On a medical mission trip to West Timor many years ago. I remember vividly teaching a young doctor how to do a few operations knowing that when our team is gone, she’s the only doctor left to manage every kind of ailment in her region. What a huge responsibility. What would you do if that were you?

Have a look at the scan. And look again. You might think this is a tracheostomy patient, but it’s not. This is a sideway (saggital) view of the airway of a patient who has had a total laryngectomy. Direct airway into the trachea. No voicebox. #headandneck #ENTsecrets #headandneckcancer #surgeon

Big submandibular salivary stone extracted. Depending on size & location, this can be accessed through the mouth or through the neck. Sialendoscopy also works in smaller stones. #headandneck #saliva #ENT #surgery #surgeon

I started the morning with a 6am zoom call with UK, US & Netherlands to collaborate on a guideline for management of severe drooling (sialorrhea). Drooling is a modifiable condition that has medical, social, psychological & practical complications. Can you think of these complications?

It is finished.

The message of Christmas is joy, peace and rest entering a weary world. As a human being, I too, need to rest from all the major head and neck tumours, complex airway conditions, vascular anomalies & congenital malignancies that have kept our team occupied this year.

One of the harder things that I had to do this year was to write a letter with kindness and generosity when my raw emotion was anger and hurt. I wonder if you had to ever do a similar thing? How did it go?

The Team at Melbourne Ear Nose Throat & Airway Clinic says goodnight to 2025. It has been our privilege to serve you this year. Our office will open again on Wednesday 7th January 2026. May you have a restful holiday season.

Here’s an axial cross-sectional CT scan of a blocked nose. The septum and nasal bones are extremely twisted. Every blocked nose has a different cause: anatomical, allergic, sinugenic, tumour, etc. #ENT #surgery #surgeon

With 6 fingers and 6 degrees, the surgeon wields their scalpel. That’s not a knife. THIS is a knife.

Microscopic view of the vocal cords. Hoarseness/hoarse voice/dysphonia that is persisting could be a sign of something sinister. There are many lesions that can arise out of the vocal cords, from benign to malignant conditions. Get your dysphonia checked by a qualified expert. #ENT #surgery #surgeon

In the aftermath of the mass shooting at Bondi Beach, 50,000 Australians lined up to donate blood. Aussies literally went beyond thoughts and prayers and bled for the victims. Some of this blood donated voluntarily will go to the shooter in critical care.

My life was changed by a Jewish carpenter who would have celebrated Hanukkah with his community in the Middle East. I sit in the rubble & I stand with solidarity with my Jewish friends and colleagues here in Australia. Today the hospital paused to light the menorah in a beautiful ceremony of unity.

Thoughts & Prayers. And Actions: Donate blood, tighten gun laws, crowd fund, attend memorial services, light candles. Australia shows that you can retaliate with courage & kindness.

I know people who will walk into this Christmas season not with peace and joy but with pain and suffering. Quotes, abstract theology & applied science do not bring answers. Hope and healing need to be tangible through a person. We are wired for human kindness and connection.

It was meant to be a Festival of Light. Tonight we saw darkness in #BondiBeach Sydney. Men killing innocents. Lives are torn. Families broken. I am sad. I am angry. I want to sit in the rubble with families who lost loved ones and I want to stand with my Jewish friends. What an utterly evil act.

#Melbourne, this is what you’re inhaling. You’re still in the #pollen & #thunderstormasthma season. Don’t pack away your saline nasal rinses, intranasal steroids, antihistamine, puffers, masks and air purifiers just yet. Today’s forecast: moderate for grass and extreme for trees. #hayfever

There’s a big trend on #Airway health. Let’s get this right. It’s not #airways. You have one unified airway. And it’s way more than the tonsils. That’s such a small part of the airway. Even complex #drooling surgery is airway surgery. ENT surgeons have been managing airway disorder for years. #ENT

How did I get here? A long surrender in the same direction. Many surgeons will have a similar journey of 12 hour days 6 days a week plus additional oncall, research, exams, supervisions, conferences, presentations, etc. #surgeon #surgicallife #surgery #ENTsecrets

A study on 1.7 million people in Hong Kong shows superior hybrid immunity to Covid in people who got vaccinated before infection vs. people who got infected first. "Our findings are a direct rebuttal to arguments for natural immunity," the authors write. doi.org/10.1016/j.va...

My daughter’s English homework. Feel free to have a go. How #Aussie are you?

