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Observational Mini-Fellowship in Rhinology

Goals & Objectives

The observational mini-fellowship with the Emory Rhinology Service intends to develop an increased awareness of the pathophysiology and diseases of the nose, paranasal sinuses, and associated skull base, with exposure to associated medical and surgical treatment. By observing patient evaluations in the outpatient clinic, fellows will learn basic and advanced history and physical examination skills for rhinologic disorders. They will also observe nasal endoscopy to gain familiarity with diagnosis and intervention in the clinic setting.

The rhinologic clinical team includes faculty physicians, otolaryngology residents, medical students and other learners, and such advanced practice providers as nurse practitioners, physician assistants, allergy nurses, and other ancillary personnel. The observational fellow will learn the importance of this team approach. Fellows may spend dedicated time with the otolaryngic allergy team to observe skin testing and vial mixing for subcutaneous and sublingual immunotherapy.

Fellows may observe multiple procedures, including diagnostic sinonasal endoscopy, postoperative endoscopic debridements following sinus and skull base surgery, endoscopic biopsies, polypectomy and office based endoscopic sinus surgery, office mucocele drainage, balloon sinuplasty, and others. Observation of office-based procedures is variable and depends on the cases available at the time of the mini-fellowship.

The fellow will observe primary and revision endoscopic sinus surgery in a busy tertiary care referral practice. Common pathologies seen in the surgical practice include chronic rhinosinusitis with and without nasal polyposis, allergic fungal rhinosinusitis, paranasal sinus mucoceles, aspirin-exacerbated respiratory disease, and benign and malignant paranasal sinus tumors. Endoscopic septoplasty and surgery for nasal obstruction are often performed as well.

The rhinology team has a very busy endoscopic skull base practice and regularly works with endoscopic neurosurgeons. Procedures include cerebrospinal fluid leak repair, resection of skull base tumors, endoscopic pituitary surgery, and transnasal approaches for intracranial tumors. Fellows will become familiar with the technical issues associated with these surgeries and benefit from the faculty attendings' experienced insight.

To aid in developing skills to treat rhinologic disorders, the fellow may choose an option that includes access to a state-of-the-art endoscopic dissection laboratory located at Emory University Hospital Midtown. This lab is equipped with endoscopic sinus and skull base dissection instruments that allow for cadaveric dissection.

The goals of the rhinology mini-fellowship experience are:

• To become familiar with the evaluation and treatment of patients with inflammatory rhinologic disorders and diseases of the associated skull base.

• To become familiar with endoscopic procedures of the paranasal sinuses and skull base.

• To develop skills in endoscopic sinus and skull base surgery in the laboratory setting.

Fellow Duties

The fellow will shadow the physician and/or advanced practice providers and observe patient evaluations and office procedures. While fellows will view surgical procedures in the operating room, they will not participate due to licensing issues. Fellows that choose the optional laboratory dissection experience will be expected to develop endoscopic sinus and skull base surgery skill sets.

Fellows are invited to participate in new or ongoing research efforts.

Fellows will not have on-call responsibilities.

Organization of the Teaching Service

Fellows will be mentored by four faculty rhinologists, Drs. John DelGaudio, Sarah Wise, C. Arturo Solares, and Joshua Levy. They will also spend time with nurse practitioner Melissa Rotella and physician assistant Leisa Stillman.

Conferences

Fellows have the option of attending all educational conferences sponsored by the Emory Department of Otolaryngology – Head and Neck Surgery. These include weekly grand rounds and didactic lectures.

Housing

While the Emory Department of Otolaryngology cannot offer room or board to visiting mini-fellows, it can assist with locating a suitable arrangement.

Length of Fellowship and Cost

The month-long Emory Rhinology observational mini-fellowship costs $2500 if the laboratory option is chosen, and $1500 if not. The fee is applied to cover mentors' time and incidentals. Checks may be made payable to 'Emory University' or wired (wire transfer instructions available upon request). Extensions of the month-long standard will be considered on a case-by-case basis.

Schedule

Monday

Dr. DelGaudio

Ambulatory surgery

Dr. Levy

Rhinology clinic

Tuesday

Dr. DelGaudio

Rhinology clinic

Dr. Wise

Ambulatory surgery

Dr. Solares

Skull base clinic

Wednesday

Dr. DelGaudio

Clinic

Dr. Wise

1st & 3rd neurosurgery combined cases, 2nd & 4th clinic

Dr. Levy

5th neurosurgery combined cases

Thursday

Dr. DelGaudio

Ambulatory surgery

Dr. Wise

Clinic

Dr. Solares

Neurosurgery combined cases

Dr. Levy

5th neurosurgery combined cases

Friday

Dr. Solares

1st, 3rd, 5th surgery

Dr. Levy

Ambulatory surgery

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