Grace Khong
Grace Khong is a Consultant Paediatric ENT Surgeon and Rhinologist at Alder Hey Children’s NHS Foundation Trust, Liverpool. She obtained her early ENT surgical training in Chennai, India completing the Diplomate of the National Board. Her higher surgical training was in the Northwest of England, where she completed two Royal College of Surgeons of England accredited Senior Clinical Fellowships – the Liverpool Rhinology Fellowship at Aintree University Hospital (2018) and Paediatric ENT fellowship in Alder Hey Children’s NHS Foundation Trust (2019).
Her practice includes complex congenital and paediatric sinonasal surgeries in collaboration with neurosurgery, craniofacial and ophthalmology teams.
She is an Associate Editor of Clinical Otolaryngology and Honorary Clinical Lecturer at the University of Liverpool.
She is on the teaching faculty of numerous dissection courses in the UK and internationally and has authored numerous book chapters on paediatric ENT and rhinology topics.
Sessions
This session is designed to equip the attendee with a broad understanding of the principles of using navigation systems for both anterior and lateral skull base surgery in children. There is very little experience globally in the use of navigation for paediatric anterior skull base surgery and none in paediatric lateral skull base surgery therefore this will be a novel session for attendees to learn about the benefits and limitations of this technology, as well as hints and common pitfalls in it’s use in children. The session will consist of presentations by a leading paediatric anterior skull base surgeon and leading paediatric lateral skull base surgeon with extensive experience of navigation systems in this population group. There will then be a panel discussion and an opportunity for attendees to gain practical experience with the navigation system.
the objectives are:
understanding of the indications of use of the navigation system in paediatric anterior and lateral skull base surgery.
understanding of how to set up the navigation system in the paediatric population for both anterior and lateral skull base surgery.
appreciation of tips in using this technology in the paediatric population and common pitfalls.
potential future uses of this technology.
the session presenters will be ms grace khong (consultant in paediatric rhinology and anterior skull base surgery) and mr sunil sharma (consultant in paediatric otology and lateral skull base surgery). The key references demonstrating the presenters’ experience in this topic are:
davies t, zammit m, todd h, sharma r, khong g. Elective paediatric functional endoscopic sinus surgery: a tertiary centre experience. J laryngol otol. 2025 aug 1:1-5. Doi: 10.1017/s0022215125102922. Epub ahead of print. PMID: 40746304.
milinis k, thompson n, atsmoni SC, sharma SD. Sinogenic intracranial suppuration in children: systematic review and meta-analysis. Otolaryngol head neck surg. 2022 aug;167(2):215-223. Doi: 10.1177/01945998211043847. Epub 2021 sep 7. PMID: 34491863.
salem j, bakundukize j, milinis k, sharma SD. Mastoid obliteration versus canal wall down or canal wall up mastoidectomy for cholesteatoma: systematic review and meta-analysis. Am j otolaryngol. 2023 mar-apr;44(2):103751. Doi: 10.1016/j.Amjoto.2022.103751. Epub 2022 dec 27. PMID: 36586321.
sharma SD, kumar g, bal j, eweiss a. Endoscopic repair of cerebrospinal fluid rhinorrhoea. Eur ann otorhinolaryngol head neck dis. 2016 jun;133(3):187-90. Doi: 10.1016/j.Anorl.2015.05.010. Epub 2016 jan 6. PMID: 26776882.
milinis k, thiagarajan j, leong s, de s, sinha a, sharma r, sharma s. Review of management practices of sinogenic intracranial abscesses in children. J laryngol otol. 2023 oct;137(10):1135-1140. Doi: 10.1017/s0022215123000166. Epub 2023 feb 8. PMID: 36751894.
Congenital obstruction of the nose is discussed
Nasal and sinus masses in children
Pediatric endoscopic skull base surgery: overcoming the challenges and improving outcomes
Description this symposium explores the unique considerations and surgical strategies involved in managing skull base pathology in the pediatric population. While many principles of endoscopic skull base surgery are shared with adult practice, the pediatric context introduces specific challenges related to anatomy, instrumentation, and perioperative care. Experts will present structured talks on practical surgical techniques, including the management of pediatric cerebrospinal fluid (CSF) leaks and endoscopic repair of congenital meningoencephaloceles.
outcome objectives by the end of the session, attendees will be able to:
understand the anatomical and physiological differences between pediatric and adult skull base surgery.
identify appropriate adaptations in equipment, instruments, and theatre setup when operating in small children.
apply specific technical strategies for managing pediatric CSF leaks, with emphasis on safety and long-term outcomes.
recognize the diagnostic and surgical considerations for pediatric meningoencephaloceles.
improve teamwork and communication between surgeons and assistants when working within the constraints of a small nasal cavity.
background pediatric skull base surgery remains a highly specialized and evolving field. Compared to adult patients, children present unique challenges due to smaller anatomical spaces, immature bone structures, and a narrower margin for error. Instrumentation must be adapted, and surgical teams require dedicated planning to ensure optimal access and safety. This symposium will provide practical guidance on operating within these constraints, including pearls on patient positioning, endoscope handling, and collaboration with surgical assistants.
through illustrative cases and expert experience, the session will highlight advances in managing pediatric CSF leaks and congenital meningoencephaloceles—two conditions that exemplify the complexity and precision required in this age group. By sharing multidisciplinary insights, the symposium aims to equip attendees with a clearer understanding of how to safely expand their skull base practice into the pediatric realm.