It’s a beautiful Saturday in Melbourne. Where else would you rather be than in the hospital with people you like running a mock exam drill for future ENT surgeon candidates? I love the skullbase. So exquisitely beautiful. #ENTsurgery #surgeon #ENT #ENTsecrets

Craftsmanship. Lots of similarities between a sushi master and the surgeon. Lots of differences too. Biggest difference is probably consent. #surgeon #surgery

22 years and 3 kids. She still steals my blanket and rolls her eyes at me. #happyanniversarybabe

#Christmas in the public hospital. #LMA #Christmastree

This is very important news in the world of #microbiology. From @dadjokesforthewin. #ENTsecrets #surgery

Microlaryngoscopy is a procedure involving suspending the larynx and using a microscope to image diseases of the voice box and airway. We can then do biopsy, remove cancer with laser, inject the vocal folds, suture, implant, excise, etc. It’s a beautiful procedure on your voice box. #ENTsecrets

In Australia, examining the ear with the therapy pet in situ can be challenging. (LOL, joking. This was my son a few years ago in a reptile park). #ENTsecrets #ENT #surgery #surgeon

That’s ear drum reconstruction. Don’t worry about ear drum perforation. We can fix it. Multiple techniques: onlay/inlay/underlay through transcanal/endaural/postauricular approach with temporalis fascia/fat/cartilage/perichondrium using microscope/otoscope/combined. It’s a beautiful operation.

This is a magnified image of blood vessels being joined together (anastomosed) under the operating microscope. This is for microvascular free flap reconstruction of a head and neck cancer defect.#ENTsecrets #ENT #surgery #surgeon #headandneck 1/2

That’s the 27th and maybe the final lecture this year. Every talk takes about 2-5 hours to prepare. The topic may be similar but audiences are different each time. There is a difference between an academic and a teacher. Both require rigorous practice and training. It doesn’t happen accidentally.

Rigid ventilating bronchoscopy in slow motion set up. LOL… #bronchoscopy #ENTsecrets #ENT #Surgery #surgeon #airway

Saudi Hospitality. One of our previous ENT fellows hosted us for dinner and dessert. Most amazing hospitality. I am missing the taste of Saudi coffee already!

Home sweet home. Half my luggage contained gifts from the hospitable people I made friends with in Bahrain & Saudi Arabia. (Yes that was a valid excuse to buy a new bag!) The kindness extended to me has been unforgettable. Tomorrow morning, Arabic coffee at my place. Let’s go!

My first time in Bahrain and Saudi Arabia was absolutely amazing. The extreme hospitality of the people. The amazing cuisines. The magnificent collaboration. These kinds of conferences and connections help me be a better surgeon for my patients. #ENTsecrets #surgery #surgeon #ENTsurgery #headandneck

We explored old castles and buildings in Al Qatif, a place rich with history and art. Precious times with my 2 previous fellows here and their head of unit. #entsecrets #ENT #surgery #surgeon I

I spent a memorable day today in Al Qatif & Tarout Island with the 3 Specialist #Paediatric #ENT #surgeon of eastern #SaudiArabia. Two of them were my fellows in Melbourne. We were with an amazing local guide @ismail_hejles. Absolutely knowledgeable, passionate about his town and truly gifted.

The world would be a much better place if we all could sit around a communion table (or floor) and deepen friendships. Hospitality is a strength. This was a memorable night in a local Saudi home. To be welcomed as a guest is a humbling honour.

#mespo2025 Every day is a school day for the curious clinician.

I work in a specialty where gentleness, care and superspecialist competence are absolute necessities. These women and so many like them around the world have advanced the care of their communities. I’m amazed to think that there are heroines walking humbly amongst us. #womeninsurgery

The best way to master a topic is to teach it. When you prepare to teach, you are forced to think hard about a topic, to break it down and then synthesise it for others to make sense. The process of deep thinking about a topic helps you master it. 1/2 #ENTsecrets #ENT #surgery #surgeon

Doing 7 talks in another country. I haven’t worn some of my suits for years. I’m afraid all my suit pants shrunk on the flight en route.

Hospitality is acceptance wrapped up in tangible experiences of sight, smell, taste, touch, music & voice. What would the world be like if we extended extreme hospitality to each other beyond cultural and religious boundaries? #Halwa reqaq was beautiful!

There’s a lot of #ENT in medicine, history, humanity, story. Learned a few things about the amazing people and history of #Bahrain. Can’t help but look at some of it from the perspective of a #HeadandNeck #surgeon. #entsecrets #surgery

In all these cases, patients presented with eye symptoms. But the origin of the disease is in the nose. We drained the abscess in the first 3 patients through the nose, going behind the eyeball. If you’re not sure, seek a specialist opinion. #ENT #Surgery #ENTsecrets #surgeon #headandneck #rhinology

My little family loves to eat everything.

As I get older, all my shirts seem to be gradually shrinking. Especially in the middle section. Does this happen to any other men? #askingforafriend

As I get older, all my shirts seem to be gradually shrinking. Especially in the middle section. Does this happen to any other men? #askingforafriend