The core of surgical training in endoscopic sinus surgery is based on hands-on instructional courses using anatomical specimens (Groscurth et al., 2001)
(Fig. 16.7). Good preservation of specimens is important. The bony scaffolding of the paranasal sinuses is the ideal basis for creating a virtual-reality environment that can provide the trainee with experience of a variety of hypothetical surgical situations. Attempts to do this are under way, providing both visual feedback and haptic feedback (a sensation of the force required to undertake a maneuver), in order to simulate different surgical situations (Rudman et al., 1998).
The training of rhinologists should include the holistic management of patients. This should include not only training in how to communicate with patients but the medical management of patients whose disease is not solely confined to the nose (e.g., asthma, immunosuppression, sarcoid, vasculitis, and ciliary dysmotility). Many rhinologists are aware of the psychological aspects of rhinological symptoms (Homer et al., 2000), yet this subject is not well covered in the medical literature or in teaching and research. Many patients who complain bitterly of postnasal drip or catarrh as primary symptoms describe them as having a much greater effect on their life, or ability to function, than might be expected. One pervading theme for the future is that surgeons should not perceive themselves as being the only people who can help their patients and that a team approach (nurse practitioners, asthma and allergy nurses) involving other disciplines (immunologists, respiratory physicians, ophthalmologists, pathologists, radiologists, neurosurgeons, anesthetists) can help everyone (Gawandee, 2001).
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