Head and Neck

BLOCK II. Pain in the head and neck area
Topic 11a. DENTISTRY: The patient with acute oral pain
Learning goals: To describe oral pain related to oral diseases and in particular to dental caries; dental caries: epidemiology, etiology, prevention and consequences of such a disease. Hard dental tissues scanning electron microscopy and dental hypersensitivity.
Topic 11b. DENTISTRY: The most common diseases of the oral cavity
Learning goals: To define distribution in the population, risk factors and clinical presentations of periodontal diseases Periodontal apparatus in health and disease. The oral biofilm and the etiology of gingivitis and periodontitis diseases. Diagnosis, classification and treatment of the different periodontal conditions
Topic 11c. DENTISTRY: Oral-facial chronic pain
Learning goals: To describe chronic oral pain not related to tooth and gum diseases (i.e, persistent idiopathic facial pain, burning mouth syndrome, oral cancer related pain).
Topic 12a. OPHTHALMOLOGY: The red eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Learning goals: to learn the different inflammatory conditions of the eye, their differential diagnosis, management and treatment will be the aim of this Topic. Particular weight is given to differentiate the conditions that require emergency and prompt management from those that may need delayed examination by a specialist.
Clinical cases of anterior uveitis, keratitis, conjunctivitis and acute attack of glaucoma will be shown and discussed.
Topic 12b. OPHTHALMOLOGY: The painful eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Topic 13c. EAR NOSE THROAT The patient with headache - its relations with nasal disease
Learning goals: To recognize the different features and symptoms related to headache and to be able to ask the right questions for a preliminary differentiation between sino-nasal headache and other causes.
Learning goals: Identification of causes of painful eye; definition of acute vs chronic pain; management and treatment using a multidisciplinary approach

BLOCK III. Nasal obstruction, epistaxis, oral mucosal diseases
Topic 13a 13b. EAR NOSE THROAT 1. The patient with nasal obstruction and/or nasal discharge
Learning goals: To recognize the different features and symptoms related to nasal obstruction and discharge and to differentiate benign from malignant disease. To get an overview of therapeutic options and to appreciate the diagnostic tools for evaluation.
Topic 14. ENT, OPHTHALMOLOGY: Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
Learning goals: Being able to identify the features of complications of sino-nasal disease that overlap with the neighbouring structures and to recognize the primary source of the disorders. To identify the gravity of each shared complication and detect those cases that need immediate interdisciplinary attention.
Topic 15a 15b 15c. DENTISTRY: The patient with oral mucosal diseases
Learning goals: Epidemiology of the diseases of the oral mucosa. Basic knowledge of the elementary mucosal lesions. The diagnostic process in oral medicine. How to examine the mouth of our patient; basic information regarding the prevalence of the oral mucosal diseases.
In particular, being able to recognize:
-oral ulcers: how to make a diagnosis.
-vesicular-bullous lesions of the oral cavity as lichen planus, pemphigoid, pemphigus, erythema multiform, and blistering viral lesions;
- pigmented oral lesions, candidiasis, and traumatic oral fibroma.

BLOCK IV. Movement Disorders: Facial Palsy, Dysphonia, Dysphagia, Dyspnoea, Ocular motion disorders
Topic 16. DENTISTRY Hypo-salivation and hyper-salivation
Learning goals: Clinical features, causes, consequences and treatment.
Topic 17. MAXILLO-FACIAL SURGERY: Oral nerve lesions are an emerging pathology, due to oral surgery increasing
Learning goals: to understand the pathophysiology of the lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery, medical therapy, acupuncture, hypnosis.
Topic 18. ENT: The adult patient with dysphonia, dysphagia and/or dyspnea
Learning goals: to recognize the different ENT-diseases related to dysphonia, dysphagia and/or dyspnoea. To get to know the diagnostic tools for evaluation and basic therapeutic options. To differentiate between acute and life- endangering and more benign courses.
Topic 19. OPHTHALMOLOGY: Abnormal eye movements: the more common causes of diplopia: eye, visual system and neurologic disorders
Prerequisites: Physiology of the ocular movements: 1) Gaze stabilization (vestibule-ocula and optokinetic reflexes); 2) Gaze shifting (smooth pursuit, saccades); 3) Vergence.
Learning goals: to understand the different mechanisms leading to disorders of the eye movements and diplopia. Differential diagnosis criteria and examples of clinical cases will be explained.

BLOCK V. FROM IMPAIRED FUNTION TO LOSS OF FUNCTION: DEAFNESS, BLINDNESS
Topic 20. OPHTHALMOLOGY: The correct process of vision: the role of ocular media and their physiopathology.
Prerequisites: Anatomy of the eye. Physiology of the mechanism of vision. The lens and the mechanism of accommodation and convergence.
The role of ocular media and their physiopathology.
Learning goals: this Topic focuses on how the process of vision is carried out and what is needed in order to correctly visualize the images. Refraction, cornea disorders and cataracts and how they can affect the correct process of vision will be described providing theoretical and practical explanations with clinical cases.
Practical session (1 hour):
assessment of visual acuity
slit lamp examination
Topic 21. OPHTHALMOLOGY: The blind eye: the more common conditions leading to complete blindness
Learning goals: Vascular disorders, e.g. retinal arterial and vein occlusions, diabetic retinopathy, ischemic optic neuropathy, cerebral ischemia involving the visual pathways and neuritis and tumors will be described. Criteria for differential diagnosis will be discussed together with clinical examples. In particular, the growing importance of the imaging of the eye and specifically of the retina and the optic nerve head will be shown and explained. These will be compared with the "traditional" examination of eye fundus.
Practical session:
Examination of the fundus oculi
Topic 22. OPHTHALMOLOGY: The eye and the brain: the pathologies involving the visual pathways from the eye to the brain cortex
Learning goals: Cerebral ischemia involving the visual pathways, optic ischemic neuropathies, neuritis and tumors will be described. Particular attention will be dedicated to the examination of the optic nerve head and how to interpret visual field changes.
Topic 23. ENT: The patient that does not hear
Learning goals: To understand the acute and chronic causes for hearing deficits and being able to detect causes that need immediate diagnostic and therapeutic attention

BLOCK VI. Neck and facial masses
Topic 24. ENT, MAXILLOFACIAL SURGERY: The patient with facial/cervical masses
Learning goals: To identify the most common causes for swelling/masses in the region. To recognize the signs for suspicion of malignant disease. Achieve a deeper understanding of the diagnostical pathway through the use of a flow chart approach. To get an overview of therapeutic options.
Topic 25. DENTISTRY: The patient with oral potentially malignant disorders and with oral cancer
Learning goals: Being able to recognize ppotentially malignant oral lesions and conditions. Suggested treatment and follow-up of a patient suffering from a leukoplakia or an erythroplakia.
Practical session **
Topic 26. OPHTHALMOLOGY: Orbital pathology: a multidisciplinary approach
Learning goals: this Topic focuses on more common orbital pathologies that can affect the eye and visual system. Grave's disease, optic nerve tumors, pseudotumour, and orbital cellulitis will be the main topics. A multidisciplinary approach involving other specialists of the orbit (otorhinolaryngologist, maxillofacial surgeon, endocrinologist) is considered for both diagnostic and medical/surgical management.

