Advanced Education in Otolaryngology DUSHYANT
C. JOSHI TABLE I T r a l n l n g c o u r s e s /'or C o n s u l t a n t s
A scheme for a better training programme to keep pace with the advancing subspecialities of ear, nose and throat surgery is necessary. After a thorough study of an institution a committee should recommend the number of trainees and type of P.G. training, eg. institution 'A' will be recognised for the diploma course and institution 'B' will be recognised for a Master's degree course while 'C' will not qualify for conducting any post graduate course.
Centre
Training Programme The programme must be so designed that the training will extend into the subspecial'ities. The following are the sub-specialities to be included in the training: 1. Head and Neck surgery 2. Rhinology 3. E,N.T. plastic surgery 4. Otology 5. Audiology 6. Paedio-audiology 7. Neuro-otology ~. Vestibulometry It is quite obvious that no one centre can provide training in all these offshoots of E.N.T. surgery, so it is suggested that the trainee should be encouraged to work in different centres. During the training period of a houseman temporal bone dissection should be started. Dushyant C. Joshi, Hon. E.N.T. Surgeon, Maharani Shantadevi Trust Hospital, Palace Road, Baroda 390 001.
Course
Duration
Material
Member & membership fees 15 members
'A'
Neuro-otology
4 days
Lectures, discussion, demonstrations
Ks. 100p
'B'
. Tympanoplasty
4 days
Lectures, demonstrations, bone dissection
Ks. 2oo/-
'C'
Audiology & Vestibulometry
I week
Lectures, demonstrations, practicals
15 members Rs. 100/-
'D'
Rhinology
5 days
Lectures, demonstrations, cadavers for practicals.
10 members Rs. 250]-
The registrar should attend the Neurology clinics and a plastic surgery unit because we have many things in common with these specialities. In western countries the juniors are discouraged to stick to one place for more than twelve months. Working at different places is extremely advantageous to the trainee and helps in the growth of the science.
A d v a n c e d T r a i n i n g For C o n s u l t a n t s The need for such training programme is rapidly increasing. A few well equipped centres should be selected for the purpose and short duration courses to be conducted in advanced sub-specialities. The course should offer very advanced clinical material and
12 members
pr~tctical training classes. Cadavers should be made available for training and demoustration. Such training courses are very popular in advartced countries, so much so that they attract people from other countries. A general guide line is given in Table I. Apart from such courses intensive study courses can be arranged at various centres, for example a small centre may host at1 intensive study course on "Facial Palsy". Our inherent nature to resist chauge works against implementing such a scheme. The need for change must be realised and a scheme evolved.
A Wrist Watch in the Oesophagus G. S. KOHLI, O. P. SACHO~.VA Jackson and Jackson the fathers of modern Broncho-Oesophagology, who have removed over 2308 foreign bodies from oesophagus, have mentioned various types of foreign bodies in the oesophagus such as safety pins, bunch ofhair, pins, coins, artificial dentures, buttons, common pin, nails, toy jack etc. A wrist watch in the oesophagus has not been mentioned in the literature.
Oesophagoscopy was done and the watch was removed from the upper end of the oesophagus, Reference 1. Jackson,C. and Jackson,C. L. (I 959), Foreignbodies in the air and food passages.W.B. Saunders and Go. Philadelphia, 2nd cd.
Case R e p o r t An 18-year-old male was admitted to the E.N.T. ward with a history of having swallowed an adult wrist watch without straps, front glass or dial. O n indirect laryngoscopy nothing was seen. X-rays of the soft-tissue of the neck A.P. and lateral views were taken and these showed a watch which was lying in the upper part of the oesophagus (Fig. 1). G. S. Kohli, Professorand/:Icad of E.N.T. Deptt., Medical College,Rohtak O. P. Sachdcva, Lecturer in E.N.T., Medical College, Rohtak Address: Dr. G. S. Kohli, 819J, Medical Enclave, Rohtak (Haryana)
Fig. 1 X-ray neck, A. P. view,showingwristwatchat file levelof the thoracic inlet.
Indian Journal of Otolaryngology, Volume 28, Number 4, December 1976
203