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I was fortunate to have the opportunity to undertake two very different fellowships, one in Paris and the other in Mumbai, to further enhance my experience in head and neck surgery. The following account highlights the experience that I was able to gain during my stays.
European Hospital, Georges Pompidou, Paris
The first part of my fellowship was 2 months spent in the Otolaryngology Department at the European Hospital, Paris under the supervision of Professor Ollivier Laccourreye. Professor Laccourreye has an international reputation in the head and neck cancer field, in particular for his expertise in laryngeal conservation surgery and the use of chemotherapy in the treatment of head and neck cancer. As well as three French fellows within the department, there is usually one visiting head and neck fellow. Perhaps surprisingly, I was the first ever fellow from the UK. The main objectives of my trip were to learn the techniques of laryngeal conservation surgery, in particular supracricoid laryngectomy, as well as seeing the results of chemotherapy used in early laryngopharyngeal cancer.
The unit provides a general Otolaryngology service, but the nature of the French Health Service is such that it very much functions as a tertiary referral unit, particularly with reference to the head and neck component of the service. As I had obtained my Certificate of Completion of Specialist Training in the United Kingdom, only a few other easily obtainable documents were necessary to enable me to get hands-on operative experience. In the out-patient setting, however, I had an observer role. In addition, I was able to attend the weekly multi-disciplinary meetings. These for me were one of the highlights. It became obvious that the philosophy of the management of early laryngeal cancer in this unit was very different from that which I had experienced in Nottingham. There was greater emphasis on surgical intervention and also greater use of chemotherapy. The results of the few cases of chemotherapy that I saw were quite impressive. There is no doubt that the experience with the use of chemotherapy gained over the years in this unit has helped to reduce the morbidity that is seen in some other units. What was also surprising was the relatively large number of second primary cases that were presented....