BLOCK VII. Vertigo
Topic 27. ENT: The patient with instability/vertigo
Learning goals: To be able to ask the right questions for a preliminary differentiation between peripheral vertigo, instability of the elderly and central vertigo

BLOCK VIII. AGE LONG: Pregnancy, growing and ageing
Topic 28. ENT: To recognize the difference in handling a paediatric patient: The child
Learning goals. To appreciate the most common causes for paediatric ENT consultations and get an overview of therapeutic options.
Open questions and discussion of clinical cases.
Topic 29. OPHTHALMOLOGY: The visual system in the child
Learning goals: this Topic focuses on the main steps of the development of the visual system from the eye to the brain. Particular weight will be given to amblyopia, strabismus and to what a pediatrician needs to know about correct development of "the good sight". Differential criteria of leucocoria and tumors of the eye and affecting vision will be also covered.
Topic 30a. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the anterior segment of the eye
Topic 30b. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the posterior segment of the eye
Learning goals: this Topic focuses on the chronic disorders of the aging eye. Epidemiologically relevant conditions like glaucoma and macular degeneration are the most important potential causes of blindness in the developed countries. New treatment paradigms are proposed, yet their increasing costs are challenging our Health Care Systems: what the doctors need to know to improve a rationale management.
Topic 31a, 31b. DENTISTRY: Oral health issues of interest for the physician
Learning goals: to present the most common mouth-related problems that a physician have to face: they include oral side effects of drugs, and anticancer treatments (chemotherapy, radiotherapy). To recognize the most common dental treatment and prosthesis rehabilitation and related problems (implant and peri- implantitis, prosthesis and denture stomatitis, restorative treatments and lichenoid lesions, )
Practical session

BLOCK IX. Distrectual expressions of systemic diseases and emergency
Topic 32. OPHTHALMOLOGY: What is a real emergency?
Learning goals: the most common reasons of eye and vision conditions leading to emergency care will be discussed. Particular weight will be given to what the general practitioner must know and can do and when a specialist is required. Practical examples of the "real life" emergency room activities dealing with eye and vision disorders will be provided, and algorithms of correct management discussed.
Topic 33. OPHTHALMOLOGY: Surgical approaches for ocular diseases
Learning goals: Most common types of surgeries for ocular pathologies will be shown and explained. This lesson will be based on videos taken from the operating room of San Paolo Hospital.
Topic 34. MAXILLOFACIAL SURGERY: Facial and craniofacial Trauma
Learning goals: to describe the most relevant clinical features in facial traumatology, focusing in particular on how to diagnose the most frequent fractures (nose, orbit, zygoma, maxilla and mandible) and how to practically handle simple or severe wounds involving facial soft tissues
Topic 35. DENTISTRY: Oral health is more than healthy teeth and gums
Learning goals: Oral health and general health: A relationship exists?
Topic 36. MAXILLOFACIAL SURGERY: Facial Palsy
Learning goals: to understand the pathophysiology of the facial nerve lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery and medical therapy.

BLOCK X. The patient with facial and craniofacial disproportion
Topic 37. MAXILLO-FACIAL SURGERY: Clinical Examination and anthropometry of the face: facial and craniofacial malformation
Learning goals: to describe rare craniofacial malformation, their impressive clinical behaviour, development during childhood and related problems are discussed. Specific surgical and non-surgical treatment are explained in details. To describe the most frequent maxilla-facial malformation, cleft lip and palate, is explained. The entire topic is analysed from a multidisciplinary point of view. Two- days at the Regional facial and craniofacial malformation Centre are offered to better understand the whole treatment goals.
To understand the pathology and complexity of its multidisciplinary treatment.
Practical session*

BLOCK II. Pain in the head and neck area
Topic 11a. DENTISTRY: The patient with acute oral pain
Learning goals: To describe oral pain related to oral diseases and in particular to dental caries; dental caries: epidemiology, etiology, prevention and consequences of such a disease. Hard dental tissues scanning electron microscopy and dental hypersensitivity.
Topic 11b. DENTISTRY: The most common diseases of the oral cavity
Learning goals: To define distribution in the population, risk factors and clinical presentations of periodontal diseases Periodontal apparatus in health and disease. The oral biofilm and the etiology of gingivitis and periodontitis diseases. Diagnosis, classification and treatment of the different periodontal conditions
Topic 11c. DENTISTRY: Oral-facial chronic pain
Learning goals: To describe chronic oral pain not related to tooth and gum diseases (i.e, persistent idiopathic facial pain, burning mouth syndrome, oral cancer related pain).
Topic 12a. OPHTHALMOLOGY: The red eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Learning goals: to learn the different inflammatory conditions of the eye, their differential diagnosis, management and treatment will be the aim of this Topic. Particular weight is given to differentiate the conditions that require emergency and prompt management from those that may need delayed examination by a specialist.
Clinical cases of anterior uveitis, keratitis, conjunctivitis and acute attack of glaucoma will be shown and discussed.
Topic 12b. OPHTHALMOLOGY: The painful eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Topic 13c. EAR NOSE THROAT The patient with headache - its relations with nasal disease
Learning goals: To recognize the different features and symptoms related to headache and to be able to ask the right questions for a preliminary differentiation between sino-nasal headache and other causes.
Learning goals: Identification of causes of painful eye; definition of acute vs chronic pain; management and treatment using a multidisciplinary approach

BLOCK III. Nasal obstruction, epistaxis, oral mucosal diseases
Topic 13a 13b. EAR NOSE THROAT 1. The patient with nasal obstruction and/or nasal discharge
Learning goals: To recognize the different features and symptoms related to nasal obstruction and discharge and to differentiate benign from malignant disease. To get an overview of therapeutic options and to appreciate the diagnostic tools for evaluation.
Topic 14. ENT, OPHTHALMOLOGY: Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
Learning goals: Being able to identify the features of complications of sino-nasal disease that overlap with the neighbouring structures and to recognize the primary source of the disorders. To identify the gravity of each shared complication and detect those cases that need immediate interdisciplinary attention.
Topic 15a 15b 15c. DENTISTRY: The patient with oral mucosal diseases
Learning goals: Epidemiology of the diseases of the oral mucosa. Basic knowledge of the elementary mucosal lesions. The diagnostic process in oral medicine. How to examine the mouth of our patient; basic information regarding the prevalence of the oral mucosal diseases.
In particular, being able to recognize:
-oral ulcers: how to make a diagnosis.
-vesicular-bullous lesions of the oral cavity as lichen planus, pemphigoid, pemphigus, erythema multiform, and blistering viral lesions;
- pigmented oral lesions, candidiasis, and traumatic oral fibroma.

BLOCK IV. Movement Disorders: Facial Palsy, Dysphonia, Dysphagia, Dyspnoea, Ocular motion disorders
Topic 16. DENTISTRY Hypo-salivation and hyper-salivation
Learning goals: Clinical features, causes, consequences and treatment.
Topic 17. MAXILLO-FACIAL SURGERY: Oral nerve lesions are an emerging pathology, due to oral surgery increasing
Learning goals: to understand the pathophysiology of the lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery, medical therapy, acupuncture, hypnosis.
Topic 18. ENT: The adult patient with dysphonia, dysphagia and/or dyspnea
Learning goals: to recognize the different ENT-diseases related to dysphonia, dysphagia and/or dyspnoea. To get to know the diagnostic tools for evaluation and basic therapeutic options. To differentiate between acute and life- endangering and more benign courses.
Topic 19. OPHTHALMOLOGY: Abnormal eye movements: the more common causes of diplopia: eye, visual system and neurologic disorders
Prerequisites: Physiology of the ocular movements: 1) Gaze stabilization (vestibule-ocula and optokinetic reflexes); 2) Gaze shifting (smooth pursuit, saccades); 3) Vergence.
Learning goals: to understand the different mechanisms leading to disorders of the eye movements and diplopia. Differential diagnosis criteria and examples of clinical cases will be explained.

