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Standing Committee: Academic Training Programme

Fellowship Programme Otology & Neuro-Otology

Van den Broek, O’Donoghue, Magnan, Pauw

A. Goals

One of the objectives of the European Academy of Otology and Neuro-Otology is to ensure a high quality training for young otorhinolaryngologists with special interest in the field of otology, neuro-otology, skull base and neuro-otologic surgery.
Most otolaryngologists presently practising in this field in Europe have worked for a variable time in a centre where highly skilled otologists have developed new diagnostic and surgical methods often in collaboration with other specialists like neurosurgeons, radiologists, maxillofacial surgeons. Many of them are self made men.

Proposals have been made for a European general otorhinolaryngology programme with a duration of six years and under the auspices of the UEMS. The otorhinolaryngology training programme is of a general nature and does not include any training in the more rare and complicated pathology in the field of otology, neuro-otology, skull base and neuro-otologic surgery.
In order to guarantee a high level of practice it is imperative that the requirements for training in this field are further defined. Only centres which meet certain criteria can participate in a fellowship programme. It is also important in order to regulate the number of people practising in this field.

Young otorhinolaryngologists who have followed the specialised training programme could achieve the title of Fellow of the European Academy of Otology and Neuro-Otology, following the charter of the UEMS.
Of course it will take some time before this can be implemented.

B. Duration of training
1. The duration of training in otology, neuro-otology, skull base and neuro-otologic surgery should be two years after the regular
    basic training programme in otorhinolaryngology.

2. This period should be spent as a fulltime fellow in one of the centres considered as a training institution by the European
    Academy of Otology and Neuro-Otology.

3. After completion of the fellowship programme with a certificate of approval from the board of the Training programme of the
    EAONO the candidate becomes a fellow of the EAONO.

C. The scope of the training programme

The training programme would include theoretical and practical training in diagnosis and treatment in otology, neuro-otology, skull base and neuro-otologic surgery. Participation in a multidisciplinary team comprising otolaryngologists, neurological surgeons, neuroradiologists, audiologists, neurophysiologists and other relevant disciplines is a desirable addition. The programme would provide:

In otology
1. Training in the more specialized areas of middle ear surgery including surgery for otosclerosis, congenital, facial nerve      pathology and choleseatoma in all its aspects.

2. Training in audiovestibular and electrophysiological procedures, including electrocochleography, brainstem audiometry, OAE      and videonystagmography.

3. Exposure and participation in a cochlear implant programme.

4. Participation in an active programme of research with the opportunity to produce scientific peer reviewed publications.

5. Participation in a programme of clinical audit.

In neuro-otology

1. Training in the investigation, medical and surgical management of diseases affecting the inner ear and its related structures.

2. Training in intra-operative cranial nerves monitoring.

3. Exposure to diagnostic imaging related to skull base and neuro-otologic surgery.

In skull base and neuro-otologic surgery

1. Exposure to those conditions affecting the anterior, lateral and posterior skull base, including the clivus, cavernous sinus,      occipital bone, sphenoid bone and foramen magnum.

2. Exposure to the use of neuronavigational techniques related to the skull base.

3. Experience in the post-operative care of patients following skull base and neuro-otologic surgery procedures, including      intensive care management.

4. Training in the post-operative rehabilitation of patients following skull base and neuro-otologic surgery.


D. The training institution
1. The center must be a recognized otolaryngology training institution.

2. The institution must have staff in otology, skull base and neuro-otologic surgery.

3. The institution has to provide a recent inventory of otologic, skull base and neuro-otologic procedures.

4. The institution must have the necessary infrastructure, diagnostic and aftercare facilities for the practice of otology,
     neuro-otology, skull base and neuro-otologic surgery. These should include neuroradiological facilities, neuromonitoring,
     neuropathology, intensive care unit, audit meetings, etc.

5. Acces to temporal bone dissection facilities.

6. Acces to a major medical library or electronic retrieval systems to support the educational needs of the Fellow.

7. No more than one Fellow to be in the institution at any given time.

8. A rotation between approved institutions may be encouraged for educational reasons.

E. The Fellow
1. Must have satisfactorily completed an approved training programme in otolaryngology – head an neck surgery, and include
    basic training in otologic surgery. The fellow must give evidence of proficiency in more routine otologic procedures like
    tympanoplasty and mastoidectomy.

2. Will be required to keep records of all aspects of training and research.

3. Will write an evaluation of the programme on completion.

F. Programme Co-ordinator will:
1. provide a written statement outlining the educational goals of the programme,

2. supervise the educational, research, administrative and financial aspects of the programme,

3. organise recruitment, counselling and evaluation of the Fellow,

4. maintain current records of all relevant otologic, neuro-otologic, skull base and patients treated at the institution.



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