Abstract
Objective
1) Validate whether a PC-based simulation program can be used to enhance temporal bone skills in those without any anatomical knowledge or surgical experience. 2) Understand the complexities of adapting simulator technology to educate novice and experienced temporal bone surgeons.
Methods
In this prospective, pilot study, individuals performed a craniectomy (measuring approximately 1”x2”) from the squamosa of cadaveric temporal bone specimens using typical otologic drills and instrumentation; the goals were to remove the bone, create straight lines along the edges of the craniectomy, and perform dural decompression without violating the dura. After performing this, the individuals then spent the next 2 weeks performing virtual temporal bone surgery on the OSC/OSU simulator. The individuals then performed the craniectomy a second time. A blinded observer (neurotologist) then assessed performance on the pre- and post-simulation tested bones.
Results
In all 6 sets of bones (12 bones total), the blinded observer was able to correctly determine which was the presimulation temporal bone and the post-simulation temporal bone. This was based primarily on the objective criteria of adequacy of dural decompression and the avoidance of dural tears. The assessment of linear edges of the craniectomy was not felt to be of sufficient importance.
Conclusions
The temporal bone simulator was able to improve the surgical skills in individuals with no prior temporal bone surgical experience or anatomy knowledge. The preliminary data from this study will be extended to a larger study group for statistical significance. Additional performance measures will need to be created to improve objective evaluation.
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