BLOCK V. FROM IMPAIRED FUNTION TO LOSS OF FUNCTION: DEAFNESS, BLINDNESS
Topic 20. OPHTHALMOLOGY: The correct process of vision: the role of ocular media and their physiopathology.
Prerequisites: Anatomy of the eye. Physiology of the mechanism of vision. The lens and the mechanism of accommodation and convergence.
The role of ocular media and their physiopathology.
Learning goals: this Topic focuses on how the process of vision is carried out and what is needed in order to correctly visualize the images. Refraction, cornea disorders and cataracts and how they can affect the correct process of vision will be described providing theoretical and practical explanations with clinical cases.
Practical session (1 hour):
assessment of visual acuity
slit lamp examination
Topic 21. OPHTHALMOLOGY: The blind eye: the more common conditions leading to complete blindness
Learning goals: Vascular disorders, e.g. retinal arterial and vein occlusions, diabetic retinopathy, ischemic optic neuropathy, cerebral ischemia involving the visual pathways and neuritis and tumors will be described. Criteria for differential diagnosis will be discussed together with clinical examples. In particular, the growing importance of the imaging of the eye and specifically of the retina and the optic nerve head will be shown and explained. These will be compared with the "traditional" examination of eye fundus.
Practical session:
Examination of the fundus oculi
Topic 22. OPHTHALMOLOGY: The eye and the brain: the pathologies involving the visual pathways from the eye to the brain cortex
Learning goals: Cerebral ischemia involving the visual pathways, optic ischemic neuropathies, neuritis and tumors will be described. Particular attention will be dedicated to the examination of the optic nerve head and how to interpret visual field changes.
Topic 23. ENT: The patient that does not hear
Learning goals: To understand the acute and chronic causes for hearing deficits and being able to detect causes that need immediate diagnostic and therapeutic attention

BLOCK VI. Neck and facial masses
Topic 24. ENT, MAXILLOFACIAL SURGERY: The patient with facial/cervical masses
Learning goals: To identify the most common causes for swelling/masses in the region. To recognize the signs for suspicion of malignant disease. Achieve a deeper understanding of the diagnostical pathway through the use of a flow chart approach. To get an overview of therapeutic options.
Topic 25. DENTISTRY: The patient with oral potentially malignant disorders and with oral cancer
Learning goals: Being able to recognize ppotentially malignant oral lesions and conditions. Suggested treatment and follow-up of a patient suffering from a leukoplakia or an erythroplakia.
Practical session **
Topic 26. OPHTHALMOLOGY: Orbital pathology: a multidisciplinary approach
Learning goals: this Topic focuses on more common orbital pathologies that can affect the eye and visual system. Grave's disease, optic nerve tumors, pseudotumour, and orbital cellulitis will be the main topics. A multidisciplinary approach involving other specialists of the orbit (otorhinolaryngologist, maxillofacial surgeon, endocrinologist) is considered for both diagnostic and medical/surgical management.

BLOCK VII. Vertigo
Topic 27. ENT: The patient with instability/vertigo
Learning goals: To be able to ask the right questions for a preliminary differentiation between peripheral vertigo, instability of the elderly and central vertigo

BLOCK VIII. AGE LONG: Pregnancy, growing and ageing
Topic 28. ENT: To recognize the difference in handling a paediatric patient: The child
Learning goals. To appreciate the most common causes for paediatric ENT consultations and get an overview of therapeutic options.
Open questions and discussion of clinical cases.
Topic 29. OPHTHALMOLOGY: The visual system in the child
Learning goals: this Topic focuses on the main steps of the development of the visual system from the eye to the brain. Particular weight will be given to amblyopia, strabismus and to what a pediatrician needs to know about correct development of "the good sight". Differential criteria of leucocoria and tumors of the eye and affecting vision will be also covered.
Topic 30a. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the anterior segment of the eye
Topic 30b. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the posterior segment of the eye
Learning goals: this Topic focuses on the chronic disorders of the aging eye. Epidemiologically relevant conditions like glaucoma and macular degeneration are the most important potential causes of blindness in the developed countries. New treatment paradigms are proposed, yet their increasing costs are challenging our Health Care Systems: what the doctors need to know to improve a rationale management.
Topic 31a, 31b. DENTISTRY: Oral health issues of interest for the physician
Learning goals: to present the most common mouth-related problems that a physician have to face: they include oral side effects of drugs, and anticancer treatments (chemotherapy, radiotherapy). To recognize the most common dental treatment and prosthesis rehabilitation and related problems (implant and peri- implantitis, prosthesis and denture stomatitis, restorative treatments and lichenoid lesions, )
Practical session

BLOCK IX. Distrectual expressions of systemic diseases and emergency
Topic 32. OPHTHALMOLOGY: What is a real emergency?
Learning goals: the most common reasons of eye and vision conditions leading to emergency care will be discussed. Particular weight will be given to what the general practitioner must know and can do and when a specialist is required. Practical examples of the "real life" emergency room activities dealing with eye and vision disorders will be provided, and algorithms of correct management discussed.
Topic 33. OPHTHALMOLOGY: Surgical approaches for ocular diseases
Learning goals: Most common types of surgeries for ocular pathologies will be shown and explained. This lesson will be based on videos taken from the operating room of San Paolo Hospital.
Topic 34. MAXILLOFACIAL SURGERY: Facial and craniofacial Trauma
Learning goals: to describe the most relevant clinical features in facial traumatology, focusing in particular on how to diagnose the most frequent fractures (nose, orbit, zygoma, maxilla and mandible) and how to practically handle simple or severe wounds involving facial soft tissues
Topic 35. DENTISTRY: Oral health is more than healthy teeth and gums
Learning goals: Oral health and general health: A relationship exists?
Topic 36. MAXILLOFACIAL SURGERY: Facial Palsy
Learning goals: to understand the pathophysiology of the facial nerve lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery and medical therapy.

