Department of Otorhinolaryngology (Ear Nose and Throat Surgery), Head and Neck Cancer Surgery

The department of Otorhinolaryngology Head and Neck Surgery operates within the functional unit of the Surgical Specialty Services of the Royal Adelaide Hospital.

The department of Otorhinolaryngology Head and Neck Surgery works in close partnership with other ENT departments of hospitals within the Central and Northern Adelaide Local Health Networks. It works in close cooperation and has an affiliation with departments of ENT surgery at the Queen Elizabeth Hospital, the Lyell McEwin Hospital and the Modbury Hospital. It also has a cooperative relationship with the head and neck division of the department of Otolaryngology Head and Neck Surgery at the Flinders Medical Centre. The ENT department at the Royal Adelaide Hospital is the major tertiary referral centre for remote areas including the Northern Territory, Broken Hill, Mount Gambier, Port Lincoln, Far West Coast of South Australia and Mildura.

The department of Otorhinolaryngology Head and Neck Surgery is a recognised centre of excellence for the treatment of head and neck cancer and is internationally recognised for its work in sinus and skull base surgery. The quality of care is evidence based, audited, and forms the basis of research that is constantly updated.

The academic unit of the department of Otorhinolaryngology Head and Neck Surgery has become a major force in research, instructional courses and state-of-the-art treatment across the country. Members of the department regularly contribute to the scientific research and presentation of scientific papers at the major meetings associated with the specialty. These include contributions to the literature at scientific meetings of the Royal Australasian College of Surgeons, the Australian Society of Otolaryngology Head and Neck Surgery and the Australian New Zealand Head and Neck Cancer Society.

Professor Peter John Wormald spends considerable time travelling throughout Australia, Australasia, and the world giving instructional courses and appearing on expert panels. He has established himself as an outstanding sinus and skull base surgeon, and leader of research into sinus disease, since the academic unit was established in Adelaide in 1997. He has a program that involves postgraduate training of surgeons in PhD as well as Masters of Surgery courses. A number of other scientists and aspiring otolaryngologists work within the academic department which has laboratories based at the Queen Elizabeth Hospital.

The Head and Neck Services are chaired by Associate Professor Suren Krishnan and the Service's program offers advanced head and neck surgical fellowships that attract international surgeons from the United Kingdom, New Zealand and the United States. The Department also provides research fellowships for surgeons from developing nations and has a program associated with Sri Lanka and Malaysia. The Head and Neck Department is also involved in clinical research and is establishing laboratory research in cooperation with the Queen Elizabeth Hospital.

The Department was the first unit to introduce Trans Oral Robotic Surgery and amongst the pioneers of Trans Oral Laser Surgery.

The Department participates in the Australian program for the training of registrars in otolaryngology head and neck surgery for the Royal Australasian College of Surgeons. Members of the consulting staff are actively involved in the educational activities training medical students, junior medical doctors, and registrars in a training program of the Royal Australasian College of Surgeons.

Members of the Department have been involved in positions of leadership in surgery in Australia:

Mr Michael Jay, a former chairman of the Department, is the immediate past president of the Australian Society of Otorhinolaryngology Head and Neck Surgery. He has been an examiner with the College of Surgeons and a former chairman of the South Australian Chairman of the Section of the College of Surgeons.

Associate Professor Suren Krishnan is a former president of the Australian New Zealand Head and Neck Cancer Society, former examiner with the College of Surgeons, and former chairman of the South Australian Section of the College of Surgeons.

Mr Guy Rees has been on the executive of the South Australian State Board of the College of Surgeons.

Mr Michael Schultz is the current South Australian examiner of the board of otolaryngology head and neck surgery at the Royal Australasian College of Surgeons.

The members of The Department of Otorhinolaryngology Head and Neck Surgery have been recognised for their contribution to the specialty, medicine and the community. Professor PJ Wormald was awarded the AMA Award for services to medicine in 2007 and was a state finalist of the Australian of the Year awards in 2011. Associate Professor Suren Krishnan was a recipient of the Medal in the Order of Australia in 2006, a state finalist of the Australian of the Year awards in 2007 and received the AMA Award for contributions to medicine in 2012. Mr Michael Jay was awarded the prestigious Medal of the Royal Australasian College of Surgeons.

Research

The Department conducts numerous research projects in conjunction with the University of Adelaide under the guidance of Professor Wormald, Associate Professor Suren Krishnan, and Senior Lecturer Mr Guy Rees. The clinical staff of the Department are also actively involved in these research projects. These projects include molecular biological behaviour of head and neck cancer, fungal sinusitis, sinus surgery, research into sleep disordered breathing and obstructive sleep apnoea, and gastro oesophageal acid reflux.

The Department also has an established head and neck cancer surgery database that is used to assist with the monitoring of treatment of head and neck surgery, and is also used for the purposes of clinical research. It also has a database of quality of life results that is being used to assist with managing head and neck cancer patients and in developing strategies to manage the life events of patients that have head and neck cancer. It also has a research program looking at the quality of life in indigenous patients with head and neck cancer.

Strategic Direction

The Department of Otorhinolaryngology Head and Neck Surgery coordinates head and neck services in South Australia in conjunction with the Flinders Medical Centre. The Department has a strong focus in head and neck surgery and advanced sinus surgery and skull base surgery. It is the centre of multidisciplinary team meetings in the management of head and neck cancer patients.
Multidisciplinary management of head and neck cancer ensures best standard of practice and ensures that patients receive best advice in the management of their head and neck cancer. The Department also works in conjunction with the department of Neurosurgery in providing a multidisciplinary skull base service. The Department works closely with the departments of Plastics and Reconstructive Surgery, Oral and Maxillo Facial Surgery, Breast Endocrine Surgery and other cancer service providers such at the departments of Radiation Oncology and Medical Oncology.

It also has a close relationship with the department of Palliative Care to provide assistance with patients with terminal head and neck and other malignancies. The Department is proud of its patient centred approach and coordinated care with allied health services such as Speech Pathology, the department of Nutrition and Dietetics and the department of Social Work.

The Department is also involved in special services such as the Adelaide Voice Clinic (run in conjunction with the department of Speech Pathology). The Voice Clinic is run by members of the Department and the Head and Neck Fellow. The Clinic has a special interest in professional voice disorders and is involved in cancer surveillance, monitoring, recording and storing information about complex cancer patients. It also has an interest in swallowing disorders.

Quality Control

The Department has a strong commitment to the maintenance of safety and quality activities. It conducts regular three monthly medical audits that track the performance of the unit and highlight specific issues and examine areas such as complications and mortality. The unit participates in Root Cause Analysis and the South Australian Audit of perioperative mortality to further improve performance and engage in best practice.

Outreach Services

The Department has a great commitment to outreach services. This includes services to regional South Australia including Gawler, Clare, Port Augusta and Mt Gambier, as well as some contribution to the Alice Springs Hospital. It also has a commitment to international outreach services for developing nations. Associate Professor Suren Krishnan, Dr Michael Switajewski, and Dr Guy Rees have provided services to Papua New Guinea and the Pacific Islands including Micronesia, Fiji, the Solomon Islands, Vanuatu and East Malaysia. It has contributed to the education and training of surgeons in Guangzhou, China, regions of India, and Rwanda and Uganda, Africa.