1 The third European ORL-Board Examination (oral part II,) during the ELS 2010 Vienna, University of Music and Arts

2 Entrance Registration Buffet Examroom IExamroom II Preexam Waiting Room Buffet for examiners Chairmen room Courtyard Toiletts Post-exam Waiting Room 1rst floor Supervisors from the Austrian Medical Academy University of Music and Art Vienna, Anton von Webern Platz 1, 1030 Wien PorterInternet Part II Oral Examination EBE-ORL-HNS 2010 September 1: Ways of the Candidates

3 TimeActivity 6.00Arrival staff 6.30Arrival candidates Cand.1preexam.+ Info question+arrival examiners Exam 1.round Break, coffee, Exam. 2.round Break, coffee, Exam. 3.round Lunch Exam. 4.round Break, coffee, Exam. 5.round Break, Coffee Call over, Preparation of the letters Farewell-Ceremony, Toast with some wine, proseccho, jiuce, water, snacks…… Departure for Heurigen Wolff 8.15 Arrival Cand preexam. Cand Arrival Cand preexam. Cand Arrival Cand preexam. Cand Arrival Cand preexam. Cand Postexam room Cand Postexam room Cand.2Exit14.45 Postexam room Cand.4Exit

4 First Part II Oral Exam Vienna, Sept Number of Candidates n=78 Bahrain1 Czech Republic1 France1 Kuwait1 New Zealand1 Romania1 Serbia1 Slovenia1 Thailand1 Venezuela1 Countries of the Candidates II Countries of the Candidates I

5 Results Part II Oral Exam Vienna Number of Candidates n=78 Not passed n=8, Passed n=70

6 The third European ORL-Board Examination (first oral part II,) during the ELS congress 2010 Vienna, University of Music and Arts 38 Examiners, 4 Supervisors, 6 Guides

7 Distribution of the 38 Examiners and Supervisors From 13 European Countries for the Oral Exam in Vienna September

8 Case Report: A mother comes with her 14 months daughter to the ENT-Specialist. The baby presents with left retro-auricular redness and fever (39.2 C) of 24 hours duration. She has had an upper airway respiratory infection one week ago. There was no ear drainage, however, she has had purulent nasal drainage. Otoscopic Picture Patients Foto of the retroauricular region For the Candidate Question 1: a) What do you see on the pictures? b)What is your first diagnosis? c)Do you have further questions? d)What is your next step?

9 Intracranial complications I. Most common is meningitis S. pneumoniae H. Influenzae 2. Cerebral abscess (temporal lobe > cerebellum) 3. Sigmoid (lateral) sinus thrombosis Cannonball chest infiltrates on chest x-ray (CXR) edema and tenderness over the mastoid cortex and is associated with thrombosis of the mastoid emissary vein as a result of lateral sinus thrombosis (Griesinger sign) 4. Jacksonian epilepsy, hemiplegia, and OM indicates a subdural abscess, until proven otherwise For the Examiner Blue Print: Diagnosis, Bacteria, possible complications and treatment of acute otitis media with early mastoiditis. By Ari Sismanis (Athens) Background Information for the examiners

10 a. Most common complication is mastoiditis, which may progress to Subperiosteal abscess 1.Bezold abscessabscess in digastric groove of SCM b. Petrous apicitis 1, Gradenigo syndrome--otorrhea, retro-orbital pain, and lateral rectus palsy secondary to irritation of CN VI within Dorello canal c. Facial Nerve paralysis: perform myringotomy, culture, and administer antibiotics Residual middle ear effusion after treatment a.70% of patients at 2 weeks b.20% after 2 months c.10% after 3 months d.90% of middle ear effusions persistent after an episode of treated AOM resolve within 90 days For the Examiner Blue Print: Diagnosis, Bacteria, possible complications and treatment of acute otitis media with early mastoiditis. By Ari Sismanis (Athens)

11 Question 3: Which complications of acute otitis media do you know? Question 1: 20% a) What do you see on the pictures? b)What is your first diagnosis? c)Do you have further questions? d)What is your next step? Question 4: What Therapy would you consider? Question 5: 30% What are the main causative organisms of AOM? Acute otitis media (AOM) Causative organisms Streptococcus pneumoniae (40%) Haemophilus influenzae (30%) Moraxella catarrhalis (20%) Diagnosis: Acute otitis media with early mastoiditis Further Diagnostic procedures necessary? Plain-X-ray? CT of the temporal bones ? 50% ?? It was immediately done: in this case it showed cloudiness of the left mastoid without any destruction of the air cells Question 2: Are further diagnostic procedures necessary?

12 SITUATION ON THE WEBSITE AS PER 06/10/2010 NUMBERS REGISTRATIONS ON WEB SITE WITH INCOMPLETE REGISTRATION. IN PROCESS OF SENDING REQUIRED DOCUMENTATION 120 CANDIDATES THAT HAVE ALREADY BEEN VALIDATED (DOCUMENTS SENT AND CORRECT). WAITING TO REGISTER FOR NEXT EXAM 31 CANDIDATES THAT HAVE PAST THE WRITTEN PART EITHER IN MANNHEIM OR PAMPLONA AND HAVE EITHER FAILED OR NOT DONE THE ORAL EXAM YET. POTENTIAL CANDIDATES FOR NEXT ORAL EXAM 42 FELLOWS OF THE EUROPEAN BOARD EXAM. CANDIDATES THAT HAVE PASSED BOTH PARTS (I AND II) 70 What will be the future of the European Exam ORL- HNS?

13 We are convinced, that the introduction of the EBE ORL-HNS is a big step forward in the harmonisation process and quality improvement of our speciality in Europe!