The utility of cadaver dissection in endoscopic sinus surgery training courses.
BACKGROUND
Understanding paranasal sinus anatomy is crucial for successful outcomes in endoscopic sinus surgery (ESS). This study was designed to evaluate subjective and objective differences in ESS cadaver dissections among participants of varying experience levels in association with the use of image guidance and computer-aided technologies in a physician training cadaver dissection laboratory.


METHODS
Participants in a 2-day cadaver dissection course completed daily predissection surveys evaluating subjective comfort with ESS. Pre- and postdissection computer tomography (CT) scans assessed completeness of dissection. Images were analyzed for maxillary antrostomy, frontal and sphenoid sinusotomy, residual ethmoid cells and partitions, and residual frontal recess cells.


RESULTS
Fifty-one sides were dissected. Participant comfort increased significantly from day 1 to 2 for overall ESS (p = 0.001) and for individual sinuses (p < 0.001 to p = 0.047). Participants with more years in practice had fewer unopened ethmoid cells (p = 0.015) and frontal recess cells (p = 0.014) on dissection day 1. Participants with increased comfort in ethmoid dissection had fewer retained ethmoid partitions on day 1 (p = 0.017). Observed differences on dissection day 1 for unopened ethmoid and frontal recess cells and retained ethmoid partitions were not present on day 2. No significant differences were found based on use of image guidance for any parameter.


CONCLUSIONS
Surgeons with increased comfort and more years in practice had more complete endoscopic cadaver dissections initially. Differences among participants diminished on dissection day 2, indicating the ability to review postdissection CT scans may improve surgeon comfort level and completeness of dissection.
Zuckerman
Jodi D
JD
Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia 30322, USA.
Wise
Sarah K
SK
Rogers
G Aaron
GA
Senior
Brent A
BA
Schlosser
Rodney J
RJ
DelGaudio
John M
JM
D001344:Autopsy; D002102:Cadaver; D004493:Education; D004517:Education, Professional; D004724:Endoscopy / Q000193:education; D005005:Ethmoid Sinus / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D010036:Otolaryngology / Q000193:education; D010256:Paranasal Sinuses / Q000033:anatomy & histology / Q000601:surgery*; D011787:Quality of Health Care; D014057:Tomography, X-Ray Computed