Otitis Media in 2021- What's New? 

Dr. Tal Marom, Samson Assuta Ashdod University Hospital

Course Objective

1. To review major interventions aimed to reduce otitis media (OM) burden: OM diagnosis and management guidelines, tympanostomy tubes insertion guidelines, vaccines (pneumococcal conjugate vaccines, influenza, RSV) and continuous medical educational activities.  
2. To review time trends in antibiotics treatment policy, in light of local bacteriology and antibiotic resistance patterns. 

Course Outline

Otitis media (OM) is a common childhood infection, and a leading cause for increased healthcare utilization, such as frequent office visits, repeated antibiotics prescriptions, and absence from school and parental work. Children with recurrent AOM episodes impose an additional burden, since they are frequently referred to be evaluated for possible hearing loss associated with chronic middle ear effusion and the need for tympanostomy tubes (TT) surgery. Four major efforts have been made to reduce OM burden: 1) publication of OM diagnosis and management guidelines for primary caregivers, 2) publication of indications for TT insertion, 3) introduction of effective new vaccines: pneumococcal conjugate vaccines, influenza and the new-coming RSV vaccine, and 4) educational and teaching activities.  These interventions changed the management of OM in ambulatory care and also the presentation of advanced/refractory OM cases and associated complications, such as mastoiditis. Despite the call to adopt a 'watchful waiting' approach in most mild-moderate OM cases, antibiotics administration rates are still high, and in many cases, unnecessary.  The bacterial changes have also resulted in the decrease of pneumococcal-OM and a concomitant increase in H. influenzae-OM. The latter infections have a higher rate of treatment failure, due to the production of beta-lactamases. A future switch of the first line therapy for OM from amoxicillin to amoxicillin/clavulanic acid is now under consideration. 

Vertigo Approach

 Dr. Ahmed Elmadia

Hearing Rehabilitation - Surgical Treatment options

Dr. Riad Hanifas, Bnei-Zion Medical Center

Face Lift - Concepts, Techniques, and Principles

Dr. Shay Duvdevani, Sheba Medical Center

Radiofrequency Ablation of Benign Thyroid Nodules.

Dr. Naomi Rabinovics

Dr. Limor Muallem Kalmovich

Course Objective

Benign thyroid nodules are a common finding and while many are asymptomatic, some may cause local compression or cosmetic symptoms. Surgical resection has traditionally been the mainstay of treatment however it often carries non-negligible rate of complications. This led to the development of non-surgical therapies such as Radiofrequency Ablation (RFA).
RFA is a minimally invasive nonsurgical treatment for benign and malignant thyroid nodules. It was first described in 2006 in Korea and its use has increased rapidly in recent years. 
Large series have shown impressive reduction of the nodule volume several months post-treatment and significant improvement in patients’ symptoms. 
In this course, we will discuss the indications of RFA of thyroid nodules and patient selection. We will further focus on the technical aspects of RFA and tips and pearls for physicians who wish to use this technique. 
At the conclusion of this course, participants will be able to articulate the different indications for RFA of thyroid nodules and demonstrate a working knowledge of the technical aspects of the procedure and patient selection.

Course Outline

Background
Indications and patient selection
General technique description
Step-by-step preparation and performance 
Complications 
Summary

Advances in parotid surgery

Prof. Avi Hefetz

Course Objective

Parotid surgery is common yet advances in this field are slim to none. The course will update on advances in parotid gland surgery.

Course Outline

The course will give an overall view on an innovative approach towards parotid surgery. The basics of parotid surgery will be discussed in a critical manner. The use of modified blair incisions will be debated and options including small incisions (miniblair incisions) will be presented.
A new approach following parotid surgery leaving no drains and  no pressure dressings will be demonstrated. 
Finally, when needed, a novel technique for reinsertion of vacuum drains in the clinic in patients with salivary collection will be presented. 
All these make parotidectomy much simpler and more comfortable to our patients.

Practical Implementation of Alpha DaRT for the Management of Patients with Squamous Cell Carcinoma of the Skin and Head and Neck

Dr. Aviram Mizrachi, Rabin Medical Center.

Course Objective

Alpha DaRT was conceived as an alternative to surgery, for patients who have unresectable tumors or who elect not to proceed with surgical resection due to morbidities. It is also an alternative to beta/gamma radiation for patients who have recurrence following prior radiation therapy, or in whom conventional radiation would lead to excessive side effects. Alpha DaRT also provides a short treatment duration, rapid clinical outcome, and no known systemic effects. All these attributes make it potentially attractive to patients looking for an alternative form of cancer treatment that maintains a high quality of life.
The purpose of the course is to review the benefits of this innovative technique that was recently approved by the Israeli Ministry of Health, how it is carried out as an outpatient procedure for patients with cancer of the skin and head and neck, and the clinical results that were achieved in a prospective trial. This virtual course will present all the steps required from patient selection and treatment preparation to actual surgical operation, and a discussion of clinical results.

Course Outline

A virtual course that starts by providing the scientific and medical background to the development of Alpha DaRT and highlighting current challenges in radiation oncology that potentially can be met by this new treatment. This will be followed by a discussion of the type of patient population most suited for this treatment. A film will be shown demonstrating preparation of applicators for insertion of Alpha DaRT into a patient’s tumor, and an actual operation accompanied by synchronized explanations of procedural details. A discussion of the successful clinical outcomes achieved in a trial of SCC of the skin and head and neck will follow, based on a recently published article in The Red Journal. Questions and comments from the audience are welcomed. 

Free flap reconstruction - choosing the right tool for the job

Dr.Yotam Shkedy, Rambam Healthcare Campus.

