title: Training model for control of an internal carotid artery injury during transsphenoidal surgery.
abstract: As the adoption of endoscopic endonasal approaches (EEA) continues to proliferate, increasing numbers of internal carotid artery (ICA) injuries are reported. The objective of this study was to develop a synthetic ICA injury-training model that could mimic this clinical scenario and be portable, repeatable, reproducible, and without risk of biological contamination.
  
  
  
  Based on computed tomography of a human head, we constructed a synthetic model using selective laser sintering with polyamide nylon and glass beads. Subsequently, the model was connected to a pulsatile pump using 6-mm silicon tubing. The pump maintains a pulsatile flow of an artificial blood-like fluid at a variable pressure to simulate heart beats. Volunteer surgeons with different levels of training and experience were provided simulation training sessions with the models. Pre- and posttraining questionnaires were completed by each of the participants.
  
  
  
  Pre- and posttraining questionnaires suggest that repeated simulation sessions improve the surgical skills and self-confidence of trainees.
  
  
  
  This ICA injury model is portable; reproducible; and avoids ethical, biohazard, religious, and legal problems associated with cadaveric models. A synthetic ICA injury model for EEA allows recurring training that may improve the surgeon's ability to maintain endoscopic visualization, control catastrophic bleeding, decrease psychomotor stress, and develop effective team strategies to achieve hemostasis.
  
  
  
  NA Laryngoscope, 127:38-43, 2017.
authors.affiliation: Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.|Department of Neurosurgery, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Muto
authors.affiliation: Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.affiliation: Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Oyama
authors.affiliation: Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Brad A
authors.initials: BA
authors.lastname: Otto
authors.affiliation: Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.|Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Prevedello
mesh_terms: D020212:Carotid Artery Injuries / Q000209:etiology* / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D004501:Education, Medical / Q000379:methods*; D004724:Endoscopy / Q000193:education* / Q000379:methods*; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000193:education* / Q000379:methods*; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000601:surgery*; D008953:Models, Anatomic; D011597:Psychomotor Performance; D015203:Reproducibility of Results; D019291:Skull Base / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
keywords: Internal carotid artery; complications; endoscopic endonasal surgery; hemorrhage; simulation; training model; vascular injury