The surgical treatment of a pharyngeal pouch with endoscopic stapling diverticulotomy is a relatively new concept. Long-term results and complications are yet to be fully studied. We describe a patient who developed persistent pharyngeal pain and foreign body sensation due to retention of a clump of staples at the cricopharyngeal sphincter. This complication has not been reported before. This case highlights the need for repeat endoscopy rather than a barium swallow X-ray if the patients are symptomatic after stapling procedures.
The endoscopic sinus surgery simulator (ES3) is currently being studied as a tool for otolaryngology resident training. While examining performance patterns on the simulator, we sought to define any relationships that may exist between subjects' previously acquired skills and their performance on the simulator.Methods: Twenty-six medical students were enrolled in our ES3 study. After completing their trials, they were asked to complete a 28-item questionnaire. This questionnaire included yes/no questions, as well as 10-point Likert scale instruments.Results: Only 4 subjects did not respond to the questionnaire. Significant contributions to simulator performance were elucidated for a number of previously learned skills, but most were short-lived. For example, experienced video gamers were significantly better at hazard avoidance in the simulator's novice mode (P ϭ 0.03), but their advantage dissipated as they advanced to intermediate mode trials. Additionally, subjects' handedness contributed to simulator performance for only the first 3 trials (P ϭ 0.04), but this relationship, too, was no longer statistically significant in later trials.Conclusions: Some study subjects had skills and characteristics that significantly aided them in their ability to perform surgery on the simulator. However, these benefits were short-lived, and these results suggest that practicing plays a more important and long-standing role than other factors in surgical simulator performance. It follows that surgical simulation should play a more prominent role in surgical education, since residents who practice on simulators such as the ES3 are, in turn, practicing for the reality of the operating room.
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