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Australian training for contemporary airway management of obstructive sleep apnoea in ENT surgery: current status and future recommendations

Published online by Cambridge University Press:  17 November 2014

S Mackay ,
S Holmes  and
A Jones
S Mackay*
Affiliation:
Division of Otolaryngology Head and Neck Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia
S Holmes
Affiliation:
Illawarra ENT Head and Neck Surgery Clinic, Wollongong, New South Wales, Australia
A Jones
Affiliation:
Division of Respiratory and Sleep Medicine, Wollongong and Shellharbour Hospitals, New South Wales, Australia
*
Address for correspondence: Associate Prof Stuart MacKay, Illawarra ENT Head and Neck Surgery Clinic, Suites 1 and 2, 8–10 Victoria Street, Wollongong, NSW 2500, Australia Fax:+61 2 4227 6292 E-mail: [email protected]
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Abstract

Background:

The identification and treatment of adult obstructive sleep apnoea and other sleep-related breathing issues demands nuanced clinical judgement to determine if surgery is appropriate and which surgery should be performed. No study to date has evaluated the sleep medicine curriculum from the perspective of the Australian ENT surgical trainee, or addressed potential strategies for improving levels of surgical skill and knowledge in this field.

Methods:

A cross-sectional survey was used to assess knowledge of sleep surgery in trainees enlisted with the Australian Society of Otolaryngology Head and Neck Surgery. After a cadaver dissection workshop on the latest reconstructive surgical techniques in adult OSA, a second survey was used to assess changes in the likelihood of applying techniques.

Results:

Overall, trainee confidence, knowledge and exposure to sleep-disordered breathing cases averaged below 50 per cent. The cadaver dissection workshop achieved consistent improvements in all areas assessed.

Conclusion:

Low confidence and lack of exposure to sleep surgery cases for ENT trainees supports a broadening of the Australian Society of Otolaryngology Head and Neck Surgery curriculum. This paper outlines possible ways to improve this situation.

Keywords

SleepSurgeryObstructive Sleep ApneaTrainingMulti-Level Airway ReconstructionSnoring
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue S1 , January 2015 , pp. S8 - S15
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Kezirian, EJ, Maselli, J, Vittinghoff, E. Obstructive sleep apnea surgery practice patterns in the United States: 2000 to 2006. Otolaryngol Head Neck Surg 2010;143:441–7CrossRefGoogle ScholarPubMed
2Lurie, A. Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol 2011;46:1–42CrossRefGoogle Scholar
3Eastwood, P, Malhotra, A, Palmer, LJ, Kezirian, EJ, Horner, RL, Ip, MS et al. Obstructive sleep apnoea: from pathogenesis to treatment. Current controversies and future directions. Respirology 2010;15:587–95CrossRefGoogle ScholarPubMed
4Woodson, BT, Nanuma, H. Comparison of methods of airway evaluation in obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 1999;120:460–3Google ScholarPubMed
5Ogawa, T, Enciso, R, Shintaku, WH, Clark, GT. Evaluation of cross-section airway configuration of obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:102–8CrossRefGoogle ScholarPubMed
6Aurora, RN, Casey, KR, Kristo, D, Auerbach, S, Bista, SR, Chowdhuri, S et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep 2010;33:1408–13Google Scholar
7MacKay, SG, Carney, SA, Woods, C, Antic, N, McEvoy, RD, Chia, M et al. Modified uvulopalatopharyngoplasty and coblation channeling of the tongue for obstructive sleep apnea: a multi-centre Australian trial. J Clin Sleep Med 2013;9:117–24Google Scholar
8Yaremchuk, K, Tacia, B, Peterson, E, Roth, T. Change in Epworth Sleepiness Scale after surgical treatment of obstructive sleep apnea. Laryngoscope 2011;121:1590–3CrossRefGoogle ScholarPubMed
9Won, CHJ, Li, KK, Guilleminault, C. Surgical treatment of obstructive sleep apnea: upper airway and maxillomandibular surgery. Proc Am Thorac Soc 2008;5:193–9CrossRefGoogle ScholarPubMed
10Aggarwal, R, Darzi, A. Technical-skills training in the 21st century. N Engl J Med 2006;355:2695–7Google Scholar
11Reznick, RK, MacRae, H. Teaching surgical skills -- changes in the wind. N Engl J Med 2006;355:2664–9Google Scholar
12Steehler, MK, Chu, EE, Na, H, Pfisterer, MJ, Hesham, HN, Malekzadeh, S. Teaching and assessing endoscopic sinus surgery skills on a validated low-cost task trainer. Laryngoscope 2013;123:841–4Google Scholar
13Brogger, J, Bakke, P, Eide, GE, Johansen, B, Andersen, A, Gulsvik, A. Long-term changes in adult asthma prevalence. Eur Respir J 2003;21:468–72Google Scholar
14Chesson, AL, Ferber, RA, Fry, JM, Grigg-Damberger, M, Hartse, KM, Hurwitz, TD et al. Practice parameters for the indications for polysomnography and related procedures. Sleep 1997;20:406–22CrossRefGoogle ScholarPubMed
15Parthasarathy, S, Haynes, PL, Budhiraja, R. A national survey of the effect of sleep medicine specialists and American Academy of Sleep Medicine accreditation on management of obstructive sleep apnea. J Clin Sleep Med 2006;2:133–42CrossRefGoogle ScholarPubMed
16Sim, MW, Stanley, JJ. Trends in otolaryngology residency training in the surgical treatment of obstructive sleep apnea. Laryngoscope 2014;124:579–82Google Scholar
17Shen, T, Shimahara, E, Cheng, J, Capasso, R. Sleep medicine clinical and surgical training during otolaryngology residency: a national survey of otolaryngology residency programs. Otolaryngol Head Neck Surg 2011;145:1043–8Google Scholar
18ACGME Program Requirements for Graduate Medical Education in Sleep Medicine. In: http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/520_sleep_medicine_2016_1-YR.pdf [17 October 2014]Google Scholar