Professors Paolo Castelnuovo and Pietro Palma, were co-hosting Biennial International 'Milano Masterclass'- "THE QUEST OF EXCELLENCE" for the 4th time already. The Milano Masterclass over the past years earned recognition around the world as a top-class learning experience. Faculty and participants feedback in previous years has been nothing but remarkable. Milanomasteclass has an exceptional "full-immersion" formula. All the ingredients of this successful formula which has been taken as a model for imitation even outside Europe, were noticable during this year meeting.
 
The the surroundings of the centraly located Executive Hotel provided an excellent venue for the 4th Biennial International 'Milano Masterclass'. Early Spring in Milan provided wonderful weather allowing delegates to explore the magnificent city with its wealth of culture, architecture and art. The venue was next to the famous Corso Como and close to Brera, heart of Milan's night life, gave the possibility to have at hand everything that a city like Milan offers: from the fashionable restaurant to the trendy resort, from the V.I.P.'s discotheque to the prestigious art galleries, from the theatres to the well-being and health temples.
 
The course was structured into two parts with the first three days emphasizing contemporary techniques in endoscopic surgical approaches and the latter three days dedicated to facial plastic and reconstructive surgery. It is worthed to emphasize, that each of the segments was attended by almost 300 people. Attendees arrived to Milan from 48 countries (increase from 41 in 2005), from all continents except Australia. There were 15% more paricipants, than during last edition of Milanomasterclass, and for the first time the number of foreign participants was higher than Italian attendees. Thanks to the wise decision of the class directors, participants from new EC member countries and East European countries were offered a lower fee. It made their participation in this meeting posssible. This generous and wise decision was clearly a milestone in unification medical professionals in mutual European spirit.
 
All above clearly shows importance of this international event. Attendees had the unique opportunity to be closely in touch with some of the most innovative and successful surgeons practicing today from Europe, Africa, North and South America, in the usual welcoming, congenial international atmosphere. The current "hottest" aspects of both endoscopic sinus/skull base surgery and rhinoplasty were addressed according to a "problem solving" format.
Both segments were structured in a "progressive" learning fashion: while starting surgeons were offered a reasoned selection of proven basic techniques, the more experienced practitioners were given the unparalleled opportunity to receive top insight into advanced procedures and incorporate more innovative techniques into their armamentarium.
 
The special emphasis was put onto video-demonstrations of original, unpublished surgical cases. These interactive sessions were allowing participants to virtually enter the operating room with the experts and be guided in greater detail through techniques with "before-and-after" documentation to demonstrate the outcome of the various procedures.
A special session in each segment was devoted to "Selected Speakers" (other than Faculty) from Europe and overseas who were demonstrating personal innovations in surgical techniques which gave rise to a stimulating interchange of ideas.
 
The meeting commenced with a session on the benchmarks and milestones of transnasal endoscopic surgery given by distinguished speakers on 'what to do and how do deal with the complications' based on their vast experiences.
Subsequent master seminars detailed contemporary advances in all aspects of this specialty including paediatric FESS. Further sessions featured rationale and results of endoscopic approaches to treatment of benign tumours and inverted papilomas of the skull base.
Next day sessions adressed the management of of the malignancies of sinonasal tract and skull base, advanced endoscopic surgery of the middle cranial fossa, new concepts in the treatment of the sellar and parasellar lesions and the topic way beyond the conventional borders and daily routine of most of us - endonasal endoscopic approaches to the posterior cranial fossa.
The final day of the sinus surgery programme started with the keynote lecture by dr Kassam on modular approach along the coronal plane from the foramen ovale to the foramen ovale, followed by the sessions on difficult and extreme duraplasties and the most frightening complications seen by the faculty.
 
The second segment of the Masterclass was devoted to all aspects of Facial Plastic and Reconstructive Surgery. Sessions on Rhinoplasty included important discussions on management of the nasal osteocartilaginous vault, scoliotic and obstructed nose, tip plastys, grafting and alloplasts.
It was interesting to compare varius rhinoplasty techniques used around the world, its fashions, tastes and trends.
A session given by Internationally respected rhinoplasty surgeons gave invaluable pearls of advice on: how to handle the dillemas of more junior colleagues, knowing so many techniques, having few patients; how to establish the rhinoplasty practice and run it for the first 5 years minimising the learning curve.
Sessions on the ageing face, blepharoplasty, otoplasty and auricular reconstruction, so important for the European practicioners concentrated on rhinoplasty, completed an excellent programme of the second segment.
 
Presentations were clear, detailed and contained enormous load of the experience and practical tips within each subject. Interpreters provided excellent translation in both directions (English, Italian), what allowed speakers to present in their chosen language without disadvantage.
All sessions included adequate opportunity for questions and fruitful dialogue between the paricipants and faculty.
 
An excellent social programme was enjoyed by all delegates with the two course dinners in particular.
The first gala dinner was held in the impressive surroundings of the charming Milanese restaurant. The fine dining and wine was surpassed by the charmming, warm atmosphere.
The second equally exquisite venue was the Museo dei Navigli. The dinner was held in the main hall. The fine dinning was this time surpassed by the extraordinary, overwelming "President chorus" singing italian love songs.
Both gala dinners provided an excellent opportunity for conversations with faculty and the exange of the ideas as well as gave to all attendees the perfect feeling of the "Old World" flavor.
 
The course was well attended, well presented and proved to be of exceptional value to attendees at all levels although on the whole the 'Masterclass' lived up to its name and the bias was towards structured learning for the more experienced.
It proved to be a great contribution to the teaching of the next generation of Rhinologists and Facial Plastic Surgeons. It is clear the course will be very popular in the next years. Next, 5th edition of the Milano masterclass will take place in march 2009 and again it will completely new with the new topics and new speakers!