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Δευτέρα 1 Νοεμβρίου 2021

3D-4K exoscope-assisted temporal bone dissection: a new frontier in surgical training

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Eur Arch Otorhinolaryngol. 2021 Oct 31. doi: 10.1007/s00405-021-07137-1. Online ahead of print.

ABSTRACT

PURPOSE: To assess if 3D-4K exoscope is a valuable tool for temporal bone dissection and to evaluate its teaching potential.

METHODS: Six consecutive 3D-4K-exoscope-assisted cortical mastoidectomies were performed by a novice, an intermediate and an expert surgeon (two dissections each). All dissections were entirely recorded and later evaluated independently by three other experienced surgeons. The dissection end-product was evaluated according to the Melbourne Mastoidectomy Scale (MMS). Paired t test was used to assess whether novice and intermediate surgeons have a score improvement in the second dissection compared to the first one. Surgeons' interactions, depth effect, and 3D impression were also assessed to perform a subjective analysis.

RESULTS: Mean MMS scores for the novice, intermediate and expert surgeon were 11.3 ± 2.8, 13.8 ± 3.9 and 19 ± 1.3, respectively. Paired t test demonstrated a statically significant improvement between the first and the second dissection both for the novice and the intermediate surgeon (+ 4.7 and + 7 points; p = 0.0002). A high-quality magnification of the temporal bone was obtained, allowing the expert surgeon to identify all the anatomical structures without injuring them. The exoscope was capable of providing a high involvement in the dissections with very effective interactions between the expert surgeon and the trainees, that had access to the same surgical field view.

CONCLUSION: 3D-4K-exoscope resulted adequate for a safe and effective mastoidectomy and showed a high potential for training and educational purposes. It can represent a valid option for surgical training of temporal bone dissection and a new interactive tool to understand the complex temporal bone anatomy.

PMID:34719728 | DOI:10.1007/s00405-021-07137-1

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