Utilization and dissection for endoscopic sinus surgery training in the residency program.
OBJECTIVE
To develop an animal cadaver model that would allow residents to learn functional endoscopic sinus surgery as a complementary model.


METHODS
Prospective experimental study.


METHODS
Two of our first-year residents were included in the study, and each operated on 5 sheep noses. All the routine steps of endoscopic sinus surgery were performed, except for sphenoidotomy, and their success and complication scores were recorded. The residents' performance for maxillary antrostomy, ethmoidectomy, and frontal sinusotomy in sheep cadaver noses were evaluated by the authors. Predissection and postdissection computer tomography assessed the completeness of dissection. Images were analyzed for maxillary antrostomy, frontal sinusotomy, residual ethmoid cells and partitions, and residual frontal recess cells. The first and last 5 sides of residents were analyzed together as the first 10 sides (group 1) and last 10 sides (group 2).


RESULTS
Group 2 had significantly better outcomes for frontal sinusotomy and ethmoidectomy (P = 0.011 and P = 0.003, respectively). The mean duration of procedures for group 1 was 15.7 minutes and that for group 2 was 10.3 minutes (P = 0.000). The difference was not significant between the 2 groups when comparing the success rates of maxillary antrostomy and the complication rates (P > 0.05).


CONCLUSIONS
The nasal cavity of the sheep is anatomically similar to the human nasal cavity, and the model using sheep cadaver for endoscopic sinus surgery training is a cost-effective and useful model for the first step of the learning curve.
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey. drbaranacar@gmail.com
Baran
B
Acar
Emre
E
Gunbey
Mehmet Ali
MA
Babademez
Hayriye
H
Karabulut
Hediye Pinar
HP
Gunbey
Rıza Murat
RM
Karasen
D000818:Animals; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D004210:Dissection / Q000009:adverse effects / Q000193:education* / Q000379:methods; D019723:Endoscopes; D004724:Endoscopy / Q000009:adverse effects / Q000193:education* / Q000379:methods; D005005:Ethmoid Sinus / Q000601:surgery; D005626:Frontal Sinus / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D007396:Internship and Residency; D007431:Intraoperative Complications; D008443:Maxillary Sinus / Q000601:surgery; D023421:Models, Animal; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012756:Sheep; D013043:Specialties, Surgical / Q000193:education*; D013664:Teaching Materials; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014420:Turbinates / Q000293:injuries