BLOCK X. The patient with facial and craniofacial disproportion
Topic 37. MAXILLO-FACIAL SURGERY: Clinical Examination and anthropometry of the face: facial and craniofacial malformation
Learning goals: to describe rare craniofacial malformation, their impressive clinical behaviour, development during childhood and related problems are discussed. Specific surgical and non-surgical treatment are explained in details. To describe the most frequent maxilla-facial malformation, cleft lip and palate, is explained. The entire topic is analysed from a multidisciplinary point of view. Two- days at the Regional facial and craniofacial malformation Centre are offered to better understand the whole treatment goals.
To understand the pathology and complexity of its multidisciplinary treatment.
Practical session*

BLOCK II. Pain in the head and neck area
Topic 11a. DENTISTRY: The patient with acute oral pain
Learning goals: To describe oral pain related to oral diseases and in particular to dental caries; dental caries: epidemiology, etiology, prevention and consequences of such a disease. Hard dental tissues scanning electron microscopy and dental hypersensitivity.
Topic 11b. DENTISTRY: The most common diseases of the oral cavity
Learning goals: To define distribution in the population, risk factors and clinical presentations of periodontal diseases Periodontal apparatus in health and disease. The oral biofilm and the etiology of gingivitis and periodontitis diseases. Diagnosis, classification and treatment of the different periodontal conditions
Topic 11c. DENTISTRY: Oral-facial chronic pain
Learning goals: To describe chronic oral pain not related to tooth and gum diseases (i.e, persistent idiopathic facial pain, burning mouth syndrome, oral cancer related pain).
Topic 12a. OPHTHALMOLOGY: The red eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Learning goals: to learn the different inflammatory conditions of the eye, their differential diagnosis, management and treatment will be the aim of this Topic. Particular weight is given to differentiate the conditions that require emergency and prompt management from those that may need delayed examination by a specialist.
Clinical cases of anterior uveitis, keratitis, conjunctivitis and acute attack of glaucoma will be shown and discussed.
Topic 12b. OPHTHALMOLOGY: The painful eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Topic 13c. EAR NOSE THROAT The patient with headache - its relations with nasal disease
Learning goals: To recognize the different features and symptoms related to headache and to be able to ask the right questions for a preliminary differentiation between sino-nasal headache and other causes.
Learning goals: Identification of causes of painful eye; definition of acute vs chronic pain; management and treatment using a multidisciplinary approach

BLOCK III. Nasal obstruction, epistaxis, oral mucosal diseases
Topic 13a 13b. EAR NOSE THROAT 1. The patient with nasal obstruction and/or nasal discharge
Learning goals: To recognize the different features and symptoms related to nasal obstruction and discharge and to differentiate benign from malignant disease. To get an overview of therapeutic options and to appreciate the diagnostic tools for evaluation.
Topic 14. ENT, OPHTHALMOLOGY: Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
Learning goals: Being able to identify the features of complications of sino-nasal disease that overlap with the neighbouring structures and to recognize the primary source of the disorders. To identify the gravity of each shared complication and detect those cases that need immediate interdisciplinary attention.
Topic 15a 15b 15c. DENTISTRY: The patient with oral mucosal diseases
Learning goals: Epidemiology of the diseases of the oral mucosa. Basic knowledge of the elementary mucosal lesions. The diagnostic process in oral medicine. How to examine the mouth of our patient; basic information regarding the prevalence of the oral mucosal diseases.
In particular, being able to recognize:
-oral ulcers: how to make a diagnosis.
-vesicular-bullous lesions of the oral cavity as lichen planus, pemphigoid, pemphigus, erythema multiform, and blistering viral lesions;
- pigmented oral lesions, candidiasis, and traumatic oral fibroma.

BLOCK IV. Movement Disorders: Facial Palsy, Dysphonia, Dysphagia, Dyspnoea, Ocular motion disorders
Topic 16. DENTISTRY Hypo-salivation and hyper-salivation
Learning goals: Clinical features, causes, consequences and treatment.
Topic 17. MAXILLO-FACIAL SURGERY: Oral nerve lesions are an emerging pathology, due to oral surgery increasing
Learning goals: to understand the pathophysiology of the lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery, medical therapy, acupuncture, hypnosis.
Topic 18. ENT: The adult patient with dysphonia, dysphagia and/or dyspnea
Learning goals: to recognize the different ENT-diseases related to dysphonia, dysphagia and/or dyspnoea. To get to know the diagnostic tools for evaluation and basic therapeutic options. To differentiate between acute and life- endangering and more benign courses.
Topic 19. OPHTHALMOLOGY: Abnormal eye movements: the more common causes of diplopia: eye, visual system and neurologic disorders
Prerequisites: Physiology of the ocular movements: 1) Gaze stabilization (vestibule-ocula and optokinetic reflexes); 2) Gaze shifting (smooth pursuit, saccades); 3) Vergence.
Learning goals: to understand the different mechanisms leading to disorders of the eye movements and diplopia. Differential diagnosis criteria and examples of clinical cases will be explained.

BLOCK V. FROM IMPAIRED FUNTION TO LOSS OF FUNCTION: DEAFNESS, BLINDNESS
Topic 20. OPHTHALMOLOGY: The correct process of vision: the role of ocular media and their physiopathology.
Prerequisites: Anatomy of the eye. Physiology of the mechanism of vision. The lens and the mechanism of accommodation and convergence.
The role of ocular media and their physiopathology.
Learning goals: this Topic focuses on how the process of vision is carried out and what is needed in order to correctly visualize the images. Refraction, cornea disorders and cataracts and how they can affect the correct process of vision will be described providing theoretical and practical explanations with clinical cases.
Practical session (1 hour):
assessment of visual acuity
slit lamp examination
Topic 21. OPHTHALMOLOGY: The blind eye: the more common conditions leading to complete blindness
Learning goals: Vascular disorders, e.g. retinal arterial and vein occlusions, diabetic retinopathy, ischemic optic neuropathy, cerebral ischemia involving the visual pathways and neuritis and tumors will be described. Criteria for differential diagnosis will be discussed together with clinical examples. In particular, the growing importance of the imaging of the eye and specifically of the retina and the optic nerve head will be shown and explained. These will be compared with the "traditional" examination of eye fundus.
Practical session:
Examination of the fundus oculi
Topic 22. OPHTHALMOLOGY: The eye and the brain: the pathologies involving the visual pathways from the eye to the brain cortex
Learning goals: Cerebral ischemia involving the visual pathways, optic ischemic neuropathies, neuritis and tumors will be described. Particular attention will be dedicated to the examination of the optic nerve head and how to interpret visual field changes.
Topic 23. ENT: The patient that does not hear
Learning goals: To understand the acute and chronic causes for hearing deficits and being able to detect causes that need immediate diagnostic and therapeutic attention

BLOCK VI. Neck and facial masses
Topic 24. ENT, MAXILLOFACIAL SURGERY: The patient with facial/cervical masses
Learning goals: To identify the most common causes for swelling/masses in the region. To recognize the signs for suspicion of malignant disease. Achieve a deeper understanding of the diagnostical pathway through the use of a flow chart approach. To get an overview of therapeutic options.
Topic 25. DENTISTRY: The patient with oral potentially malignant disorders and with oral cancer
Learning goals: Being able to recognize ppotentially malignant oral lesions and conditions. Suggested treatment and follow-up of a patient suffering from a leukoplakia or an erythroplakia.
Practical session **
Topic 26. OPHTHALMOLOGY: Orbital pathology: a multidisciplinary approach
Learning goals: this Topic focuses on more common orbital pathologies that can affect the eye and visual system. Grave's disease, optic nerve tumors, pseudotumour, and orbital cellulitis will be the main topics. A multidisciplinary approach involving other specialists of the orbit (otorhinolaryngologist, maxillofacial surgeon, endocrinologist) is considered for both diagnostic and medical/surgical management.

