The last week of April was one of those rare stretches that offered a perfect blend of clinical insight, academic exchange, and surgical depth. From the silent suffering of Obstructive Sleep Apnea (OSA) to the intricacies of nasal framework surgery, and finally to the high-stakes realm of sinonasal and skull base cancers, each session I participated in reaffirmed the diverse yet interconnected roles we ENT surgeons play.
Beginning in Alappuzha: Sleep, Snoring, and Structured Evaluation
On April 24th, I was invited by the Association of Otolaryngologists of India – Alappuzha chapter to deliver a talk titled “Clinical Evaluation of Patients with Obstructive Sleep Apnea.” The meeting was held at Hotel Ramada in Alappuzha, nestled against the serene backdrop of the Kerala backwaters. With OSA increasingly recognized as a public health issue and ENT playing a frontline role, this session focused on practical, outpatient-level strategies for diagnosing and managing sleep-disordered breathing.
Key highlights from my talk included:
- Application of screening tools like STOP-BANG and Epworth Sleepiness Scale.
- Role of nasal endoscopy and flexible laryngoscopy in assessing upper airway obstruction.
- Introducing the concept and logistics of Drug-Induced Sleep Endoscopy (DISE).
- Discussing the evolving role of ENT-led sleep clinics and multidisciplinary care pathways.
The strong engagement from the audience reinforced the need for localized, ENT-driven solutions in the evolving landscape of sleep medicine.
Rhinoplasty and Precision: Chairing Osteotomy Talks in Kannur
Just two days later, on April 26th, I had the opportunity to chair a session at Rhinocraft 1.0, a focused rhinoplasty workshop hosted by Baby Memorial Hospital, Kannur. The session I chaired revolved around one of the most critical aspects of rhinoplasty—osteotomies, presented by Dr. Muhammed Shareef.
The workshop featured a powerhouse faculty:
- Dr. Virendra Ghaisas brought clarity to closed rhinoplasty techniques, highlighting minimal access for optimal structural correction.
- Dr. Qazi Imtiaz Majid shared his approach to challenging revision rhinoplasties and patient expectation management.
- Dr. Kshitij M. Patil offered insightful tips on radix augmentation and dorsal preservation.
- My colleagues Dr. Jabir Bin Umer and Dr. Muhammed Shareef talked on patient selection in rhinoplasty, ostetomies in rhinoplasty etc.
- Discussions on ethnic rhinoplasty reminded us of the anatomical variations we must respect in planning and execution. The event beautifully demonstrated that rhinoplasty, when performed thoughtfully, lies at the crossroads of form, function, and finesse.
Culminating at the Skull Base: Sinosurge 2025 in Thalassery
The academic week culminated with Sinosurge 2025, held on April 27th at Malabar Cancer Centre, Thalassery. This advanced CME focused on a niche yet crucial area: sinonasal and skull base malignancies.
I had the honor of chairing the session on Radiological Anatomy of the Skull Base by Dr. Cessal Kainickal, which explored the nuances of CT-based navigation and how detailed radiological understanding informs safe and complete tumor resections.
Some other standout moments of the program included:
- Case-based discussions on identifying tumor extensions to the orbit and anterior skull base, emphasizing surgical boundaries and dural involvement.
- Updates on multimodal management involving endoscopic resection, adjuvant radiotherapy, and the emerging role of immunotherapy in select malignancies.
- Practical tips for post-operative surveillance imaging and recurrence detection.
Sinosurge 2025 served as a strong reminder of how radiology, surgical skill, and oncologic principles must align seamlessly in managing these complex cases.
One Specialty, Many Dimensions
From screening a sleepy patient in the clinic to shaping a deviated nasal pyramid, and finally to resecting a skull base tumor—this past week reinforced the incredible scope and depth of our specialty.
ENT is no longer confined to ears, noses, and throats in isolation. It’s about restoring breath, balance, beauty, and beyond.
Gratitude to the organizing committees of AOI Alappuzha, Rhinocraft 1.0, and Sinosurge 2025 for the opportunity to engage, share, and learn.