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Ali A, Morris JM, Decker SJ, Huang YH, Wake N, Rybicki FJ, Ballard DH. Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: neurosurgical and otolaryngologic conditions. 3D Print Med 2023; 9:33. [PMID: 38008795 PMCID: PMC10680204 DOI: 10.1186/s41205-023-00192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Medical three dimensional (3D) printing is performed for neurosurgical and otolaryngologic conditions, but without evidence-based guidance on clinical appropriateness. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness recommendations for neurologic 3D printing conditions. METHODS A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with neurologic and otolaryngologic conditions. Each study was vetted by the authors and strength of evidence was assessed according to published guidelines. RESULTS Evidence-based recommendations for when 3D printing is appropriate are provided for diseases of the calvaria and skull base, brain tumors and cerebrovascular disease. Recommendations are provided in accordance with strength of evidence of publications corresponding to each neurologic condition combined with expert opinion from members of the 3D printing SIG. CONCLUSIONS This consensus guidance document, created by the members of the 3D printing SIG, provides a reference for clinical standards of 3D printing for neurologic conditions.
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Affiliation(s)
- Arafat Ali
- Department of Radiology, Henry Ford Health, Detroit, MI, USA
| | | | - Summer J Decker
- Division of Imaging Research and Applied Anatomy, Department of Radiology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Yu-Hui Huang
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Nicole Wake
- Department of Research and Scientific Affairs, GE HealthCare, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
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Kryukov AI, Nosulya EV, Kunelskaya NL, Garov EV, Romanenko SG, Kirasirova EA, Khamzalieva RB, Tovmasyan AS, Gurov AV, Kucherov AG, Yushkina MA, Artemyev ME. [Residency is a fundamental stage of professional training of an otorhinolaryngologist]. Vestn Otorinolaringol 2023; 88:93-98. [PMID: 37184562 DOI: 10.17116/otorino20228802193] [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: 05/16/2023]
Abstract
Systematic analysis of various indicators of the educational process becomes important to assess the effectiveness of the training of residents. One of the most common tools for monitoring the effectiveness of the educational process is a questionnaire of students. OBJECTIVE To analyze the results of the assessment of the quality of training in the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology according to the survey of residents. MATERIAL AND METHODS The study includes the results of an anonymous questionnaire survey of a sample group of residents of the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology of the second year of study. RESULTS The data obtained allow us to judge the satisfaction with the quality of training of the absolute majority of the interviewed residents, their active use of specialized electronic search engines, a high assessment of the level of lectures, the desire to improve their surgical training. The importance for the professional development of residents of participation in weekly scientific and clinical conferences of the Sverzhevky Research Clinical Institute of Otorhinolaryngology, meetings of the Moscow Scientific Society of Otorhinolaryngologists, traditional annual scientific and practical conferences of otorhinolaryngologists of Moscow, as well as in the activities of the Youth Council of the Institute is noted. CONCLUSION The results of the survey create prerequisites for improving the educational process, the formation of professional competencies and readiness for independent work among residents.
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Affiliation(s)
- A I Kryukov
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E V Nosulya
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - N L Kunelskaya
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E V Garov
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - S G Romanenko
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E A Kirasirova
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - R B Khamzalieva
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A S Tovmasyan
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A V Gurov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A G Kucherov
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - M A Yushkina
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - M E Artemyev
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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Hochman JB, Pisa J, Singh S, Gousseau M, Unger B. Comparison of Summative Temporal Bone Dissection Scales Demonstrate Equivalence. Int Arch Otorhinolaryngol 2022; 26:e556-e560. [PMID: 36405459 PMCID: PMC9668416 DOI: 10.1055/s-0041-1740162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/11/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction
Temporal bone surgery is a unique and complicated surgical skill that requires extensive training. There is an educational requirement to maximize trainee experience and provide effective feedback.
Objective
We evaluate three temporal bone dissection scales for efficacy, reliability, and accuracy in identifying resident skill during temporal bone surgery.
Methods
Residents of various skill levels performed a mastoidectomy with posterior tympanotomy on identic 3D-printed temporal bone models. Four blinded otologic surgeons evaluated each specimen at two separate intervals using three separate dissection scales: the Welling Scale (WS), the Iowa Temporal Bone Assessment Tool (ITBAT), and the CanadaWest Scale (CWS). Scores from each scale were compared in their ability to accurately separate residents by skill level, inter- and intrarater reliability, and efficiency in application.