BLOCK VII. Vertigo
Topic 27. ENT: The patient with instability/vertigo
Learning goals: To be able to ask the right questions for a preliminary differentiation between peripheral vertigo, instability of the elderly and central vertigo

BLOCK VIII. AGE LONG: Pregnancy, growing and ageing
Topic 28. ENT: To recognize the difference in handling a paediatric patient: The child
Learning goals. To appreciate the most common causes for paediatric ENT consultations and get an overview of therapeutic options.
Open questions and discussion of clinical cases.
Topic 29. OPHTHALMOLOGY: The visual system in the child
Learning goals: this Topic focuses on the main steps of the development of the visual system from the eye to the brain. Particular weight will be given to amblyopia, strabismus and to what a pediatrician needs to know about correct development of "the good sight". Differential criteria of leucocoria and tumors of the eye and affecting vision will be also covered.
Topic 30a. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the anterior segment of the eye
Topic 30b. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the posterior segment of the eye
Learning goals: this Topic focuses on the chronic disorders of the aging eye. Epidemiologically relevant conditions like glaucoma and macular degeneration are the most important potential causes of blindness in the developed countries. New treatment paradigms are proposed, yet their increasing costs are challenging our Health Care Systems: what the doctors need to know to improve a rationale management.
Topic 31a, 31b. DENTISTRY: Oral health issues of interest for the physician
Learning goals: to present the most common mouth-related problems that a physician have to face: they include oral side effects of drugs, and anticancer treatments (chemotherapy, radiotherapy). To recognize the most common dental treatment and prosthesis rehabilitation and related problems (implant and peri- implantitis, prosthesis and denture stomatitis, restorative treatments and lichenoid lesions, )
Practical session

BLOCK IX. Distrectual expressions of systemic diseases and emergency
Topic 32. OPHTHALMOLOGY: What is a real emergency?
Learning goals: the most common reasons of eye and vision conditions leading to emergency care will be discussed. Particular weight will be given to what the general practitioner must know and can do and when a specialist is required. Practical examples of the "real life" emergency room activities dealing with eye and vision disorders will be provided, and algorithms of correct management discussed.
Topic 33. OPHTHALMOLOGY: Surgical approaches for ocular diseases
Learning goals: Most common types of surgeries for ocular pathologies will be shown and explained. This lesson will be based on videos taken from the operating room of San Paolo Hospital.
Topic 34. MAXILLOFACIAL SURGERY: Facial and craniofacial Trauma
Learning goals: to describe the most relevant clinical features in facial traumatology, focusing in particular on how to diagnose the most frequent fractures (nose, orbit, zygoma, maxilla and mandible) and how to practically handle simple or severe wounds involving facial soft tissues
Topic 35. DENTISTRY: Oral health is more than healthy teeth and gums
Learning goals: Oral health and general health: A relationship exists?
Topic 36. MAXILLOFACIAL SURGERY: Facial Palsy
Learning goals: to understand the pathophysiology of the facial nerve lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery and medical therapy.

BLOCK X. The patient with facial and craniofacial disproportion
Topic 37. MAXILLO-FACIAL SURGERY: Clinical Examination and anthropometry of the face: facial and craniofacial malformation
Learning goals: to describe rare craniofacial malformation, their impressive clinical behaviour, development during childhood and related problems are discussed. Specific surgical and non-surgical treatment are explained in details. To describe the most frequent maxilla-facial malformation, cleft lip and palate, is explained. The entire topic is analysed from a multidisciplinary point of view. Two- days at the Regional facial and craniofacial malformation Centre are offered to better understand the whole treatment goals.
To understand the pathology and complexity of its multidisciplinary treatment.
Practical session*

BLOCK I. Anatomic-functional basis of head and neck related functions
Topic 1. ANATOMY: Headache related to disorders of the masticatory apparatus
Anamnesis and diagnostic process of headache
Learning goals: Clinical features: to recognize different types of secondary headache and to localize the correlated pain in the facial framework.
Anatomical features: to describe the boundaries of the temporal, nose, lips, chin and cheek regions.
Overlapping of symptoms between acoustic and masticatory apparatus
Learning goals: Clinical features: To identify acoustic symptoms associated with articular and muscular temporomandibular disorders and to differentiate them from manifestations of otitis media.
Anatomical features: To describe the masticatory muscles, the temporomandibular joint and the tympanic cavity.
Trigeminal neuralgia
Learning goals: Clinical features: to recognize the idiopathic form of trigeminal neuralgia and to differentiate it from those forms caused by disorders within the territories innervated by trigeminal nerve.
Anatomical features: to describe course and function of the trigeminal nerve fibers.
Occlusal-related pain
Learning goals: Clinical features: to identify the most frequent pathologies of dental and periodontal tissues having a pain irradiation in the temporal and pre-auricular areas and to understand the principles of dental occlusion and temporomandibular disorders.
Anatomical features: To describe alveolar processes, teeth and dental occlusion.
Topic 2. PHYSIOLOGY: Somatosensory system: trigeminal district
Oro-facial sensory innervations: sensory perception in mouth
Learning goals: To describe the receptive fields, the functional and adaptation properties of mechano-termal receptors in the oro-facial region, and the proprioceptive innervation of the oro-facial district; to describe the integrative system underlying taste and texture perception.
Oro-facial sensory innervations: pain perception in mouth
Learning goals: To describe the neural substrates of the oro-facial pain; central pathways of the trigeminal system: from touch to pain perception; to define the psycho-physical laws of sensory perception in oro-facial region; to describe the central pathways of the oro-facial sensory innervation.
Oro-facial sensory innervations: Teeth innervation
Learning goals: To describe the functional and adaptation properties of the dentinal, pulpal and periodontal receptors.
Oro-facial sensory innervations: autonomic sensory innervation of mouth
Learning goals: To describe the vegetative afferents from oro-facial region.
Oro-facial sensory innervations: reflexes
Learning goals: To describe the somatosensory and vegetative reflexes of the oro- facial region.
Topic 3. ANATOMY: Nose and paranasal sinuses
Learning goals: to observe and recognize the position and main anatomical characteristics of the paranasal air sinuses and their spatial relationships with the nasal cavity, the orbit and the oral cavity including the alveolar processes; to describe the physiological and the clinical access to the maxillary sinus; to depict the main features of the nasal and paranasal mucosa with the correspondent vascular and nervous supply.
Topic 4. ANATOMY: Peripheral Facial Palsy
Anamnesis and diagnostic process of facial palsy
Learning goals: Clinical features: to describe the most frequent signs and symptoms of peripheral facial palsy.
Anatomical features: to describe the territories supplied by facial nerve (lacrimal apparatus, tongue, mimic muscles and platysma, salivatory glands).
Etiology of facial palsy
Learning goals: Clinical features: identify different types of peripheral facial palsy (Bell's palsy, neoplastic infective and vascular forms) and to explain how to orient the diagnosis using instrumental evaluations.
Anatomical features: To describe the intracranial course of the facial nerve (facial canal) and the course of all nerve branches. To depict limits and content of the pterygopalatine and the infratemporal fossae and of the submandibular space.
Altered salivation and facial expressions
Learning goals: Clinical features: to learn the link between xerostomia and changes in the mimicry.
Anatomical features: To describe the extra cranial course of the facial nerve and its anastomosis with other cranial nerves (trigeminal and glossopharyngeal). To depict limits and content of the parotid space, and to learn the organization of para- and retropharyngeal spaces.
Topic 5. PHYSIOLOGY: Neural control of Face expression
Neural control of facial expressions.
Learning goals: to describe functions of the mimic muscles. To describe the central control of mimic muscles: the emotional vs the voluntary facial expressions.
Topic 6. ANATOMY: Oro-pharyngeal Dysphagia
Anamnesis and diagnostic process of Oro-pharyngeal Dysphagia
Learning goals: Clinical features: to describe the most important clinical and etiological features of this condition and to differentiate it from esophageal dysphagia.
Anatomical features: to describe the phases of swallowing.
Oral phase of swallowing
Learning goals: Clinical features: to understand the normal mechanism of bolus formation, lip closure and tongue position in the adult swallowing and to identify atypical deglutition.
Anatomical features: to describe all muscular, nervous and visceral structures involved in the oral phase of swallowing including the tongue and the soft palate.
Pharyngeal phase of swallowing
Learning goals: Clinical features: to understand the subdivision between air and bolus compartments in the pharynx.
Anatomical features: to describe the structure and architecture of the pharynx with nerves and vessels supply. To identify the Eustachian tube and to understand its role during swallowing. To learn the location and clinical significance of Waldeyer's lymphatic ring.
Topic 7. PHYSIOLOGY: Neural control of Masticatory function
Neural control of mastication.
Learning goals: to describe the main reflexes acting on temporo mandibular joint fed by mechanoreceptors, nociceptors and proprioceptors; to define the resting posture of the jaw; to describe the phases of mastication and their pattern of muscular activation; to describe the neural control of mastication: integration by brain stem cranial nerve nuclei of reflex inputs and commands from other central nervous system nuclei; to define the different mechanisms controlling the voluntary bite vs chewing.
Topic 8. ANATOMY: Voice disorders
Production of the voice
Learning goals Clinical features: to describe the different steps of phono-articulatory process and the clinical consequences of each step disturbance.
Anatomical features: To describe the structure and architecture of the larynx.
Voice reduction correlated with laryngeal muscles disturbance
Learning goals: Clinical features: to understand possible causes altering the vibration of vocal cords.
Anatomical features: To define the laryngeal vessels and nerves supply. To learn the course of vagus nerve in the neck fascial compartments, and to explain its functional importance. To depict the position of the trachea, thyroid cartilage, larynx, thyroid and parathyroid glands in relation to the supra-hyoid and infra-hyoid muscles. To describe the carotid arteries system, the internal jugular vein, the functions of the deep and superficial cervical veins within the anterior triangle of the neck.
Topic 9. PHYSIOLOGY: Laryngeal functions
Neural control of laryngeal functions
Learning goals: to overview of the different laryngeal functions.
The phono-articulatory process
Learning goals: to describe neuromuscular control of voice/sounds emission: whispering, speaking, singing; to describe the control exerted by the acoustic inputs on the laryngeal function; to describe the control exerted by the somatosensory inputs on the laryngeal function; to describe the control exerted by the acoustic inputs on speech articulation.
Neural control of swallowing.
Learning goals: to describe the mechanisms of salivary production and its autonomic control.
Topic 10. PHYSIOLOGY: The neurophysiological basis of vertigo, nausea and vomiting
Learning goals: to recall the mechanism controlling posture.
Vertigo
Learning goals: to describe the neural basis of vertigo vs dizziness and motion sickness
Nausea and vomiting
Learning goals: to describe the neural basis of nausea; to describe the neural structures involved in emesis

