A Post Hoc Summary of a Memorable Annual Meeting: The 27th Annual NASBS Meeting

Dear NASBS members and Journal readers:

I cannot find strong enough words to express my utter delight with how the 2017 “edition” of our yearly scientific meeting has turned out! I have been asked to provide you with a summary of this memorable event.

I am not quite sure where to begin. In as much as I am not a particular fan of statistical jargon and lifeless numbers, I still think the following data will give you an idea of how successful and record-shattering the meeting has been. I will not repeat it after each group of numbers, but essentially every piece of data has broken all prior records. We had 869 total registrants, including 153 exhibitors and 41 guests. The best we had done prior was 570 total registrants in 2016. There were 412 submitted abstracts, culminating in 187 oral presentations and 164 posters. The scientific sessions included 134 moderators, 103 panelists, 203 speakers, 6 plenary moderators, 3 honored guests, and 1 keynote speaker. Overall, 36 countries were represented, and the international representation was very palpable among presenters and audience alike.

The 2-day premeeting dissection course was more than full. There were 31 participants and 33 faculty members. It was expertly directed by Carlos David and Dan Nuss, at the LSU state-of-the-art facilities. The program this year covered open and endoscopic approaches, hand-in-hand, and per skull base region.

The main meeting took off on Friday, March 3. The layout of each day was to start the day with four parallel main topic (MT) sessions, followed by four parallel expert debate (ED) sessions. The ED sessions provided an opportunity for several experts to address cases presented by three moderators. After an exhibitor break, all attendees gathered for a 2-hour plenary session. After lunch, we disbanded again into four parallel Pecha Kucha sessions/master video sessions, to be followed by four to five parallel proffered papers sessions. The day ended with either a constructive criticism video session or a special session. Sunday was naturally a half day and ended with a look at the present and future through a “State of the Art and Future of…” session.

If the heart of the meeting was its scientific achievements, its soul was the Albert Rhoton Memorial, which inaugurated the plenary proceedings on Friday. I chose “Mastery and Legacy in Skull Base Surgery: Lessons in Synchronicity” as the theme of the 2017 meeting. There could not have been a more fitting giant, alive or dead, than Al Rhoton to invoke that theme. I was honored that his son, Eric and Eric's wife attended. In addition, more than 25 of his research fellows over many generations came to pay tribute to the legendary educator, 4 of whom gave spectacular presentations. Jeff Sorenson, who helped me put this memorial together, presented a very nice video montage of testimonials. I did my best to summarize what Dr. Rhoton meant to all of us. I had also commissioned a beautiful oil painting of one of his portraits showing him holding a brain, and offered it to the Rhoton family, along with a poster collage of his numerous dissections, designed by Jeff Sorenson, that pixelated together to form his face.

Dr. Roberto Heros, my first Honored Guest, gave a straight from the heart address about mentorship and residency training. I could not have chosen a better role model, master surgeon, and educator extraordinaire to discuss this topic. His address was a beautiful blend of honesty, wisdom, and humor. I then gave my presidential address where I discussed the themes of mastery, legacy, and synchronicity in our field, as well as reiterated how vitalized and expansive our society had become. We offered, for the first time this year, the opportunity for Industry to sponsor a dinner symposium and one was given on Friday evening.

The past president's dinner was a grand affair, particularly since we included all former Rhoton fellows as well as Eric Rhoton and his wife. Off the cuff, speeches were given by many and for the enjoyment of all!