Course Objective

The objective of the course is to present the approach used for choosing the best free flap for a given defect.

Course Outline

- Overview of goals of reconstruction and reconstructions types available.
- Overview of the different free flaps used in head & neck surgery.
- Advantages and disadvantages of each free flap.
- Clinical cases to demonstrate the choice of optimal free flap for each defect.
- Summary.

Pediatric OSAS- more complicate than we think

Dr. Uri Alkan, Rabin Medical Center 

Course Objective

There are differences between adult sleep apnea and pediatric sleep apnea. Adults usually have daytime sleepiness, children are more likely to have behavioral problems.  In children the most common underlying condition is enlargement of the adenoids and tonsils. However, obesity, craniofacial anomalies and neuromuscular disorders also plays a role in children. While an adenotonsillectomy might improve obstructive sleep apnea in most pediatric patients. Other forms of upper airway surgery might be recommended, based on the child’s condition, as well as medications such as topical nasal steroids and Singulair, or Positive airway pressure therapy.
In most cases adenotonsillectomy is the best way to manage pediatric OSAS patients, notwithstanding, in mild and sever OSAS cases the best treatment option is still debatable. 

Course Outline

What is Pediatric OSA: Diagnosis, epidemiology, pathophysiology, types of Pediatric OSAS, investigation, management options.
discutient of management difficult cases of very mild and very sever OSAS

Contemporary diagnosis and management of dysphagia

Dr. Yuval Nachalon, Tel-Aviv Sourasky Medical Center.

Course Objective

Following the course, participants should be able to:
1.    Identify common causes of dysphagia
2.    Describe the assessment process in a patient with dysphagia 
3.    Discuss  various diagnostics for swallowing problems and the utilization of each diagnostic
4.    Describe non-surgical compensatory and rehabilitative treatments for dysphagia
5.    Describe  surgical options for dysphagia 
6.    Discuss methods of tailoring the  treatment to the patient

Course Outline

-    Etiologies of dysphagia
-    Dysphagia diagnostics
o    Screening and assessment 
o    Instrumental assessment
-    Dysphagia therapeutics
o    Non-surgical
o    Surgical
-    Implementing dysphagia practice in the health care system
o    Institutional/patient access barriers
o    Interdisciplinary collaboration
o    Dysphagia assessment and treatment during COVID-19 

Post tonsillectomy bleeding and fatality, bad luck or preventable ?

Prof. Jean-yves sichel

Course Outline

Tonsillectomy in children or adults is a very common procedure. It is usually a simple procedure however devastating complication may occur, especially severe bleeding with possible neurological damage 
For a long time, it has been thought that post tonsillectomy bleeding is not related to surgical technic, however; important publications during the last 15 years change this understanding.
This course will present the main papers which associate surgical technics of tonsillectomy (cold and hot technics) with the risk of post tonsillectomy bleeding.
In addition the course will attempt to explain the causes of mortality by bleeding after tonsillectomy based on the literature and the experience of the senior instructor after participation in a few investing committees of the Israeli ministry of health after such cases.

Biodesign methodology for health care innovation in otolaryngology

Dr. Yona Vaisbuch, Rambam Medical Center.

Course Objective

The participant will appriciate the values of need driven innovation and multidisplinary approach.
The participant will know the fundamentals of the biodesign methodolgy.

The participants will feel empowered to initiate translational research and innovation projects.  

Course Outline

How to efficiently conduct clinical immersion?
How to characterise a need statment?
How do you efficiently assess existing solutions and importent stakeholders?
How do you perform a market analysis for a particular need?
How do you design innovative solutions using need criterias?
How does an innovator objectively select the concept that best addresses the need?
Case-Stories: from the otolaryngology need areas
 

Intergrated Clinical approach to CRS phenotype s

Dr. Meir Warman, Kaplan Medical Center

Course Objective

To describe the CRS different phenotypes and to give clinical tools that woukd asisst in systematic approach , accurate diagnosis and appropriate treatment in CRS patients 

Course Outline

The course will cover the following topics 
Introduction on CRS
Edotypes and phenotypes of CRSWNP
Presentation of CRS phenotypes 
 Suggessted treatment  for each phenotypes
Prognosis and followup 

Extended Endoscopic Sinonasal and Skull Base Approaches- Lessons Learned in the Rabin Medical Center During the Years 2015-2020

Prof. Ethan Soudry, Rabin Medical Center

Course Objective

To review the indications, surgical nuances, complications and long term outcomes of extended endoscopic sinonasal and skull base approaches and to present lessons learned in the Rabin Medical Center during the years 2015-2020 with these approaches.

Course Outline

The various extended sinonasal and skull base approaches will be reviewed. For each approach we will discuss the indications and the surgical nuances  including preoperative imaging and video demonstrations.  We will mainly focus on the complications and long term outcomes of these approaches including our own personal experience in these approaches in the Rabin Medical Center during the years 2015-2020 (approx. 300 cases) and review of the relevant literature. Following the course the participants should become familiar with the various approaches and understand when each should be considered as well as recognize relevant surgical nuances  and the complications and long term outcomes of these approaches. 

Management of nose and paranasal sinuses fibro-osseous lesions

Prof. Roee Landsberg

Course Objective

To introduce the different types of fibro-osseous lesions of the nose and paranasal sinuses, including clinical presentation, imaging, management considerations, external and mainly endoscopic surgical techniques.

Course Outline

The course is based on literature overview and the presenter's experience, with case presentations, including surgical videos demonstrating advanced endoscopic surgical techniques.