Otologic Skills Training

Wiet, Gregory J.; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

doi:10.1016/j.otc.2017.05.005

Cited by 29 publications

(29 citation statements)

References 71 publications

(78 reference statements)

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“…Swine models are frequent examples in this kind of technique [58], and sheep temporal bones have also been used [59], but there is a multitude of experimental designs that have proven their utility. A very insightful review on this topic was published by Bergin et al [60] which identified 11 animal models that can be used for middle ear surgery, as well as Wiet et al [61] who researched otologic training models.…”

Section: Discussionmentioning

confidence: 99%

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Morosanu

Nicolae

Moldovan

et al. 2018

Neurol Neurochir Pol.

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Introduction. Due to its high complexity, neurosurgery consists of a demanding learning curve that requires intense training and a deep knowledge of neuroanatomy. Microsurgical skill development can be achieved through various models of simulation, but as human cadaveric models are not always accessible, cadaveric animal models can provide a reliable environment in which to enhance the acquisition of surgical dexterity. The aim of this review was to analyse the current role of animal brains in laboratory training and to assess their correspondence to the procedures performed in humans. Material and methods. A Pubmed literature search was performed to identify all the articles concerning training cranial and spinal techniques on large animal heads. The search terms were 'training model' , and 'neurosurgery' in association with 'animal' , 'sheep' , 'cow' , and 'swine'. The exclusion criteria were articles that were on human brains, experimental fundamental research, or on virtual simulators. Results. The search retrieved 119 articles, of which 25 were relevant to the purpose of this review. Owing to their similar neuroanatomy, bovine, porcine and ovine models prove to be reliable structures in simulating neurosurgical procedures. On bovine skulls, an interhemispheric transcalosal and retrosigmoid approach along with different approaches to the Circle of Willis can be recreated. Ovine model procedures have varied from lumbar discectomies on sheep spines to craniosynostosis surgery, whereas in ex vivo swine models, cadaveric dissections of lateral sulcus, median and posterior fossa have been achieved. Conclusions. Laboratory training models enhance surgical advancements by familiarising trainee surgeons with certain neuroanatomical structures and promoting greater surgical dexterity. The accessibility of animal brains allows trainee surgeons to exercise techniques outside the operating theatre, thus optimising outcomes in human surgical procedures.

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Section: Discussionmentioning

confidence: 99%

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Morosanu

Nicolae

Moldovan

et al. 2018

Neurol Neurochir Pol.

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“…One of the more challenging areas to gain proficiency in is temporal bone surgery [2]. Procedures involving the temporal bone require knowledge of complex micro-anatomy, use of an operating microscope, and avoidance of devastating complications [3,4]. Unfortunately, the opportunities to perform otologic procedures in residency are decreasing and procedures are usually performed individually, making it difficult for trainees to learn in the operating room (OR) [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

Compton

Agrawal

Ladak

et al. 2020

J of Otolaryngol - Head & Neck Surg

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Background: Trainees in Otolaryngology-Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology. CardinalSim is a virtual reality temporal bone surgical simulator that offers a high-quality, inexpensive adjunct to traditional teaching methods. The objective of this study was to establish the face and content validity of CardinalSim through a national study. Methods: Otolaryngologists and resident trainees from across Canada were recruited to evaluate CardinalSim. Ethics approval and informed consent was obtained. A face and content validity questionnaire with questions categorized into 13 domains was distributed to participants following simulator use. Descriptive statistics were used to describe questionnaire results, and either Chi-square or Fishers exact tests were used to compare responses between junior residents, senior residents, and practising surgeons. Results: Sixty-two participants from thirteen different Otolaryngology-Head and Neck Surgery programs were included in the study (32 practicing surgeons; 30 resident trainees). Face validity was achieved for 5 out of 7 domains, while content validity was achieved for 5 out of 6 domains. Significant differences between groups (p-value of < 0.05) were found for one face validity domain (realistic ergonomics, p = 0.002) and two content validity domains (teaching drilling technique, p = 0.011 and overall teaching utility, p = 0.006). The assessment scores, global rating scores, and overall attitudes towards CardinalSim, were universally positive. Open-ended questions identified limitations of the simulator. Conclusion: CardinalSim met acceptable criteria for face and content validity. This temporal bone virtual reality surgical simulation platform may enhance surgical training and be suitable for patient-specific surgical rehearsal for practicing Otolaryngologists.

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“…Training on cadaveric temporal bones is the gold standard since it provides the highest fidelity, but several limitations to this approach exist. First, adequate numbers of cadaveric temporal bones are difficult to acquire . Use of cadaveric material also requires a specialized laboratory that involves a significant amount of preparation and clean‐up after use as well as the inherent risk of infection when handling biological tissues .…”

Section: Applications Of Temporal Bone Simulationmentioning

confidence: 99%

“…Use of cadaveric material also requires a specialized laboratory that involves a significant amount of preparation and clean‐up after use as well as the inherent risk of infection when handling biological tissues . Maintaining and running a specialized laboratory is costly and a surgical expert is still required to provide formative feedback during the learning process. Cadaveric bones can only be used once, and they cannot be used for patient‐specific rehearsal of surgical approaches for otologic pathology.…”

Section: Applications Of Temporal Bone Simulationmentioning

confidence: 99%

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A review of simulation applications in temporal bone surgery

Kashikar

Kerwin

Moberly

et al. 2019

Laryngoscope Investig Oto

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Background Temporal bone surgery is a technically challenging and high‐risk procedure in an anatomically complex area. Safe temporal bone surgery emphasizes a consummate anatomic understanding and technique development that requires the guidance of an experienced otologic surgeon and years of practice. Temporal bone simulation can augment otologic surgical training and enable rehearsal of surgical procedures. Objectives The purpose of this article is to provide an updated review of temporal bone simulation platforms and their uses. Data Sources PubMed literature search. Search terms included temporal bone, temporal bone simulation, virtual reality (VR), and presurgical planning and rehearsal. Discussion Various simulation platforms such as cadaveric bone, three‐dimensional (3D) printed models, and VR simulation have been used for temporal bone surgery training. However, each simulation method has its drawbacks. There is a need to improve upon current simulation platforms to enhance surgical training and skills assessment, as well as a need to explore other clinically significant applications of simulation, such as preoperative planning and rehearsal, in otologic surgery. Conclusions There is no replacement for actual surgical experience, but high‐fidelity temporal bone models such as those produced with 3D printing and computer simulation have emerged as promising tools in otolaryngologic surgery. Improvements in the fidelity of both 3D printed and VR simulators as well as integration of a standardized assessment format would allow for an expansion in the use of these simulation platforms in training and assessment. Level of Evidence 5

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Otologic Skills Training

Cited by 29 publications

References 71 publications

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

A review of simulation applications in temporal bone surgery

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