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Rak K, Kaulitz S, Voelker J, Müller-Graff T, Engert J, Spahn B, Hackenberg S, Grasso P, Hagen R. [Online training for hearing implant surgery : A new approach to otological training. German version]. HNO 2024; 72:317-324. [PMID: 38530381 PMCID: PMC11045577 DOI: 10.1007/s00106-024-01451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is a need to broaden education facilities in an on-line format. Therefore, a first basic on-line training for otosurgery was developed. MATERIALS AND METHODS The system consists of an artificial temporal bone model together with a set of basic surgical instruments and implant dummies. As an essential part of the training kit, a high-resolution camera set is included that allows for connection to a video streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, a pre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. RESULTS Over the three courses held to date, 28 participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of a questionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. CONCLUSION The presented program of an otosurgical online training allows for basal education in practical exercises on a remote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.
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Affiliation(s)
- Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Stefan Kaulitz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Jonas Engert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Stephan Hackenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Peter Grasso
- MED-EL Elektromedizinische Geräte Gesellschaft m.b.H., Innsbruck, Österreich
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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Wisotzky EL, Rosenthal JC, Meij S, van den Dobblesteen J, Arens P, Hilsmann A, Eisert P, Uecker FC, Schneider A. Telepresence for surgical assistance and training using eXtended reality during and after pandemic periods. J Telemed Telecare 2023:1357633X231166226. [PMID: 37093788 DOI: 10.1177/1357633x231166226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called "TeleSTAR" using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear-Nose-Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.
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Affiliation(s)
- Eric L Wisotzky
- Fraunhofer Heinrich-Hertz-Institute HHI, Berlin, Germany
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Rostock University Medical Center, Rostock, Germany
- Department of Informatics, Humboldt University, Berlin, Germany
| | - Jean-Claude Rosenthal
- Fraunhofer Heinrich-Hertz-Institute HHI, Berlin, Germany
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Senna Meij
- Delft University of Technology, Faculty of Mechanical Engineering, BioMechanical Engineering, Delft, The Netherlands
| | - John van den Dobblesteen
- Delft University of Technology, Faculty of Mechanical Engineering, BioMechanical Engineering, Delft, The Netherlands
| | - Philipp Arens
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Hilsmann
- Fraunhofer Heinrich-Hertz-Institute HHI, Berlin, Germany
| | - Peter Eisert
- Fraunhofer Heinrich-Hertz-Institute HHI, Berlin, Germany
- Department of Informatics, Humboldt University, Berlin, Germany
| | | | - Armin Schneider
- Munich Surgical Imaging, Munich, Germany
- Department of Engineering Sciences, Jade Hochschule, Wilhelmshaven, Germany
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van Bonn SM, Grajek JS, Schuldt T, Schraven SP, Schneider A, Rettschlag S, Oberhoffner T, Weiss NM, Mlynski R. [Interactive intraoperative annotation of surgical landmarks in student education to support learning efficiency and motivation]. HNO 2022; 70:609-617. [PMID: 35665824 PMCID: PMC9166199 DOI: 10.1007/s00106-022-01187-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The development of technological innovations has not only changed social life and the healthcare system, but also affects medical education. The aim of this pilot study was to evaluate whether students, when observing a microsurgical procedure of the temporal bone, gain an additional understanding of the anatomical structures and surgical site when visualization is used that provides identical views for the surgeon and viewer in 3D. MATERIALS AND METHODS During regular attendance tutorials, students were randomly assigned to three different groups: control group, 2D group, or 3D group. Evaluation questionnaires and intraoperative student annotation of the surgical view were used to assess the subjective didactic value of different visualization formats and resultant learning experiences for the students. RESULTS A total of 47 students were included in the investigations during conventional attendance tutorials. The majority indicated a high added value of the 3D visualization in terms of method (70%) and vividness (80%) compared to the 2D group and self-study; 69% of the students fully agreed with the statement that 2D and 3D visualization increases learning motivation and is a very good way to improve recognition of anatomical topography and structures. CONCLUSION New interactive visualization options in teaching promote learning efficiency and motivation among students. Especially 3D visualization and intraoperative annotation of the surgical view by the student is a useful didactic tool and increases the quality of clinical teaching. It supports the perception of anatomical topography and enables more focused surgical training.
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Affiliation(s)
- Sara M van Bonn
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland.
| | - Jan S Grajek
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Tobias Schuldt
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Sebastian P Schraven
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Armin Schneider
- Fachbereich Ingenieurwissenschaften, Jade Hochschule, Friedrich-Paffrath-Straße 101, 26389, Wilhelmshaven, Deutschland
| | - Stefanie Rettschlag
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Tobias Oberhoffner
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Nora M Weiss
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf‑ und Halschirurgie, Head and Neck Surgery, St. Elisabeth Hospital, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Deutschland
| | - Robert Mlynski
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
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Trainee-Trainer outcomes in Mastoid surgery: A comparative study. The Journal of Laryngology & Otology 2021; 136:293-296. [PMID: 34702379 DOI: 10.1017/s0022215121003285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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