Usefulness of temporal bone prototype for drilling training: A prospective study

作者：Aussedat C; Venail F; Nguyen Y; Lescanne E; Marx M; Bakhos D

来源：Clinical Otolaryngology, 2017, 42(6): 1200-1205.

DOI：10.1111/coa.12846

<jats:sec><jats:title>Objectives</jats:title><jats:p>Dissection of cadaveric temporal bones (<jats:styled-content style="fixed-case">TB</jats:styled-content>s) is considered the gold standard for surgical training in otology. For many reasons, access to the anatomical laboratory and cadaveric <jats:styled-content style="fixed-case">TB</jats:styled-content>s is difficult for some facilities. The aim of this prospective and comparative study was to evaluate the usefulness of a physical <jats:styled-content style="fixed-case">TB</jats:styled-content> prototype for drilling training in residency.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Prospective study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Tertiary referral centre.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Thirty‐four residents were included. Seventeen residents (mean age 26.7±1.6) drilled on only cadaveric <jats:styled-content style="fixed-case">TB</jats:styled-content>s (“<jats:italic>traditional</jats:italic>” group), in the traditional training method, while seventeen residents (mean age 26.5±1.7) drilled first on a prototype and then on a cadaveric <jats:styled-content style="fixed-case">TB</jats:styled-content> (“<jats:italic>prototype</jats:italic>” group).</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>Drilling performance was assessed using a validated scale. Residents completed a mastoid image before and after each drilling to enable evaluation of mental representations of the mastoidectomy.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>No differences were observed between the groups with respect to age, drilling experience and level of residency. Regarding drilling performance, we found a significant difference across the groups, with a better score in the prototype group (<jats:italic>P</jats:italic>=.0007). For mental representation, the score was statistically improved (<jats:italic>P</jats:italic>=.0003) after drilling in both groups, suggesting that <jats:styled-content style="fixed-case">TB</jats:styled-content> drilling improves the mental representation of the mastoidectomy whether prototype or cadaveric <jats:styled-content style="fixed-case">TB</jats:styled-content> is used.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The <jats:styled-content style="fixed-case">TB</jats:styled-content> prototype improves the drilling performance and mental representation of the mastoidectomy in the young resident population. A drilling simulation with virtual or physical systems seems to be a beneficial tool to improve <jats:styled-content style="fixed-case">TB</jats:styled-content> drilling.</jats:p></jats:sec>

• 出版日期2017-12