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OTORHINOLARYNGOLOGY (EAR, NOSE & THROAT)
HEAD & NECK CANCER SURGERY

The Otorhinolaryngology, Head and Neck Surgery Department operates within the Surgical Specialties Services Functional Unit at the Royal Adelaide Hospital. The Otorhinolaryngology & Head and Neck Unit works in partnership with the other ENT Units in Lyell McEwin, Modbury and Queen Elizabeth Hospitals in the Central Northern Health Service and also has an affiliation with the Head & Neck Unit from Flinders Medical Centre. The Unit is the tertiary referral centre for remote areas including the Northern Territory, Broken Hill, South Australia, Mt Gambier, Port Lincoln, Far West Coast and Mildura.

The Department of Otolaryngology, Head & Neck Surgery is a recognised centre of excellence for the treatment of Head & Neck Cancer. The quality of care is evidence based, audited and forms the basis of research that is constantly updated.

Activities

The Academic Unit in Otorhinolaryngology, Head & 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 papers at The Australian Society of Otolaryngology, Head & Neck Surgery Annual Scientific meetings, The Australian Head and Neck Society and The Royal Australasian College of Surgeons Meetings.

The Professor Peter John Wormald spends considerable time travelling throughout Australasia and the world giving instructional courses and appearing on expert panels. He has established himself as one of the outstanding sinus surgeons and leaders of research into sinus disease since the Academic Unit was established here in Adelaide in 1997. He has two Ph.D Trainees along with a number of other scientists and aspiring Otolaryngologists working within the Academic Departmen and an Advanced Surgical Trainee undertaking a PhD.

The Department provides one Head and Neck Surgery Fellowships yearly and has provided fellowships to doctors from The United Kingdom, Sri Lanka, USA, Malaysia, Myanmar and New Zealand.

The Department participates in the Australian programme for the training of registrars for Otorhinolaryngology, Head & Neck Surgery for the College of Surgeons Australia. Members of the consultant staff are actively involved in the educational activities of the Royal Australasian College of Surgeons and the Australian Society of Otolaryngology, Head and Neck Surgery. Mr Michael Jay is the current Chairman of the Board of Otolaryngology, Head & Neck Surgery and a former Senior Examiner .

Mr Krishnan is an examiner and the current Chairman of the Head & Neck Section of Australian Society of Otolaryngology, Head & Neck Surgery and was also a former Chairman of the South Australian Board of RACS. Mr Guy Rees is a member of the South Australian Board.

Research

The Department conducts numerous research projects in conjunction with the University of Adelaide under the guidance of Professor Wormald, Senior Lecturer Guy Rees and the clinical staff. These research projects include molecular biological behaviour of head and neck cancer, fungal sinusitis, sinus surgery, closure of CSF leaks, obstructive sleep apnoea and gastro-laryngeal acid reflux.

The Department has established a Head and Neck Cancer Surgery Database which is used to assist with research projects.

Strategic Direction

The Otorhinolaryngological, Head & Neck Unit, under the leadership of Michael Jay coordinates the Head & Neck Services for the South Australia, with Flinders Medical Centre also performing some cancer surgery. However, the bulk is referred directly to the Royal Adelaide Hospital, where patients are seen and assessed at the Head & Neck Clinic on a Thursday afternoon. This plan concentrates the skills, workforce, and equipment to ensure that patients receive the very best standards of practice. The Head and Neck Clinic comprises of ENT surgeons, Plastic Surgeons, Specialist Radiologist, Speech Pathologist, Dietician, Radiation Oncologists and Palliative Care Physicians.

The Department has a professional, very active and cooperative relationship with the Department of Plastic and Reconstructive Surgery which provides an excellent reconstructive service for complex resections in Head & Neck Surgery and in particular free flap reconstruction.

Mr Michael Schultz, who has a special interest in skull-base surgery and otology, and Prof P. J. Wormald who is skilled in pituitary surgery and closure of CSF leaks, work cooperatively with the Department of Neurosurgery

The Adelaide Voice Clinic is run by the Speech Pathology Department and consultants Michael Jay, Suren Krishnan, Guy Rees and Michael Switajewski. The Head and Neck Fellow conducts a cancer surveillance clinic twice a month, utilising the Voice Clinic facilities and which involves monitoring recording and storing information about complex cancer cases.

Quality Control

The Department has a strong commitment to the maintenance of Safety and Quality Activities and conducts regular three monthly medical audits which highlight specific issues. The unit participates in Root Cause Analysis and SA Audit of Peri-operative Mortality to further improve performance and engage in Best Practice

Outreach

Continued commitment to outreach services to Papua New Guinea and the Pacific Islands including Micronesia, Fiji & the Solomon Islands, Guangzhou in China, India, Vanuatu and East & West Malaysia have been well established and continue to flourish. Mr Guy Rees and Mr Suren Krishnan & Michael Switajewski have provided this service.