Simulation training in endoscopic skull base surgery: A scoping review

Abstract

Objective Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning. Endoscopic simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical outcomes. The current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill enhancement. Methods In accordance with Preferred Reporting Items for Systemic Review and Meta‐Analyses guidelines, we systematically searched PubMed, Embase, CINAHL, and Cochrane databases. Studies were categorized according to the type of simulation models investigated. Results We identified 238 unique references, with 55 studies ultimately meeting inclusion criteria. Of these, 19 studies described cadaveric dissection models, 17 discussed three‐dimensional (3D) printed models, 14 examined virtual surgical planning and augmented reality‐based models, and five 5 articles described task trainers. Conclusions There are a wide variety of simulation models for endoscopic skull base surgery, including high‐fidelity cadaveric, virtual reality, and 3D‐printed models. These models are an asset for trainee development and preoperative surgical preparation.

Training in Endoscopic Endonasal Neurosurgical Procedures: A Systematic Review of Available Models

“…It has been widely accepted that EEN poses a steep learning curve that demands extensive commitment and time. 12 Koc et al claimed that the difficulty of working with endoscopes decreases approximately after the first 40 cases. 57 Similarly, Koutourousiou et al presented a case series demonstrating that the gross-total resection rate of cranial base chordoma increased from 36.4% to 88.9% within an 8-year period of practicing EEN.…”

“…These distinct features emphasize the paramount role of simulation in becoming surgically proficient in EEN. [9][10][11][12] Four training modalities have hitherto been reported to serve the purpose of EEN training: cadaveric models, synthetic models, animal models, and virtual reality (VR). 11,13 Cadaveric models have long been considered the gold standard for EEN training as cadaveric specimens can be fixed, allowing replicability and extended usage over a long period.…”

Development of 3-dimensional printed simulation surgical training models for endoscopic endonasal and transorbital surgery

“…Careful simulation before the real operation may contribute to improved patient safety and clinical outcomes by enhancing the surgical planning and procedural performance of the surgeon (25). The portability or digital transferability of the model is another advantage of the 3D model, which allows accessibility in multiple locations (13).…”

“…Encouragingly, recent advances in threedimensional (3D) printing technology have allowed diverse simulation models for EES procedures (8-12). Such models have been used in medical education and surgical skill training as precise replications of the complex anatomical structures of the skull base (10,13). The development of patient-specific models and improvement of cost-effectiveness have allowed these models to be used in preoperative planning and patient counseling (8).…”

The Current State of Visualization Techniques in Endoscopic Skull Base Surgery

“…Several augmented reality training models have been specifically developed for ESBS [ 31 ]. These training models allow trainees to gain exposure to a wide range of skull base pathologies before experiencing surgery with real-life patients.…”