BLOCK I. Anatomic-functional basis of head and neck related functions
Topic 1. ANATOMY: Headache related to disorders of the masticatory apparatus
Anamnesis and diagnostic process of headache
Learning goals: Clinical features: to recognize different types of secondary headache and to localize the correlated pain in the facial framework.
Anatomical features: to describe the boundaries of the temporal, nose, lips, chin and cheek regions.
Overlapping of symptoms between acoustic and masticatory apparatus
Learning goals: Clinical features: To identify acoustic symptoms associated with articular and muscular temporomandibular disorders and to differentiate them from manifestations of otitis media.
Anatomical features: To describe the masticatory muscles, the temporomandibular joint and the tympanic cavity.
Trigeminal neuralgia
Learning goals: Clinical features: to recognize the idiopathic form of trigeminal neuralgia and to differentiate it from those forms caused by disorders within the territories innervated by trigeminal nerve.
Anatomical features: to describe course and function of the trigeminal nerve fibers.
Occlusal-related pain
Learning goals: Clinical features: to identify the most frequent pathologies of dental and periodontal tissues having a pain irradiation in the temporal and pre-auricular areas and to understand the principles of dental occlusion and temporomandibular disorders.
Anatomical features: To describe alveolar processes, teeth and dental occlusion.
Topic 2. PHYSIOLOGY: Somatosensory system: trigeminal district
Oro-facial sensory innervations: sensory perception in mouth
Learning goals: To describe the receptive fields, the functional and adaptation properties of mechano-termal receptors in the oro-facial region, and the proprioceptive innervation of the oro-facial district; to describe the integrative system underlying taste and texture perception.
Oro-facial sensory innervations: pain perception in mouth
Learning goals: To describe the neural substrates of the oro-facial pain; central pathways of the trigeminal system: from touch to pain perception; to define the psycho-physical laws of sensory perception in oro-facial region; to describe the central pathways of the oro-facial sensory innervation.
Oro-facial sensory innervations: Teeth innervation
Learning goals: To describe the functional and adaptation properties of the dentinal, pulpal and periodontal receptors.
Oro-facial sensory innervations: autonomic sensory innervation of mouth
Learning goals: To describe the vegetative afferents from oro-facial region.
Oro-facial sensory innervations: reflexes
Learning goals: To describe the somatosensory and vegetative reflexes of the oro- facial region.
Topic 3. ANATOMY: Nose and paranasal sinuses
Learning goals: to observe and recognize the position and main anatomical characteristics of the paranasal air sinuses and their spatial relationships with the nasal cavity, the orbit and the oral cavity including the alveolar processes; to describe the physiological and the clinical access to the maxillary sinus; to depict the main features of the nasal and paranasal mucosa with the correspondent vascular and nervous supply.
Topic 4. ANATOMY: Peripheral Facial Palsy
Anamnesis and diagnostic process of facial palsy
Learning goals: Clinical features: to describe the most frequent signs and symptoms of peripheral facial palsy.
Anatomical features: to describe the territories supplied by facial nerve (lacrimal apparatus, tongue, mimic muscles and platysma, salivatory glands).
Etiology of facial palsy
Learning goals: Clinical features: identify different types of peripheral facial palsy (Bell's palsy, neoplastic infective and vascular forms) and to explain how to orient the diagnosis using instrumental evaluations.
Anatomical features: To describe the intracranial course of the facial nerve (facial canal) and the course of all nerve branches. To depict limits and content of the pterygopalatine and the infratemporal fossae and of the submandibular space.
Altered salivation and facial expressions
Learning goals: Clinical features: to learn the link between xerostomia and changes in the mimicry.
Anatomical features: To describe the extra cranial course of the facial nerve and its anastomosis with other cranial nerves (trigeminal and glossopharyngeal). To depict limits and content of the parotid space, and to learn the organization of para- and retropharyngeal spaces.
Topic 5. PHYSIOLOGY: Neural control of Face expression
Neural control of facial expressions.
Learning goals: to describe functions of the mimic muscles. To describe the central control of mimic muscles: the emotional vs the voluntary facial expressions.
Topic 6. ANATOMY: Oro-pharyngeal Dysphagia
Anamnesis and diagnostic process of Oro-pharyngeal Dysphagia
Learning goals: Clinical features: to describe the most important clinical and etiological features of this condition and to differentiate it from esophageal dysphagia.
Anatomical features: to describe the phases of swallowing.
Oral phase of swallowing
Learning goals: Clinical features: to understand the normal mechanism of bolus formation, lip closure and tongue position in the adult swallowing and to identify atypical deglutition.
Anatomical features: to describe all muscular, nervous and visceral structures involved in the oral phase of swallowing including the tongue and the soft palate.
Pharyngeal phase of swallowing
Learning goals: Clinical features: to understand the subdivision between air and bolus compartments in the pharynx.
Anatomical features: to describe the structure and architecture of the pharynx with nerves and vessels supply. To identify the Eustachian tube and to understand its role during swallowing. To learn the location and clinical significance of Waldeyer's lymphatic ring.
Topic 7. PHYSIOLOGY: Neural control of Masticatory function
Neural control of mastication.
Learning goals: to describe the main reflexes acting on temporo mandibular joint fed by mechanoreceptors, nociceptors and proprioceptors; to define the resting posture of the jaw; to describe the phases of mastication and their pattern of muscular activation; to describe the neural control of mastication: integration by brain stem cranial nerve nuclei of reflex inputs and commands from other central nervous system nuclei; to define the different mechanisms controlling the voluntary bite vs chewing.
Topic 8. ANATOMY: Voice disorders
Production of the voice
Learning goals Clinical features: to describe the different steps of phono-articulatory process and the clinical consequences of each step disturbance.
Anatomical features: To describe the structure and architecture of the larynx.
Voice reduction correlated with laryngeal muscles disturbance
Learning goals: Clinical features: to understand possible causes altering the vibration of vocal cords.
Anatomical features: To define the laryngeal vessels and nerves supply. To learn the course of vagus nerve in the neck fascial compartments, and to explain its functional importance. To depict the position of the trachea, thyroid cartilage, larynx, thyroid and parathyroid glands in relation to the supra-hyoid and infra-hyoid muscles. To describe the carotid arteries system, the internal jugular vein, the functions of the deep and superficial cervical veins within the anterior triangle of the neck.
Topic 9. PHYSIOLOGY: Laryngeal functions
Neural control of laryngeal functions
Learning goals: to overview of the different laryngeal functions.
The phono-articulatory process
Learning goals: to describe neuromuscular control of voice/sounds emission: whispering, speaking, singing; to describe the control exerted by the acoustic inputs on the laryngeal function; to describe the control exerted by the somatosensory inputs on the laryngeal function; to describe the control exerted by the acoustic inputs on speech articulation.
Neural control of swallowing.
Learning goals: to describe the mechanisms of salivary production and its autonomic control.
Topic 10. PHYSIOLOGY: The neurophysiological basis of vertigo, nausea and vomiting
Learning goals: to recall the mechanism controlling posture.
Vertigo
Learning goals: to describe the neural basis of vertigo vs dizziness and motion sickness
Nausea and vomiting
Learning goals: to describe the neural basis of nausea; to describe the neural structures involved in emesis