Results
Nineteen residents from 9 postgraduate programs participated. Assessment was clustered into junior (postgraduate year or PGY 1, 2), intermediate (PGY 3) and senior resident (PGY 4, 5) cohorts. Analysis of variance (ANOVA) found significant differences between cohort performance (
p
< 0.05) for all 3 scales considering the PGY level and the subjective account of temporal bone surgical experience. The inter-rater reliability was consistent across each scale. The intrarater reliability was comparable between the CWS (0.711) and the WS (0.713), but not the ITBAT (0.289). Time (in seconds) to complete scoring for each scale was also comparable between the CWS (42.7 ± 16.8), the WS (76.6 ± 14.5), and the ITBAT (105.6 ± 38.9).
Conclusion
All three scales demonstrated construct validity and consistency in performance, and consideration should be given to judicious use in training.
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Affiliation(s)
- Jordan B. Hochman
- Division of Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Justyn Pisa
- Department of Otolaryngology Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Shubhi Singh
- Department of Otolaryngology Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Michael Gousseau
- Department of General Otolaryngology, Dr. Michael Gousseau Medical Corporation, Portage La Prairie, Manitoba, Canada
| | - Bert Unger
- Division of Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
- Laboratory for Surgical Modeling, Simulation and Robotics, University of Manitoba, Manitoba, Canada
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4
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Chytas D, Chronopoulos E, Salmas M, Babis GC, Nikolaou VS. Letter to the Editor Regarding "Mixed Reality-Based Preoperative Planning for Training of Percutaneous Transforaminal Endoscopic Discectomy: A Feasibility Study". World Neurosurg 2020; 139:660. [PMID: 32689668 DOI: 10.1016/j.wneu.2020.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Dimitrios Chytas
- Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, "Konstantopoulio-Patission" Hospital, Nea Ionia, Greece.
| | - Efstathios Chronopoulos
- Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, "Konstantopoulio-Patission" Hospital, Nea Ionia, Greece
| | - Marios Salmas
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George C Babis
- Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, "Konstantopoulio-Patission" Hospital, Nea Ionia, Greece
| | - Vasileios S Nikolaou
- Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, "Konstantopoulio-Patission" Hospital, Nea Ionia, Greece
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Abstract
: Patient safety demands enhancements in training. Graduated cadaveric bone exposure is fundamental to otologic training. Printed bone models (PBM) provide a low-cost, anatomically consistent adjunct to cadaveric materials in trainee skill acquisition.The purpose of this study is to determine if resident training level can be distinguished on the basis of performance employing a printed temporal bone model, graded by a previous validated scale. METHODS Nineteen residents (11 male, 8 female) from 9 graduate programs, attending a National Otolaryngology Conference, completed a mastoidectomy with posterior tympanotomy on identic 3D PBMs and a Likert scale (1-7) survey on subjective appreciation of the simulation. Four experts graded participant performance using the previously validated Welling Scale. RESULTS ANOVA revealed significant performance differences between the junior/intermediate and junior/senior PGY cohorts. No difference was observed between intermediate/senior cohorts on the basis of PGY or subjective temporal bone dissection experience. Clustering aspects of the scale with specific focus on thinning tasks found a similar outcome to the composite scale scores.Subjective experience judged printed bone to be similar to cadaveric in drill-bone interaction. Participants believed the simulation would improve surgical performance, comfort with actual patients, and operative speed. CONCLUSION Subjectively, printed bone compared favorably to cadaveric.The simulation demonstrated construct validity but was challenged in differentiating senior from intermediate trainee performance. This may be a function of the PBM inherent character, limitations in grading instrument fidelity or sample size. It is also possible that the dominant period of skill acquisition for mastoidectomy and posterior tympanotomy are primarily acquired during the junior training.
