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Acute ENT care, cochlear implantation and otitis media in the pandemic, and ENT post-graduate education

Published online by Cambridge University Press:  10 February 2021

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Abstract

Type
Editorial
Copyright
Copyright © JLO (1984) Limited, 2021

We reach this month, the first anniversary of the West hearing the word ‘lockdown’, in relation to a large city in China. Wuhan is an important academic and commercial hub, but was perhaps not a place known to the majority of the world's population until a year ago. We at The Journal of Laryngology & Otology continue to receive a flow of articles in relation to coronavirus disease 2019 (Covid-19) from around the world, and endeavour to publish those that we feel add something new, interesting or useful.

Colleagues grapple globally with the basic sciences relevant to ENT, the practicalities and the implications for ENT services during this ‘war’ with a virus and its aftermath. Despite the increase in article submissions, being a journal editor at the moment is surely more comfortable than being a local or national politician.

The Oxford English Dictionary notes a dramatic increase during 2020 of words such as ‘circuit breaker’, ‘lockdown’, ‘shelter-in-place’, ‘bubbles’, ‘face masks’ and ‘key workers’. The over-use of ‘unprecedented’ is often mentioned, but the Oxford English Dictionary comments: ‘…what was genuinely unprecedented this year was the hyper-speed at which the English-speaking world amassed a new collective vocabulary relating to the coronavirus, and how quickly it became, in many instances, a core part of the language’.1 We approach the anniversary of the coining of ‘Covid-19’, which first appeared in February 2020.

This issue covers the matters of otitis media in the Covid-19 era, from Iran;Reference Raad, Ghorbani, Mikaniki, Haseli and Karimi-Galougahi2 the feasibility of paediatric cochlear implantation, from the North of England;Reference Mohammed, Kennedy, Whitehead, Ahmad and Banerjee3 rapid access (urgent) ENT care,Reference Stubbington, Morrison, Sevilla and Judd4 protection during microlaryngoscopy,Reference Zoabi and Ronen5 dysgeusia symptomsReference Elibol and Baran6 and transnasal humidified rapid-insufflation ventilatory exchange (‘THRIVE’) during the pandemic.Reference Hey, Milligan, Adamson, Nixon and McNarry7 This supplements and complements recent articles in The Journal on acute care, by Osborne and colleagues,Reference Osborne, Bentley, Farrow, Chan and Murphy8 on ethics, by Leonard,Reference Leonard9 and on smell and taste dysfunction, by Jain and colleagues.Reference Jain, Kumar, Baisla, Goyal, Pandey and Das10

The imposed unwelcome revolution in working practices has been superimposed on an evolution of education and training in ENT, not only in the UK, but around the world. Surgical colleges, regulatory bodies (such as the General Medical Council), specialty associations, hospitals, deaneries and universities have all been grappling with this. How to reconcile a need for ENT skills in the general medical workforce (general practitioners and others) and specialists with the barriers imposed by a crowded undergraduate and post-graduate curriculum? Undergraduate and post-graduate curricula are increasingly time-pressured, and a political imperative to increase throughput must be balanced against a professional desire to maintain or improve quality.

One such scheme in the UK has been ‘run-through’ training, in which young doctors make a firm commitment to the specialty (shortly after qualifying in medicine) and are carried right through to independent specialist practice. This issue of The Journal includes a representative survey of a cohort of recent trainees,Reference Howard and Kumar11 and shows the pluses and minuses of this pattern of selection and training, and will be of interest to both sceptics and enthusiasts of such schemes. The run-through scheme increased trainer engagement and gave geographical stability to the trainees, who were well motivated from an early stage in their medical careers. This complements surveys of the attitudes and experiences towards ENT training of students and general practitioners, investigated in recent issues of The Journal,Reference Mayer, Smith and Carrie12,Reference Dimitrov, Unadkat, Khanna, Rennie and Saleh13 and a more historical but seminal article in The Journal on undergraduate ENT education.Reference Powell, Cooles, Carrie and Paleri14

We hope sincerely that our January 2022 editorial will have a more optimistic tone and give more prominence to non-coronavirus matters.

References

Oxford Languages. 2020 Words of an unprecedented year. In: https://pages.oup.com/ol/word-of-the-year-2020 [25 January 2021]Google Scholar
Raad, N, Ghorbani, J, Mikaniki, N, Haseli, S, Karimi-Galougahi, M. Otitis media in coronavirus disease 2019: a case series. J Laryngol Otol 2021;135:1013CrossRefGoogle ScholarPubMed
Mohammed, H, Kennedy, L, Whitehead, D, Ahmad, N, Banerjee, A. A prospective study on the feasibility of cochlear implantation during the coronavirus disease 2019 crisis and trends of assessment: experience in a UK centre. J Laryngol Otol 2021;135:2127CrossRefGoogle Scholar
Stubbington, TJ, Morrison, B, Sevilla, C, Judd, O. What still presents urgently to ENT during a pandemic? Experience of an ENT rapid access clinic during the coronavirus disease 2019 pandemic. J Laryngol Otol 2021;135:7073CrossRefGoogle Scholar
Zoabi, T, Ronen, O. A novel technique for protecting staff during microlaryngoscopy procedures. J Laryngol Otol 2021;135:8385CrossRefGoogle ScholarPubMed
Elibol, E, Baran, H. The relation between serum D-dimer, ferritin and vitamin D levels, and dysgeusia symptoms, in patients with coronavirus disease 2019. J Laryngol Otol 2021;135:4549CrossRefGoogle ScholarPubMed
Hey, SY, Milligan, P, Adamson, RM, Nixon, IJ, McNarry, AF. Transnasal humidified rapid-insufflation ventilatory exchange (‘THRIVE’) in the coronavirus disease 2019 pandemic. J Laryngol Otol 2021;135:8687CrossRefGoogle Scholar
Osborne, MS, Bentley, E, Farrow, A, Chan, J, Murphy, J. Impact of coronavirus disease 2019 on urgent referrals to secondary care otolaryngology: a prospective case series. J Laryngol Otol 2020;134:957–60CrossRefGoogle Scholar
Leonard, CG. Ethical implications of coronavirus disease 2019 for ENT surgeons – a discussion. J Laryngol Otol 2020;134:854–5CrossRefGoogle Scholar
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Howard, E, Kumar, BN. The ENT run through pilot: a questionnaire survey of 23 trainees. J Laryngol Otol 2021;135:7479CrossRefGoogle Scholar
Mayer, AW, Smith, KA, Carrie, S, Collaborative Authors. A survey of ENT undergraduate teaching in the UK. J Laryngol Otol 2020;134:553–7CrossRefGoogle ScholarPubMed
Dimitrov, L, Unadkat, S, Khanna, A, Rennie, C, Saleh, H. ENT training amongst general practitioners: results from a questionnaire. J Laryngol Otol 2020;134:109–15CrossRefGoogle Scholar
Powell, J, Cooles, FAH, Carrie, S, Paleri, V. Is undergraduate medical education working for ENT surgery? A survey of UK medical school graduates. J Laryngol Otol 2011;125:896905CrossRefGoogle ScholarPubMed