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he Biannual International Congresses of the ESPO
have provided a prominent worldwide forum for
presentation of the latest research and evaluation of
new and current practice, and also act as a meeting
point for all colleagues with an interest in treating
children with ENT disorders. It is my great pleasure
to welcome ESPO 2014 to Dublin.
With this important forum taking place here next summer, it is worth
exploring how paediatric ENT has changed and evolved in Ireland
over the years. It no longer just deals primarily with tonsillectomy,
adenoidectomy and the insertion of grommets. It has become a broad
and complex sub-specialty within the field of otolaryngology/head
and neck surgery boasting six subdivisions: (1) general; (2) otology;
(3) cochlear implant; (4) rhinology; (5) head and neck; and (6)
airway. Most countries in the western world now have dedicated, full-
time, paediatric ENT surgeons. The development of paediatric ENT
has largely been driven by the prevalence of head and neck disorders
in children.
suBstantial change
The care of children has undergone substantial changes in the last
century. Hospitals for sick children were founded in the first decade
of the 20th century. Nurses and doctors did pioneering work in those
child-friendly institutions, although diagnostic and therapeutic
management was modest. Antibiotics changed paediatric ENT, curing
what were previously lethal infections. Vaccines against mumps,
rubella, measles and polio had an equally dramatic effect on viral
infections that caused severe ENT sequelae.
The HIB vaccine has nearly eliminated the dreadful epiglottitis and
pneumococcal vaccines have proved very effective in preventing
infections from streptococcus pneumoniae. Cochlear implants have
been a wonderful success and transformed the lives of children born
deaf. Recently, beta blockers have revolutionised the management
of subglottic haemangiomas. These airway lesions were associated
with a high morbidity prior to this. The HPV vaccine will, we hope,
eradicate laryngeal papillomatosis which has caused untold distress to
many children over the years.
Children benefit from being looked after by dedicated nurses and
doctors in dedicated clinics able to cater for their needs. Wards need
to include play areas and accommodation for parents.
team Players
Many children with ENT problems have other co-morbidities which
require a multi-disciplinary approach. The modern paediatric
otolaryngologist has to be, very much, a team player, not just within
his/her specialty, but within all the other paediatric sub-specialties in
the hospital.
The future looks very exciting for paediatric ENT with the
development of molecular biology, molecular genetics and
pharmacology. New treatments, it is to be hoped, will eradicate some
of our more troublesome and chronic disorders which continue to be
a great burden on society, e.g. massive cystic hygroma of the head and
neck or subglottic stenosis.
esPo's international
congress set for
DuBlin next summer
the 2014 BiAnnuAl internAtionAl Congress of the europeAn soCiety of pAediAtriC
otorhinolAryngology (espo) will tAke plACe At the nAtionAl Convention Centre
in duBlin from sAturdAy, mAy 31 to tuesdAy, june 3, next yeAr. john d. russell,
ChAirmAn of the loCAl orgAnising Committee of the Congress, provides An
overview of the development of pAediAtriC ent in irelAnd
the national Convention Centre is the venue for the Biannual
international Congress of the eSPo, which takes place from Saturday,
May 31 to tuesday, June 3, 2014.
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