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Compton EC, Agrawal SK, Ladak HM, Chan S, Hoy M, Nakoneshny SC, Siegel L, Dort JC, Lui JT. Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study. J Otolaryngol Head Neck Surg 2020; 49:17. [PMID: 32264952 PMCID: PMC7137498 DOI: 10.1186/s40463-020-00411-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trainees in Otolaryngology-Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology. CardinalSim is a virtual reality temporal bone surgical simulator that offers a high-quality, inexpensive adjunct to traditional teaching methods. The objective of this study was to establish the face and content validity of CardinalSim through a national study. METHODS Otolaryngologists and resident trainees from across Canada were recruited to evaluate CardinalSim. Ethics approval and informed consent was obtained. A face and content validity questionnaire with questions categorized into 13 domains was distributed to participants following simulator use. Descriptive statistics were used to describe questionnaire results, and either Chi-square or Fishers exact tests were used to compare responses between junior residents, senior residents, and practising surgeons. RESULTS Sixty-two participants from thirteen different Otolaryngology-Head and Neck Surgery programs were included in the study (32 practicing surgeons; 30 resident trainees). Face validity was achieved for 5 out of 7 domains, while content validity was achieved for 5 out of 6 domains. Significant differences between groups (p-value of < 0.05) were found for one face validity domain (realistic ergonomics, p = 0.002) and two content validity domains (teaching drilling technique, p = 0.011 and overall teaching utility, p = 0.006). The assessment scores, global rating scores, and overall attitudes towards CardinalSim, were universally positive. Open-ended questions identified limitations of the simulator. CONCLUSION CardinalSim met acceptable criteria for face and content validity. This temporal bone virtual reality surgical simulation platform may enhance surgical training and be suitable for patient-specific surgical rehearsal for practicing Otolaryngologists.
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Affiliation(s)
- Evan C Compton
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sumit K Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Hanif M Ladak
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Sonny Chan
- Department of Computer Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Monica Hoy
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Steven C Nakoneshny
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada
| | - Lauren Siegel
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Joseph C Dort
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.
| | - Justin T Lui
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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Maniam P, Schnell P, Dan L, Portelli R, Erolin C, Mountain R, Wilkinson T. Exploration of temporal bone anatomy using mixed reality (HoloLens): development of a mixed reality anatomy teaching resource prototype. J Vis Commun Med 2019; 43:17-26. [PMID: 31645155 DOI: 10.1080/17453054.2019.1671813] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Mixed reality (MR), a technology which supplements the real world with virtual objects, is increasingly becoming available as a teaching tool in medical education. The Microsoft HoloLens device allows operators to experience MR using a head-mounted device without interfering with their physical reality, stimulating a realistic learning experience using virtual objects. This project aimed to develop a MR anatomy teaching application with HoloLens for exploring the anatomy of the temporal bone. The educational application was developed from a multidisciplinary collaboration between undergraduate and postgraduate students across several academic disciplines with Medtronic, a medical technology company. 3D anatomical models were built using ZBrush and Blender, while the HoloLens1 application was developed using Windows 10, Visual Studio 2017, Unity and Mixed Reality Toolkit (MRTK). Modules developed within the application included a basic HoloLens tutorial, a virtual temporal bone with surgical anatomy landmarks and free drilling of the temporal bone. The basic tutorial allows the operator to adapt to the MR environment prior to exploring the anatomical landmarks of the 3D temporal bone. The free drilling of the temporal bone using vertex displacement and texture stretching replicates a real-time bone drilling experience and allows the operator to explore the anatomical relationship between different otological structures.
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Affiliation(s)
- Pavithran Maniam
- School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Philipp Schnell
- Department of Computing, School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - Lilly Dan
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - Rony Portelli
- Department of Computing, School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - Caroline Erolin
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - Rodney Mountain
- Department of Otolaryngology, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Tracey Wilkinson
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, United Kingdom
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Zhang ZY, Duan WC, Chen RK, Zhang FJ, Yu B, Zhan YB, Li K, Zhao HB, Sun T, Ji YC, Bai YH, Wang YM, Zhou JQ, Liu XZ. Preliminary application of mxed reality in neurosurgery: Development and evaluation of a new intraoperative procedure. J Clin Neurosci 2019; 67:234-238. [PMID: 31221576 DOI: 10.1016/j.jocn.2019.05.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/20/2019] [Accepted: 05/21/2019] [Indexed: 11/25/2022]
Abstract
During neurological surgery, neurosurgeons have to transform the two-dimensional (2D) sectional images into three-dimensional (3D) structures at the cognitive level. The complexity of the intracranial structures increases the difficulty and risk of neurosurgery. Mixed reality (MR) applications reduce the obstacles in the transformation from 2D images to 3D visualization of anatomical structures of central nervous system. In this study, the holographic image was established by MR using computed tomography (CT), computed tomography angiography (CTA) and magnetic resonance imaging (MRI) data of patients. The surgeon's field of vision was superimposed with the 3D model of the patient's intracranial structure displayed on the mixed reality head-mounted display (MR-HMD). The neurosurgeons practiced and evaluated the feasibility of this technique in neurosurgical cases. We developed the segmentation image masks and texture mapping including brain tissue, intracranial vessels, nerves, tumors, and their relative positions by MR technologies. The results showed that the three-dimensional imaging is in a stable state in the operating room with no significant flutter and blur. And the neurosurgeon's feedback on the comfort of the equipment and the practicality of the technology was satisfactory. In conclusion, MR technology can holographically construct a 3D digital model of patient's lesions and improve the anatomical perception of neurosurgeons during craniotomy. The feasibility of the MR-HMD application in neurosurgery is confirmed.
