletter �14

Newsletter Editor:

Miss Emma StapletonConsultant ENT Surgeon

Manchester Royal Infirmary Email: emma.stapleton@mft.nhs.uk

Address: ENT UK

The Royal College of Surgeons35-43 Lincoln's Inn Fields

London, WC2A 3PE

The views expressed here in the ENT UK Newsletter

are not necessarily the views of ENT UK as an organisation, but rather the views of individual contributors or the editorial staff

The Otorhinolaryngologist

The Otorhinolaryngologist journal has a brand new group of editors and reviewers from the UK consultant community. Many of you will recognise this journal for its key involvement in training and CPD. There will now be a new drive to publish original articles that will receive national exposure. 

In particular, trainees may be interested in publishing articles including audit projects with completed cycles and key learning points to share with other units; case reports inclusive of a literature review; quality improvement projects, clinical reviews and original research studies.

It is  free to publish and we’ll endeavour to give you a quick decision and publication date. For author information click here, or you can contact Ram Moorthy, Journal Editor, for more information.