The second plenary session on Saturday began with my second honored guest, Alan Crockard, my mentor from my United Kingdom days in the late 1980s. With his inimitable eloquence and erudition, he told us what skull base surgery had taught him over the decades, including his pioneering work on transoral surgery. We also learned about Christopher Columbus, sailing, and bird watching. He was followed by Lieutenant General Russel Honore, a Louisiana native who had shepherded the people of New Orleans through the Hurricane Katrina disaster relief efforts in 2005. He was an extremely entertaining, spontaneous, and dynamic speaker who had very enlightening opinions about leadership, resilience, and proper education of children in an ever changing world. He then did a book signing for his book “Leadership in the New Normal.” With the audience energized by his speech, I then gathered the General and six leaders (Roberto Heros, Alan Crockard, Fred Gentili, Jatin Shah, Dan Nuss, and John Leonetti) for a 45-minute heart-to-heart panel interview, inspired by the Proust/Pivot/Lipton interview style. I asked the panel a series of probing, semipersonal questions, which I thought would benefit the audience and get us all to know these leaders a bit better.

Saturday ended with three special sessions: Advances in skull base imaging, benign intracranial hypertension, and women in skull base surgery. Each of these sessions represents an extension of one of the several new initiatives I created this year. We expanded the representation of other disciplines, such as oculoplastic/orbital surgeons, neuroradiologists, and others. The large contingent of ophthalmologists present at the meeting was unprecedented. I am particularly proud of the initiative to increase the involvement of women in the NASBS. This was highlighted by an impressive panel of women skull base surgeons who gave insightful presentations on mentorship, teamwork, leadership, maternity leave, and other important topics. We identified some problems with recruiting women into the field, and it is my hope that this initiative expands further in future years, and that panels are set up to confront/include chairpersons and program directors from training programs with poor female representation among their residents and faculty. Everybody then “let their hair down” at the new member reception (close to 120 new members!) followed by the gala dinner at the iconic House of Blues. All had fun!

Sunday was marked by my third honored guest, Dr. Fred Gentili. He gave a tour de force presentation about his 30 years in skull base surgery. Besides illustrating his superlative surgical skills and profound interest in precise decision-making, his presentation demonstrated the principles of career adaptation and the acceptance of new technology. A classical open skull base surgeon was not afraid to embrace endonasal endoscopy and become a master of it. This was followed by the award ceremonies, with best papers in basic science, clinical and international categories. Six speakers then addressed their futuristic views of where the skull base field is progressing in various disciplines. This look at the future was then brought to a close by the new President, Ian Witterick, who announced the 2018 meeting would be held on Coronado Island, just off the coast of San Diego, California, United States. Reluctantly, we adjourned.

Fig. 1 A group of former Rhoton fellows, Eric Rhoton and Eric's wife, Jacques Morcos, and Jeff Sorenson pose next to the Al Rhoton painting.

In closing, I had a spectacular year and a spectacular meeting. I surrounded myself by the most capable members of a scientific program committee, under the leadership of Mustafa Baskaya and Zoukaa Sargi. I thank them most sincerely for their efforts, time, and genuine enthusiasm. Why was our meeting such a runaway success? It is all in the preparation, the attention to detail, the twice a month phone conferences. It is because we were inclusive, nationally and internationally. NASBS can and should become the premier skull base meeting in the world, for the world. We made sure we invited speakers from everywhere, that the usual names did not monopolize the podium, generally restricting invited talks to two per speaker. We made sure we had a cohesive theme, sessions flowed seamlessly, that overlap was avoided, and redundancy eliminated. We introduced new features: constructive criticisms video sessions, to help coach the young about the art and craft of technique; rapid-fire oral presentations, to include more good quality papers; expert debate sessions, to bring more people around the table and involve the audience; dinner symposia, which industry and participants value; the Lipton interview, a novel and more personal way to question and benefit from our leaders; also, we embraced new disciplines (orbital/oculoplastic surgeons, neuroradiologists,…); and there were many other features that I hope multiply in future years.

Most of all, I thank all those who attended, for making this gathering very special to me. I thank you all for writing and saying that this was one of the best meetings you have been to. I am very thankful that I have not seen any significant criticism…at least not coming my way.

I am very grateful for the privilege and pleasure to have acted as your president this past year. See you on Coronado Island in February 2018!