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Affiliation(s)
- Zhen-Yu Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Wen-Chao Duan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Ruo-Kun Chen
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Feng-Jiang Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Bin Yu
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Yun-Bo Zhan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Ke Li
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Hai-Biao Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Tao Sun
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Yu-Chen Ji
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Ya-Hui Bai
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Yan-Min Wang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Jin-Qiao Zhou
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China
| | - Xian-Zhi Liu
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Road 1, Zhengzhou, Henan 450000, China.
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Mixed Reality-Based Preoperative Planning for Training of Percutaneous Transforaminal Endoscopic Discectomy: A Feasibility Study. World Neurosurg 2019; 129:e767-e775. [PMID: 31203062 DOI: 10.1016/j.wneu.2019.06.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To explore the effect of preoperative planning using mixed reality (MR) on training of percutaneous transforaminal endoscopic discectomy (PTED). METHODS Before the training, we invited an experienced chief physician to plan the puncture path of PTED on the X-ray films of the lumbar spine model and the 3D Slicer platform, respectively, and used this as the standard to guide trainees. In the aggregate, 60 young residents were randomly divided into Group A (N = 30) and Group B (N = 30). Group A learned the 2-dimensional standard planning route, whereas Group B learned the standard route planning based on MR through the 3D Slicer platform. Then, trainees were asked to conduct PTED puncture on a lumbar spine model. Questionnaires were distributed to trainees before and after the training. During the training, puncture times, operating time (minutes), and fluoroscopy times were recorded. RESULTS After the training, it was obvious that more trainees showed their recognition of MR, believing that MR could help preoperative planning and training of PTED. Their high satisfaction with the training indicated the success of our training. Moreover, puncture times, operating time (minutes), and fluoroscopy times of Group B were significantly lower than those of Group A. CONCLUSIONS MR technology contributes to preoperative planning of PTED and is beneficial in the training of PTED. It significantly reduces puncture times and fluoroscopy times, providing a standardized method for the training of PTED.
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Kashikar TS, Kerwin TF, Moberly AC, Wiet GJ. A review of simulation applications in temporal bone surgery. Laryngoscope Investig Otolaryngol 2019; 4:420-424. [PMID: 31453352 PMCID: PMC6703115 DOI: 10.1002/lio2.277] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/07/2019] [Accepted: 03/17/2019] [Indexed: 01/04/2023] Open
Abstract
Background Temporal bone surgery is a technically challenging and high-risk procedure in an anatomically complex area. Safe temporal bone surgery emphasizes a consummate anatomic understanding and technique development that requires the guidance of an experienced otologic surgeon and years of practice. Temporal bone simulation can augment otologic surgical training and enable rehearsal of surgical procedures. Objectives The purpose of this article is to provide an updated review of temporal bone simulation platforms and their uses. Data Sources PubMed literature search. Search terms included temporal bone, temporal bone simulation, virtual reality (VR), and presurgical planning and rehearsal. Discussion Various simulation platforms such as cadaveric bone, three-dimensional (3D) printed models, and VR simulation have been used for temporal bone surgery training. However, each simulation method has its drawbacks. There is a need to improve upon current simulation platforms to enhance surgical training and skills assessment, as well as a need to explore other clinically significant applications of simulation, such as preoperative planning and rehearsal, in otologic surgery. Conclusions There is no replacement for actual surgical experience, but high-fidelity temporal bone models such as those produced with 3D printing and computer simulation have emerged as promising tools in otolaryngologic surgery. Improvements in the fidelity of both 3D printed and VR simulators as well as integration of a standardized assessment format would allow for an expansion in the use of these simulation platforms in training and assessment. Level of Evidence 5.