BLOCK II. Pain in the head and neck area
Topic 11a. DENTISTRY: The patient with acute oral pain
Learning goals: To describe oral pain related to oral diseases and in particular to dental caries; dental caries: epidemiology, etiology, prevention and consequences of such a disease. Hard dental tissues scanning electron microscopy and dental hypersensitivity.
Topic 11b. DENTISTRY: The most common diseases of the oral cavity
Learning goals: To define distribution in the population, risk factors and clinical presentations of periodontal diseases Periodontal apparatus in health and disease. The oral biofilm and the etiology of gingivitis and periodontitis diseases. Diagnosis, classification and treatment of the different periodontal conditions
Topic 11c. DENTISTRY: Oral-facial chronic pain
Learning goals: To describe chronic oral pain not related to tooth and gum diseases (i.e, persistent idiopathic facial pain, burning mouth syndrome, oral cancer related pain).
Topic 12a. OPHTHALMOLOGY: The red eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Learning goals: to learn the different inflammatory conditions of the eye, their differential diagnosis, management and treatment will be the aim of this Topic. Particular weight is given to differentiate the conditions that require emergency and prompt management from those that may need delayed examination by a specialist.
Clinical cases of anterior uveitis, keratitis, conjunctivitis and acute attack of glaucoma will be shown and discussed.
Topic 12b. OPHTHALMOLOGY: The painful eye
Prerequisites: Anatomy of the anterior segment of the eye. Anatomy of trigeminal innervation (face and eye). Physiology of aqueous humor dynamics. Differential diagnosis with structures causing pain in the periorbital region.
Topic 13c. EAR NOSE THROAT The patient with headache - its relations with nasal disease
Learning goals: To recognize the different features and symptoms related to headache and to be able to ask the right questions for a preliminary differentiation between sino-nasal headache and other causes.
Learning goals: Identification of causes of painful eye; definition of acute vs chronic pain; management and treatment using a multidisciplinary approach

BLOCK III. Nasal obstruction, epistaxis, oral mucosal diseases
Topic 13a 13b. EAR NOSE THROAT 1. The patient with nasal obstruction and/or nasal discharge
Learning goals: To recognize the different features and symptoms related to nasal obstruction and discharge and to differentiate benign from malignant disease. To get an overview of therapeutic options and to appreciate the diagnostic tools for evaluation.
Topic 14. ENT, OPHTHALMOLOGY: Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
Learning goals: Being able to identify the features of complications of sino-nasal disease that overlap with the neighbouring structures and to recognize the primary source of the disorders. To identify the gravity of each shared complication and detect those cases that need immediate interdisciplinary attention.
Topic 15a 15b 15c. DENTISTRY: The patient with oral mucosal diseases
Learning goals: Epidemiology of the diseases of the oral mucosa. Basic knowledge of the elementary mucosal lesions. The diagnostic process in oral medicine. How to examine the mouth of our patient; basic information regarding the prevalence of the oral mucosal diseases.
In particular, being able to recognize:
-oral ulcers: how to make a diagnosis.
-vesicular-bullous lesions of the oral cavity as lichen planus, pemphigoid, pemphigus, erythema multiform, and blistering viral lesions;
- pigmented oral lesions, candidiasis, and traumatic oral fibroma.

BLOCK IV. Movement Disorders: Facial Palsy, Dysphonia, Dysphagia, Dyspnoea, Ocular motion disorders
Topic 16. DENTISTRY Hypo-salivation and hyper-salivation
Learning goals: Clinical features, causes, consequences and treatment.
Topic 17. MAXILLO-FACIAL SURGERY: Oral nerve lesions are an emerging pathology, due to oral surgery increasing
Learning goals: to understand the pathophysiology of the lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery, medical therapy, acupuncture, hypnosis.
Topic 18. ENT: The adult patient with dysphonia, dysphagia and/or dyspnea
Learning goals: to recognize the different ENT-diseases related to dysphonia, dysphagia and/or dyspnoea. To get to know the diagnostic tools for evaluation and basic therapeutic options. To differentiate between acute and life- endangering and more benign courses.
Topic 19. OPHTHALMOLOGY: Abnormal eye movements: the more common causes of diplopia: eye, visual system and neurologic disorders
Prerequisites: Physiology of the ocular movements: 1) Gaze stabilization (vestibule-ocula and optokinetic reflexes); 2) Gaze shifting (smooth pursuit, saccades); 3) Vergence.
Learning goals: to understand the different mechanisms leading to disorders of the eye movements and diplopia. Differential diagnosis criteria and examples of clinical cases will be explained.

