<i>Ex vivo</i> ovine model for teaching open laryngotracheal surgery

Soliman, Ahmed M. S.; Ianacone, David C.; Isaacson, Glenn

doi:10.1016/j.wjorl.2018.04.002

Cited by 12 publications

(6 citation statements)

References 24 publications

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“…In order to control the endotracheal tube cuff pressure more conveniently, we used the sheep tracheae to simulate the human tracheae. Sheep tracheae ex vivo were chosen as they serve as a realistic in expensive and safe model to mimic the human tracheae for variety of surgical procedures related to laryngotracheal emergency situations specifically due to their surgical simulation with human organs [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Qin

Zhou

Zhao

et al. 2022

Applied Bionics and Biomechanics

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Background. Endotracheal intubation is a widely used treatment. Excessive pressure of the endotracheal tube cuff leads to a series of complications. Here, we used tracheae of sheep to analyze the relationship between the air injection volume and endotracheal tube cuff pressure so as to guide the doctors and nurses in controlling the pressure of the endotracheal tube cuff during clinical work and minimise the risk of complications. Materials and Methods. Forty sheep tracheae were utilised and were divided into five groups according to their diameters. Different sizes of endotracheal tubes were inserted into each trachea, and the cuff pressure with the increase of air injection volume was recorded. The formulas that reflect the relationship between air injection volume and cuff pressure were obtained. Then, sheep tracheae were randomly selected; different types of tubes were inserted, and the stipulated volume of air was injected. The actual pressure was measured and compared with the pressure predicted from the formulas. Statistical analysis was conducted to verify whether the formulas obtained from the first part of the experiment were in accordance with the expert evaluation table, which consists of opinions of several experts. Results. After obtaining 15 formulas, we collected the differences between the theoretical cuff pressure and the actual cuff pressure that satisfied the expert evaluation. Relying on the formulas, the medical turntable was obtained, which is a tool that consists of two round cards with data on them. The top card has a notch. The two cards are stacked together, and as the top card rotates, the data on the bottom card can be easily seen in a one-to-one relationship. Conclusion. The formulas are capable of showing the relationship between the cuff air injection volume and pressure of endotracheal tube cuff. The medical turntable can estimate the air injection volume to ensure that the pressure stays in an acceptable range.

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Section: Introductionmentioning

confidence: 99%

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Qin

Zhou

Zhao

et al. 2022

Applied Bionics and Biomechanics

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“…It is stated that the ovine larynx is similar to human airways and can be a realistic experimental model, closely approximating an adult human larynx with similar insertion‐ and penetration forces during cricothyroid cannulation . The ovine larynx has been widely used in experimental settings …”

Section: Methodsmentioning

confidence: 99%

Percutaneous vs surgical emergency cricothyroidotomy: An experimental randomized crossover study on an animal‐larynx model

Andresen

Kramer‐Johansen

Kristiansen

2019

Acta Anaesthesiol Scand

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Background Airway management is a paramount clinical skill for the anaesthesiologist. The Emergency Cricothyroidotomy (EC) constitutes the final step in difficult airway algorithms securing a patent airway via a front‐of‐neck access. The main distinction among available techniques is whether the procedure is surgical and scalpel‐based or percutaneous and needle‐based. Methods In an experimental randomized crossover trial, using an animal larynx model, we compared two EC techniques; the Rapid Four Step Technique and the Melker Emergency Cricothyrotomy Kit®. We assessed time expenditure and success rates among 20 anaesthesiologists and related this to previous training, seniority and clinical experience with EC. Results All participants achieved successful airway access with both methods. Average time to successful airway access for scalpel‐based EC was 54 (±31) seconds and for percutaneous EC 89 (±38) seconds, with 35 (95% CI: 14‐57) seconds time difference, P = .003. Doctors with recent (<12 months) EC training performed better compared to the non‐training group (37 vs 61 seconds, P = .03 for scalpel‐based EC, and 65 vs 99 seconds, P = .02 for percutaneous EC). We found no differences according to clinical seniority or previous real‐life EC experience. Conclusions Our study demonstrated that anaesthesiologists achieved successful airway access on an animal experimental model with both EC methods within a reasonable time frame, but the scalpel‐based EC is performed more promptly. Recent EC training affected the time expenditure positively, while seniority and clinical EC experience did not. EC procedures should be regularly trained for.

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“…Head & neck surgical simulators (Supplemental Table 4) included 3 models intended for transoral robotic surgery (TORS) training using the DaVinci robotic surgery system, a murine model of microsurgical parotid tumor excision, a microvascular anastomosis model, an ovine parotid surgery and facial nerve dissection model, and 2 laryngectomy models. [75][76][77][78][79][80][81][82] Notable for its ease of implementation, the microvascular anastomosis model used chicken thighs acquired from grocery stores to allow residents to practice anastomosing the ischiatic artery. 76 The murine parotid tumor model required trainees to excise the tumor with preservation of the facial nerve using a high-magnification dissection microscope, which was found to be a useful, realistic, and appropriately challenging exercise.…”

Section: Head and Neck/facial Plasticsmentioning

confidence: 99%

Thinking Beyond the Temporal Bone Lab: A Systematic Process for Expanding Surgical Simulation in Otolaryngology Training

James

Irace

Drusin

et al. 2022

Ann Otol Rhinol Laryngol

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The COVID-19 pandemic led to a temporary lapse in the development of otolaryngology trainee operative skills due to the cancellation of elective procedures and redeployment of trainees and attendings to COVID-19 units. Although transient, this disruption provided an opportunity for otolaryngology programs to develop contingency plans and formalize nascent simulation training curricula. Integration of formal simulation training alongside current didactic and surgical education may offset lost exposure during surgically lean times while providing the framework and resources for enhanced baseline training. Here, we provide an up-to-date overview of surgical simulation models in otolaryngology and identify easily implementable, low-cost, low fidelity models for junior trainees. By taking advantage of rapid advancements in technology and a paradigm shift to a more hands-on approach in medical education, formal simulation training may prove to be a beneficial tool at all stages of residency training, allowing for expanded peer-mentored skill development and providing a safe haven during unforeseen disruptions in surgical case volume.

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Ex vivo ovine model for teaching open laryngotracheal surgery

Cited by 12 publications

References 24 publications

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Percutaneous vs surgical emergency cricothyroidotomy: An experimental randomized crossover study on an animal‐larynx model

Thinking Beyond the Temporal Bone Lab: A Systematic Process for Expanding Surgical Simulation in Otolaryngology Training

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