AB159. SOH25_AB_155. Emergencies facing the otologist

Background: Otolaryngologists in Ireland are trained to a high standard to incorporate the management of all emergency cases pertaining to any subset of otolaryngology, despite being appointed to a consultant position with a subspecialty interest. We audit all emergency cases presented to the lone otologist in a busy university hospital.

Methods: A retrospective audit was carried out of all emergency cases requiring surgical intervention over a 12-year period. We categorised each case into the relevant subspecialties of otology, rhinology, head and neck, and arrest of secondary tonsillectomy haemorrhage.

Results: A total of 100 patients required emergency surgical management, amounting to just 3.3% of 3,002 surgical cases over a 12-year period. Head and neck emergency cases inclusive of neck abscesses and airway management accounted for 59% of all cases, with 13% of cases related to epistaxis management and periorbital abscesses in a rhinology setting. Otology emergencies presenting primarily in relation to temporal lobe abscesses and otogenic meningitis amounted to just 11% of all emergencies. Surgical management of post-tonsillectomy haemorrhage accounted for the remaining 17% of cases.

Conclusions: The training system for otolaryngology in Ireland prepares future consultants for the acute emergent take and management of surgical emergencies. Regardless of subspecialty interest, the new consultant must be adequately trained to manage any emergency that arises within the specialty.

Keywords: Emergency; ENT; otologist; subspecialty; training