title: The 70-degree telescope as a teaching tool for cleft palate repair and pharyngoplasty surgery.
abstract: OBJECTIVE
  To determine the optimum positioning of a 70-degree telescope to provide a maximum view of the palate and posterior pharynx for observers while minimally obstructing the direct view of a surgeon.
  
  
  METHODS
  Simulator testing of clinical protocol.
  
  
  METHODS
  Simulation center of an academic tertiary care children's hospital.
  
  
  METHODS
  The palate and pharynx of an infant airway mannequin was exposed with a Dingman mouthgag. A 4 mm, 70-degree endoscope was secured to the Mayo stand to provide a projected image of the simulated operative procedure. Various positions of the 70-degree telescope were photodocumented by manipulating the angle of the scope, the extension past the lower lip, and the distance of the scope tip away from the midline. Using a 4-point Likert scale, three surgeons rated the randomized photos from both the direct operative view and the projected endoscopic view.
  
  
  RESULTS
  Average rating for the adequacy of the view for pharyngeal surgery was 2.4/4.0 and for palate surgery was 3.1/4.0 (p=.001). Only 4 of 22 scope positions were rated as minimally obstructive to direct view by all three surgeons. Only 1 position--scope parallel and just lateral to the tongue blade--was rated as minimally obstructive and adequate for both pharyngeal and palatal surgery by all three surgeons.
  
  
  CONCLUSIONS
  In training centers, a 70-degree telescope attached to a Mayo stand may be useful for teaching and assessing cleft palate and pharyngoplasty surgery, while providing minimal obstruction to direct view by the surgeon.
authors.affiliation: University of Pittsburgh Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Avenue Faculty Pavilion, 7th Floor, Pittsburgh, PA 15224, United States. Electronic address: JabbourN@chp.edu.
authors.forename: Noel
authors.initials: N
authors.lastname: Jabbour
authors.affiliation: Vanderbilt University, Department of Otolaryngology, United States.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Chinnadurai
authors.affiliation: Vanderbilt University, Department of Otolaryngology, United States.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Wootten
authors.affiliation: Mayo Clinic Rochester, Department of Otolaryngology, United States.
authors.forename: Shelagh A
authors.initials: SA
authors.lastname: Cofer
authors.affiliation: Vanderbilt University, Department of Otolaryngology, United States.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Goudy
mesh_terms: D002972:Cleft Palate / Q000601:surgery*; D019723:Endoscopes; D006801:Humans; D008348:Manikins; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education* / Q000295:instrumentation; D010614:Pharynx / Q000601:surgery*
keywords: Cleft palate; Endoscopy; Pharyngoplasty; Teaching; Training; Video