Ex vivo ovine model for pediatric flexible endoscopy training

Isaacson, Glenn; Ianacone, David C.; Wolfson, Marla R.

doi:10.1016/j.ijporl.2015.10.002

Cited by 13 publications

(10 citation statements)

References 18 publications

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“…Anatomically, the upper aerodigestive tract is divided into an airway and a foodway with an overlapping epiglottis and soft palate in both species. The ovine larynx has an overall similar structure and is used for human surgical training (Isaacson et al, 2015(Isaacson et al, , 2016Ianacone et al, 2016). In both species, the cricopharyngeus muscle is the main component of the upper oesophageal sphincter (Samson et al, 2021).…”

Section: Limitations Of Our Studymentioning

confidence: 99%

Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

et al. 2022

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Aim: Convalescing preterm infants often require non-invasive respiratory support, such as nasal continuous positive airway pressure or high-flow nasal cannulas. One challenging milestone for preterm infants is achieving full oral feeding. Some teams fear nasal respiratory support might disrupt sucking–swallowing–breathing coordination and induce severe cardiorespiratory events. The main objective of this study was to assess the safety of oral feeding of preterm lambs on nasal respiratory support, with or without tachypnoea.Methods: Sucking, swallowing and breathing functions, as well as electrocardiogram, oxygen haemoglobin saturation, arterial blood gases and videofluoroscopic swallowing study were recorded in 15 preterm lambs during bottle-feeding. Four randomly ordered conditions were studied: control, nasal continuous positive airway pressure (6 cmH2O), high-flow nasal cannulas (7 L•min–1), and high-flow nasal cannulas at 7 L•min–1 at a tracheal pressure of 6 cmH2O. The recordings were repeated on days 7–8 and 13–14 to assess the effect of maturation.Results: None of the respiratory support impaired the safety or efficiency of oral feeding, even with tachypnoea. No respiratory support systematically impacted sucking–swallowing–breathing coordination, with or without tachypnoea. No effect of maturation was found.Conclusion: This translational physiology study, uniquely conducted in a relevant animal model of preterm infant with respiratory impairment, shows that nasal respiratory support does not impact the safety or efficiency of bottle-feeding or sucking–swallowing–breathing coordination. These results suggest that clinical studies on bottle-feeding in preterm infants under nasal continuous positive airway pressure and/or high-flow nasal cannulas can be safely undertaken.

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Section: Limitations Of Our Studymentioning

confidence: 99%

Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

et al. 2022

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“…16 Their ex vivo application in airway simulation is diverse and accommodates both open and endolaryngeal procedures. 17,18…”

Section: Discussionmentioning

confidence: 99%

“…16 Their ex vivo application in airway simulation is diverse and accommodates both open and endolaryngeal procedures. 17,18 Use of refashioned lamb tissue for LTR and advanced airway surgery has also recently been described 7 demonstrating its versatility. The cartilaginous construct permits good tissue handling.…”

Section: Discussionmentioning

confidence: 99%

Validation of Animal Models for Simulation Training in Pediatric Laryngotracheal Reconstruction

Okhovat

Milner

Clement

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: To assess and compare the face (FV) and content validity (CV) of three ex vivo animal models for simulation training in pediatric laryngotracheal reconstruction (LTR). Methods: Feasibility of performing LTR was assessed on the head and neck of three different animals (lamb/suckling-pig/rabbit) and laryngeal dimensions and qualitative observations were recorded. A 19-item five-point Likert scale questionnaire was completed for each model to assess FV and CV. Data was prospectively collected and analyzed using descriptive and nonparametric statistics. Results: All three models were suitable for LTR simulation with laryngeal dimensions corresponding to 0-2 years (rabbit), 5-10 (pig) and >10 years (lamb model). Five trainees and five expert pediatric otolaryngologists performed LTR on each model. The overall median FV score was 5 for the lamb model (IQR 4-5), 3 for the rabbit (IQR 2-3), and 4 for the pig (IQR 4-4). The overall median CV score was 5 for the lamb (IQR 5-5), 2 for the rabbit (IQR 2-3), and 4 for the pig model (IQR 4-4). Comparison of the models demonstrated the lamb to be favored as the most realistic and practical model for simulation training in pediatric LTR, with both the lamb and the porcine model attaining validation thresholds. Conclusion: Our study is the first comparative validation assessment of animal models for use in pediatric LTR simulation and it supports the use of ex vivo lamb and porcine models for use in LTR surgical skills training. The lamb model was the favored simulation model while the rabbit was considered inferior for simulation training in pediatric LTR. Level of Evidence: 3b

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“…In particular, the ex vivo ovine model showed its utility in endoscopic ear surgery [ 7 , 8 , 9 , 10 ], on orbital procedures [ 11 , 12 ], on parotid gland surgery, and in facial nerve reconstruction/reanimation [ 13 , 14 ]. In addition, it is also used in open laryngeal and tracheal surgery training [ 15 , 16 , 17 ], in microlaryngeal surgery, and lastly, to simulate several pediatric procedures [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Training on Ex Vivo Ovine Model in Otolaryngology Head and Neck Surgery: A Comprehensive Review

Fermi

Chiari

Mattioli

et al. 2022

IJERPH

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Background: Nowadays, head and neck surgical approaches need an increased level of anatomical knowledge and practical skills; therefore, the related learning curve is both flat and long. On such procedures, surgeons must decrease operating time as much as possible to reduce the time of general anesthesia and related stress factors for patients. Consequently, little time can be dedicated for training skills of students and young residents in the operating theater. Fresh human cadavers offer the most obvious surrogate for living patients, but they have several limitations, such as cost, availability, and local regulations. Recently, the feasibility of using ex vivo animal models, in particular ovine ones, have been considered as high-fidelity alternatives to cadaveric specimens. Methods: This comprehensive review explores all of head and neck otolaryngology applications with this sample. We analyzed studies about ear surgery, orbital procedures, parotid gland and facial nerve reanimation, open laryngeal and tracheal surgery, microlaryngoscopy procedures, laryngotracheal stenosis treatment, and diagnostic/operative pediatric endoscopy. For each different procedure, we underline the main applications, similarities, and limitations to human procedures so as to improve the knowledge of this model as a useful tool for surgical training. Results: An ovine model is easily available and relatively inexpensive, it has no limitations associated with religious or animal ethical issues, and it is reliable for head and neck surgery due to similar consistencies tissues and neurovascular structures with respect to humans. However, some other issues should be considered, such as differences about some anatomical features, the risk of zoonotic diseases, and the absence of bleeding during training. Conclusion: This comprehensive review highlights the potentials of an ex vivo ovine model and aims to stimulate the scientific and academic community to further develop it for other applications in surgical education.

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Ex vivo ovine model for pediatric flexible endoscopy training

Cited by 13 publications

References 18 publications

Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

Validation of Animal Models for Simulation Training in Pediatric Laryngotracheal Reconstruction

Surgical Training on Ex Vivo Ovine Model in Otolaryngology Head and Neck Surgery: A Comprehensive Review

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