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Affiliation(s)
- Tanisha S Kashikar
- Ohio University Heritage College of Osteopathic Medicine Athens Ohio U.S.A
| | - Thomas F Kerwin
- Office of Research The Ohio State University Columbus Ohio U.S.A
| | - Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Columbus Ohio U.S.A
| | - Gregory J Wiet
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Columbus Ohio U.S.A.,Department of Pediatric Otolaryngology Nationwide Children's Hospital Columbus Ohio U.S.A
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11
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Pisa J, Gousseau M, Mowat S, Westerberg B, Unger B, Hochman JB. Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures. Ann Otol Rhinol Laryngol 2017; 127:51-58. [DOI: 10.1177/0003489417745090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Justyn Pisa
- Surgical Hearing Implant Program, Department of Otolaryngology-Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Michael Gousseau
- Department of Otolaryngology-Head and Neck Surgery, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada
| | - Stephanie Mowat
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brian Westerberg
- BC Rotary Hearing and Balance Centre at St. Paul’s Hospital, Division Otolaryngology-Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Bert Unger
- Laboratory for Surgical Modeling, Simulation and Robotics; Biomedical Engineering Program; Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jordan B. Hochman
- Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Health Sciences, University of Manitoba, Canada
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12
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Unger B, Sepehri N, Rampersad V, Pisa J, Michael Gousseau, Hochman JB. Elements of virtual temporal bone surgery: Manipulandum format may be more important to surgeons than haptic device force capabilities. Laryngoscope Investig Otolaryngol 2017; 2:358-362. [PMID: 29299508 PMCID: PMC5743167 DOI: 10.1002/lio2.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/28/2017] [Accepted: 09/16/2017] [Indexed: 11/08/2022] Open
Abstract
Background Temporal bone simulations are critiqued for poor drill‐bone interaction. This project appraises the import of increasing haptic device and manipulandum fidelity on the perceived realism of drilling a virtual temporal bone. Virtual surgical contact forces rely on haptic device fidelity and are transmitted through a manipulandum. With identical software, both device hardware and manipulandum may each contribute to realism. We compare the three degrees of freedom (DOF), 3N Geomagic Touch (3D Systems, SC) to a 6DOF, 5.5N HD2 (Quanser, ON) with the both standard (“HD2–Standard”) and in‐house customized otic drill manipulandum (“HD2–Modified”). Methods Six otologic surgeons performed three virtual mastoidectomy surgeries on a temporal bone surgical simulator. The HD2 manipulandum was modified for attached otic drill with gravity compensation and requisite mechanical modifications. Surgeons, in random order, performed the dissection with the different hardware platforms. Results Two‐tailed t‐tests demonstrate that for the acoustic properties of each simulation, the HD2–Modified manipulandum was favored (p ≤ 0.0004). For overall similarity of bone, both HD2–Standard (p ≤ 0.05) HD2–Modified (p ≤ 0.03)) were favored over the Geomagic; however they were not appreciably different when directly compared to each other. There was no preference for increasing haptic device fidelity in virtual drill bone interaction. In forced rank, users favored the HD2–Modified in osseus, vibrational and overall realism, as well as being preferred for education and preoperative rehearsal (p ≤ 0.0164). Conclusion Increasing manipulandum realism was favored. However surprisingly, there was no preference for increased device fidelity, illustrating incremental stiffness had nominal impact. There may be a ceiling to drill bone interaction in virtual haptic simulation. Level of Evidence 2b.
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Affiliation(s)
- Bertram Unger
- Department of Medical Education University of Manitoba Winnipeg Manitoba Canada
| | - Nariman Sepehri
- Faculty of Engineering University of Manitoba Winnipeg Manitoba Canada
| | - Vivek Rampersad
- Department of Otolaryngology-Head and Neck Surgery University of Manitoba Winnipeg Manitoba Canada
| | - Justyn Pisa
- Department of Otolaryngology-Head and Neck Surgery Health Sciences Centre Winnipeg Manitoba Canada
| | - Michael Gousseau
- Faculty of Medicine University of Manitoba Winnipeg Manitoba Canada
| | - Jordan B Hochman
- Department of Otolaryngology-Head and Neck Surgery University of Manitoba Winnipeg Manitoba Canada
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Konakondla S, Fong R, Schirmer CM. Simulation training in neurosurgery: advances in education and practice. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2017; 8:465-473. [PMID: 28765716 PMCID: PMC5524176 DOI: 10.2147/amep.s113565] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the "real-life" feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms.
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Affiliation(s)
- Sanjay Konakondla
- Department of Neurosurgery and Neuroscience Institute, Geisinger Medical Center, Geisinger Health System, Danville, PA, USA
| | - Reginald Fong
- Department of Neurosurgery and Neuroscience Institute, Geisinger Medical Center, Geisinger Health System, Danville, PA, USA
| | - Clemens M Schirmer
- Department of Neurosurgery and Neuroscience Institute, Geisinger Medical Center, Geisinger Health System, Danville, PA, USA
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