9th Asean Otorhinolaryngological (ORL) Head And Neck Congress

02 Apr 2001

By Mr Lim Hng Kiang

Distinguished guests,

Ladies and gentlemen,

I am very pleased to join you this morning on the occasion of the opening of the 9^th ASEAN ORL Head and Neck Congress. The fourth ASEAN ORL Head and Neck Congress was held in Singapore in 1989. We are delighted to host this Congress for a second time.

I am glad that more than 600 participants from the ASEAN and other countries are participating in this Congress. We warmly welcome all overseas participants to Singapore. The organisers have prepared a comprehensive three-day programme with an impressive representation of speakers from the ASEAN region and internationally. We can expect a stimulating exchange of scientific knowledge and clinical experience between the ASEAN and international ENT communities over the next few days. The main focus is to look at the challenges of ORL in the new millennium, the impact of technology and the strategies to deal with the changes.

Technological advances

Technological advances have revolutionized the ways that doctors work and treat their patients. As many of you will know, new technologies have emerged which allow better visualisation and therefore earlier diagnosis and treatment of disease conditions. This in turn has resulted in better outcomes in patient treatment. Other technologies have transformed the ways that medical conditions are treated. Some traditional methods of ENT treatment and surgery have been replaced by safer, less invasive and more effective methods. As a result, some of the newer and less invasive treatments have reduced patient morbidity and shortened hospital stays.

ENT specialists in Singapore and other parts of the world have taken advantage of these technological advances to improve patient care. Let me now share with you some recent developments related to the ENT specialty in Singapore.

Otorhinolaryngology in Singapore

The ENT specialty here started as a small surgical specialty in 1957. It has since expanded in terms of the pool of expertise and scope of services.

The number of ENT specialists in Singapore has increased from 30 in 1989 when the Congress was last held here to 55 today. Thirty of them are in the public sector and 25 in the private sector. The local training programme is expected to increase the number of ENT specialists to 67 by 2010. This is necessary to meet the needs of our population. Between 1990 and 2000, the number of ENT specialist outpatient attendances in our public sector hospitals has increased by 44%, from about 83,600 to about 120,500, and the number of ENT admissions into these hospitals has increased by 18%, from about 5,100 to 6,000.

Our ENT trainees undergo a structured training programme. To acquire new knowledge and skills, some of our ENT specialists in the public sector hospitals have had training attachments in established centres in the USA, UK, Canada and Australia. Between 1990 and 2000, 18 specialists have been trained overseas for periods ranging from 3 months to 14 months, the majority for 12 months. On their return, some of these specialists helped to establish and develop the ENT subspecialties in Singapore. These study and manage disorders specifically affecting the nose, voice and inner ear, head and neck cancers and ENT disorders in children.

With rapid socioeconomic development and increasing affluence, the pattern of ENT conditions seen here has changed somewhat over the years, moving towards the pattern encountered in developed countries. For instance, we are seeing less cases of chronic ear infections and more of sleep breathing-related disorder, a condition often associated with obesity. More patients are also seeing the specialists for allergic conditions of the nose, and sinus and voice problems. The obvious exception is cancer of the nasopharynx, which is rare in western populations, but is the fifth commonest cancer in Singaporean men and the tenth commonest cancer in Singaporean women.

Our ENT specialists have responded appropriately to these changing trends. In the last few years, they have worked closely with the respiratory medicine specialists and established programmes for the management of sleep breathing-related disorder. They have set up an endoscopic sinus surgery faculty. The endoscopic sinus surgery course held annually in Singapore since 1995 has always been very well attended, with many overseas participants. Our Cochlear Implant Programme, established since 1996, has enabled about 80 patients with profound deafness, mostly children, to hear.

Besides providing clinical services, our ENT specialists have been active in both basic and clinical research on the common conditions affecting our population. They work closely with specialists from other disciplines, such as neurosurgeons, plastic surgeons and oncologists, in a multi-disciplinary approach to complex medical problems.

Otorhinolaryngology in the future

As we look ahead in the new millennium, the ENT fraternity in Singapore is optimistic that patients will benefit from even safer and better treatments in the future. Current research may lead to advances in the development of hearing aids, which will help the many hearing-impaired patients. New technologies have emerged which are changing the ways that surgeries are performed and learned. Virtual reality is a useful tool for the training of surgeons and is helpful in complex surgical cases. Image-guided surgeries can reduce potential complications, such as injury to the eye or brain in sinus surgeries. At present, a major limiting factor in the use of these technologies is the high costs involved. However, it is likely that over time, the costs will be reduced, leading to more widespread use of these technologies. The relentless pursuit of new knowledge in areas like molecular biology offers hopes of better understanding of disease processes and progression and also hopes of new forms of treatment for diseases such as head and neck cancers.

This Congress provides the opportunity for ENT and related health professionals from the ASEAN countries to discuss issues of mutual concern and to explore how, collectively as a group, more can be done to advance various areas of the specialty. It also provides the opportunity for international ENT experts to share their knowledge and to interact with health professionals from this part of the world. Finally, I trust that your discussions will not only update your knowledge on the recent developments in the field but also help to further your goals and aspirations.

My best wishes for a most exciting and successful Congress. I am pleased to declare the 9^th ASEAN ORL Head and Neck Congress open.