Joseph Manjaly
Joe Manjaly is a Consultant Otologist, Auditory Implant and ENT Surgeon. He is Clinical Lead for Adult ENT at the Royal National ENT Hospital & University College London Hospitals. He graduated from Bristol University in 2008 and underwent ENT Higher surgical training on the London North Thames rotation followed by an advanced fellowship in Otology & Auditory Implants at University Hospitals Cambridge. He specialises in stapedectomy under sedation as well as cochlear, middle ear & bone conduction implantation for adults & children. He is the author of a number of popular trainee textbooks, including ‘ENT OSCES’ & 'Advanced ENT Training' both published by CRC press. He is a council member for the British Society of Otology. He creates a variety of educational social media content on various channels as @earsurgeonjoe
Sessions
There continue to be significant shifts in the landscape of bone conduction implants over recent years. This instructional session aims to provide ENT surgeons audiologists and other allied health professionals with a structured framework to confidently counsel and select appropriate implantable hearing solutions for patients with conductive and mixed hearing loss, as well as single-sided deafness.
I will critically review current bone conduction options—including percutaneous and transcutaneous systems (BAHA, Ponto, OSIA, Bonebridge, Sentio)—and also touch on the weigh up between these and active middle ear implants. Drawing on experience from a high-volume UK auditory implant centre, I will share clinical outcomes, complication rates, and evolving patient preferences demonstrated over the last 4 years.
Topics will include candidacy criteria, surgical techniques (including minimally invasive approaches), device-specific pros and cons, emerging trends and how to more clearly understand what patients care particularly about.
Having been popularised in the 1950s, stapes surgery remains one of the most life-impacting operations in otology – but we know as a specialty that it carries at least a small degree of risk in even the best hands. As patient expectations around the care they receive evolves, there is a need to reframe how we train and support the next generation of stapes surgeons, and to be consistent in our messaging to patients.
This instructional session explores the multifaceted challenges and evolving strategies for modern stapes surgery, drawn from my own mentorship and experience of over 160 cases performed under local anaesthetic with sedation. Technical considerations such as sedation protocols, intraoperative stressors and decision-making in complex cases will be discussed with video case examples.
Crucial to this topic is the changing psychosocial context in which we practise. The proliferation of online reviews and patient forums means each surgical outcomes are under scrutiny—making trust, communication, and counselling skills more important than ever. I will explore a patient-centred, emotionally intelligent approach to pre-operative counselling that moves beyond paternalism to shared decision-making. Attendees will gain practical strategies for helping patients appreciate risk, understand functional deficits, and prepare for a range of outcomes.
This session is designed for trainees and young consultants in otology who want to build long-term confidence in offering stapes surgery and wish to be guided in a prudent way to achieve it.