BLOCK V. FROM IMPAIRED FUNTION TO LOSS OF FUNCTION: DEAFNESS, BLINDNESS
Topic 20. OPHTHALMOLOGY: The correct process of vision: the role of ocular media and their physiopathology.
Prerequisites: Anatomy of the eye. Physiology of the mechanism of vision. The lens and the mechanism of accommodation and convergence.
The role of ocular media and their physiopathology.
Learning goals: this Topic focuses on how the process of vision is carried out and what is needed in order to correctly visualize the images. Refraction, cornea disorders and cataracts and how they can affect the correct process of vision will be described providing theoretical and practical explanations with clinical cases.
Practical session (1 hour):
assessment of visual acuity
slit lamp examination
Topic 21. OPHTHALMOLOGY: The blind eye: the more common conditions leading to complete blindness
Learning goals: Vascular disorders, e.g. retinal arterial and vein occlusions, diabetic retinopathy, ischemic optic neuropathy, cerebral ischemia involving the visual pathways and neuritis and tumors will be described. Criteria for differential diagnosis will be discussed together with clinical examples. In particular, the growing importance of the imaging of the eye and specifically of the retina and the optic nerve head will be shown and explained. These will be compared with the "traditional" examination of eye fundus.
Practical session:
Examination of the fundus oculi
Topic 22. OPHTHALMOLOGY: The eye and the brain: the pathologies involving the visual pathways from the eye to the brain cortex
Learning goals: Cerebral ischemia involving the visual pathways, optic ischemic neuropathies, neuritis and tumors will be described. Particular attention will be dedicated to the examination of the optic nerve head and how to interpret visual field changes.
Topic 23. ENT: The patient that does not hear
Learning goals: To understand the acute and chronic causes for hearing deficits and being able to detect causes that need immediate diagnostic and therapeutic attention

BLOCK VI. Neck and facial masses
Topic 24. ENT, MAXILLOFACIAL SURGERY: The patient with facial/cervical masses
Learning goals: To identify the most common causes for swelling/masses in the region. To recognize the signs for suspicion of malignant disease. Achieve a deeper understanding of the diagnostical pathway through the use of a flow chart approach. To get an overview of therapeutic options.
Topic 25. DENTISTRY: The patient with oral potentially malignant disorders and with oral cancer
Learning goals: Being able to recognize ppotentially malignant oral lesions and conditions. Suggested treatment and follow-up of a patient suffering from a leukoplakia or an erythroplakia.
Practical session **
Topic 26. OPHTHALMOLOGY: Orbital pathology: a multidisciplinary approach
Learning goals: this Topic focuses on more common orbital pathologies that can affect the eye and visual system. Grave's disease, optic nerve tumors, pseudotumour, and orbital cellulitis will be the main topics. A multidisciplinary approach involving other specialists of the orbit (otorhinolaryngologist, maxillofacial surgeon, endocrinologist) is considered for both diagnostic and medical/surgical management.

BLOCK VII. Vertigo
Topic 27. ENT: The patient with instability/vertigo
Learning goals: To be able to ask the right questions for a preliminary differentiation between peripheral vertigo, instability of the elderly and central vertigo

BLOCK VIII. AGE LONG: Pregnancy, growing and ageing
Topic 28. ENT: To recognize the difference in handling a paediatric patient: The child
Learning goals. To appreciate the most common causes for paediatric ENT consultations and get an overview of therapeutic options.
Open questions and discussion of clinical cases.
Topic 29. OPHTHALMOLOGY: The visual system in the child
Learning goals: this Topic focuses on the main steps of the development of the visual system from the eye to the brain. Particular weight will be given to amblyopia, strabismus and to what a pediatrician needs to know about correct development of "the good sight". Differential criteria of leucocoria and tumors of the eye and affecting vision will be also covered.
Topic 30a. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the anterior segment of the eye
Topic 30b. OPHTHALMOLOGY: The aging eye: Age-related conditions involving the posterior segment of the eye
Learning goals: this Topic focuses on the chronic disorders of the aging eye. Epidemiologically relevant conditions like glaucoma and macular degeneration are the most important potential causes of blindness in the developed countries. New treatment paradigms are proposed, yet their increasing costs are challenging our Health Care Systems: what the doctors need to know to improve a rationale management.
Topic 31a, 31b. DENTISTRY: Oral health issues of interest for the physician
Learning goals: to present the most common mouth-related problems that a physician have to face: they include oral side effects of drugs, and anticancer treatments (chemotherapy, radiotherapy). To recognize the most common dental treatment and prosthesis rehabilitation and related problems (implant and peri- implantitis, prosthesis and denture stomatitis, restorative treatments and lichenoid lesions, )
Practical session

BLOCK IX. Distrectual expressions of systemic diseases and emergency
Topic 32. OPHTHALMOLOGY: What is a real emergency?
Learning goals: the most common reasons of eye and vision conditions leading to emergency care will be discussed. Particular weight will be given to what the general practitioner must know and can do and when a specialist is required. Practical examples of the "real life" emergency room activities dealing with eye and vision disorders will be provided, and algorithms of correct management discussed.
Topic 33. OPHTHALMOLOGY: Surgical approaches for ocular diseases
Learning goals: Most common types of surgeries for ocular pathologies will be shown and explained. This lesson will be based on videos taken from the operating room of San Paolo Hospital.
Topic 34. MAXILLOFACIAL SURGERY: Facial and craniofacial Trauma
Learning goals: to describe the most relevant clinical features in facial traumatology, focusing in particular on how to diagnose the most frequent fractures (nose, orbit, zygoma, maxilla and mandible) and how to practically handle simple or severe wounds involving facial soft tissues
Topic 35. DENTISTRY: Oral health is more than healthy teeth and gums
Learning goals: Oral health and general health: A relationship exists?
Topic 36. MAXILLOFACIAL SURGERY: Facial Palsy
Learning goals: to understand the pathophysiology of the facial nerve lesions, the clinical features, and therapeutic options. Physiological neural repair modalities are explained as well as treatment options: microsurgery and medical therapy.

BLOCK X. The patient with facial and craniofacial disproportion
Topic 37. MAXILLO-FACIAL SURGERY: Clinical Examination and anthropometry of the face: facial and craniofacial malformation
Learning goals: to describe rare craniofacial malformation, their impressive clinical behaviour, development during childhood and related problems are discussed. Specific surgical and non-surgical treatment are explained in details. To describe the most frequent maxilla-facial malformation, cleft lip and palate, is explained. The entire topic is analysed from a multidisciplinary point of view. Two- days at the Regional facial and craniofacial malformation Centre are offered to better understand the whole treatment goals.
To understand the pathology and complexity of its multidisciplinary treatment.
Practical session*