Tehran University of Medical Sciences
Office of Vice-Chancellor for Global Strategies & International Affairs
International Human Capacity Development (IHCD)
Code : 10950-346876      Publish Date : Sunday, May 24, 2015 Visit : 2267

Sabbatical leave | Sabbatical Leave Report | Rhinology , Sinus Surgery

Rhinology , Sinus Surgery
Rhinology , Sinus Surgery - by Dr. Ebrahim Razmpa
 
Application Code :
280-0115-0002
 
Created Date : Thursday, February 12, 2015 23:22:32Update Date : Sunday, February 15, 2015 11:38:22
IP Address : 194.225.53.5Submit Date : Sunday, February 15, 2015 11:38:45Email : erazmpa@sina.tums.ac.ir
Final Sabbatical Leave Report Form
Name : Ebrahim
Surname : Razmpa
From : Sunday, October 12, 2014
To : Sunday, January 11, 2015
Position : Professor
School/Research center : School of Medicine
E-mail : erazmpa@sina.tums.ac.ir
subject : Rhinology , Sinus Surgery
Venue : Stanford University
Country : United States
Sabbatical Leave Period(...Month) : 3
Certification : http://gsia.tums.ac.ir/images/UserFiles/23610/Forms/280/Binder1.pdf
Tickets : http://gsia.tums.ac.ir/images/UserFiles/23610/Forms/280/Binder2.pdf
Visa : http://gsia.tums.ac.ir/images/UserFiles/23610/Forms/280/Binder5.pdf
Insurance Receipt : http://gsia.tums.ac.ir/images/UserFiles/23610/Forms/280/Binder3.pdf
1.Brief summary of Leave : My main goal was to develop a productive line of research and get more experiences and improve skills to
• Discuss pathophysiology of chronic rhinosinusitis and medical treatment options
• Define advanced endoscopic approaches for management of chronic rhinosinusitis
• Formulate strategies and solutions to manage “difficult to manage sino-nasal disease”
• Review complications of sinus surgery and their proper management
• Describe endoscopic and open surgical techniques with focus on the frontal sinus
• Identify strategies to treat benign and malignant lesions of the skull base
• Apply endoscopic application for treatment of neurological disorders
• Describe proper endoscopic instrument handling and surgical techniques
• Perform techniques involved in traditional and powered sphenoethmoidectomy
• Discuss intricacies of image-guided endoscopic sinus surgery
• Identify difficult and critical areas of paranasal sinuses
• Demonstrate various frontal sinus approaches and describe their technical implementation
To provide advanced training, Stanford Otolaryngology - Head & Neck Surgery offers several clinical instructorships. The rhinology courses at Stanford University designed to prepare individuals for successful academic careers in rhinology. The Stanford Sinus Center offers a high-volume tertiary clinical experience covering all aspects of advanced medical and surgical rhinology. There was specific emphasis on advanced endoscopic procedures as well as medical and surgical focus on the frontal sinus, emerging technologies, and endoscopic skull base surgery. Difficult cases, prevention, diagnosis and management of complications werw reviewed. 
Equally emphasized was personal academic mentorship to develop and refine skills in teaching, research, writing, and presentation. Opportunities for clinical and translational basic science research were plentiful .
I think I finished my course successfully and have got main objectives .
2.List the objectives of your sabbatical leave as listed in your proposal and indicate how completely they were met : My main goal was to develop a productive line of research and get more experiences and improve skills in several ways . I observed a lot of advanced surgical procedurs , I attended in clinic to see how they approach to the patients and their problems by respecting and keeping privasy .
I also attended several kinds of scientific programs and workshops and improved my skills in different fields . 
After finishing this course I improved my ability to Discuss pathophysiology of chronic rhinosinusitis and medical treatment options , Define advanced endoscopic approaches for management of chronic rhinosinusitis, Formulate strategies and solutions to manage “difficult to manage sino-nasal disease” , Review complications of sinus surgery and their proper management , Identify strategies to treat benign and malignant lesions of the skull base , Describe proper endoscopic instrument handling and surgical techniques ,Discuss intricacies of image-guided endoscopic sinus surgery , Identify difficult and critical areas of paranasal sinuses
I attended several workshops and courses , the most important were : 
Western rhinologic course 
Cadaver dissection
Research program day
A lot of scientific conferences , seminars , lectures
Some private meetings to discuss about educational topics and get ideas to improve our department programs .
3.Acheivements(Publications,research,et.al.) :
I was engaged in some clinical researches , the most important was :
“Posterior Nasal Nerve Cryoablation Device for Treatment of Chronic Rhinitis”
Rhinitis is one of the most common chronic conditions for which medical care is sought. It is defined as inflammation of the mucous membranes lining the nose, characterized by nasal symptoms including itching, sneezing, rhinorrhea, and/or nasal congestion. The impact of rhinitis on quality of life and both work and school productivity is significant. Studies have demonstrated that rhinitis patients experience difficulty sleeping, daytime fatigue, and decreased levels of cognitive functioning. Furthermore, rhinitis can worsen other chronic conditions such as sinusitis, otitis and asthma, all of which have significant morbidity. 
Pharmacologic interventions such as nasal corticosteroids, oral antihistamines, and oral and topical decongestants have become the first line therapies for rhinitis. However, a significant number of patients do not achieve satisfactory control of symptoms, and side effects exist in association with these modalities. Surgical techniques have also been developed to treat rhinitis, including electrocautery, chemocautery, laser cautery, microdebrider turbinoplasty, radiofrequency ablation, subtotal turbinectomy, total inferior turbinectomy, and submucosal resection. These primarily seek to address the nasal obstructive component through reduction of the inferior turbinate. 
An alternate surgical technique for the treatment of rhinitis involves transection of the posterior nasal nerve to eliminate parasympathetic innervation to the mucosa. Rhinnorhea and nasal congestion are mediated to a significant degree by the parasympathetic autonomic innervation to the nose. Prior studies have shown improvement in rhinitis symptoms after cryoablation of the neural branches entering the nose from the sphenopalatine foramen. Although published reports reflect improvement in symptoms and a low rate of complications, endoscopic cryoneurolysis techniques and tools have not been fully optimized to achieve consistent outcomes.
4.Assessment of Value of Sabbatical leave(benefits,faculty development,future professional activities,...) :
Attending an advaced and well equipped department in a referral scientific center has numerous advantages and improves ones ability in different ways .
There was specific emphasis on advanced procedures as well as medical and surgical aspects , emerging technologies, Difficult cases, prevention, diagnosis and management of complications werw reviewed. So as well as getting familiar with new advaced technics , we improve our ability to change our mind and transfer our knowledge to the others .
Equally emphasized was personal academic mentorship to develop and refine skills in teaching, research, writing, and presentation. Opportunities for clinical and translational basic science research were plentiful .
My main goal was to develop a productive line of research and get more experiences and improve skills in diagnostic , theraputic , educational techics and I think this course helped me to do so .
Now by improvement of my knowledge I can help my colleagues to change our department educational policy to adapt with modern advanced methods .
finished my course successfully and have got main objectives .
I attended several workshops and courses , the most important were : 
Western rhinologic course 
Cadaver dissection
Research program day
A lot of scientific conferences , seminars , lectures
Some private meetings to discuss about educational topics and get ideas to improve our department programs . 
I also invited some known scientists to come to Iran to attend our annual congress and have workshops for our colleagues .
Additional material may be attached in response to the above summary : http://gsia.tums.ac.ir/images/UserFiles/23610/Forms/280/Binder1_1.pdf
Department Head/Research Center Chair : Faculty: Peter H. Hwang, MD (Clinical Instructorship Director)