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Alcalá Rueda I, Sánchez Barrueco Á, Cenjor Español C, Castaño AB, Villacampa Aubá JM. Everything but the squeal: a guide for head and neck surgery training on the live porcine model. Eur Arch Otorhinolaryngol 2023; 280:2927-2936. [PMID: 36826522 PMCID: PMC10175473 DOI: 10.1007/s00405-023-07882-5] [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: 01/19/2023] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE The porcine model has been demonstrated to be cost-effective for head and neck surgery training. There is no literature describing the porcine head and neck anatomy. The purpose of this study is to provide a porcine surgical guide for training head and neck residents. METHODS Five head and neck dissections were performed under general anesthesia on the Large White pig model in the animal facilities of the University Hospital Fundación Jiménez. Sessions were photographed, and reference anatomical measurements were taken. RESULTS The sternum-chin distance (x = 15.80 cm, σ = 0.44), chin-chin distance (x = 11.10 cm, σ = 2.30), prelaryngeal musculature length (x = 10.30 cm, σ = 1.92) and supraomohyoid triangle area (x = 7.07 cm2, σ = 3.91) were among the measurements obtained. The porcine head and neck anatomy was detailed. CONCLUSIONS Head and neck porcine anatomy was thoroughly described, with emphasis on the similarities with human anatomy. The porcine model is capable of simulating human anatomy for surgery training.
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Affiliation(s)
- Ignacio Alcalá Rueda
- Alfonso X El Sabio University (UAX), Madrid, Spain.,Otolaryngology Department, University Hospital General de Villalba, Madrid, Spain
| | - Álvaro Sánchez Barrueco
- Alfonso X El Sabio University (UAX), Madrid, Spain. .,Otolaryngology Department, University Hospital General de Villalba, Madrid, Spain. .,Otolaryngology Department, University Hospital Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain.
| | - Carlos Cenjor Español
- Otolaryngology Department, University Hospital Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain
| | - Abel Bogoya Castaño
- Otolaryngology Department, University Hospital Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain
| | - José Miguel Villacampa Aubá
- Alfonso X El Sabio University (UAX), Madrid, Spain.,Otolaryngology Department, University Hospital General de Villalba, Madrid, Spain.,Otolaryngology Department, University Hospital Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain
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Jing TT, Shah SJ, Dadario NB, Jafri FN. Evaluation of a Novel Three-Dimensional Emergency Cricothyrotomy Task Trainer. Cureus 2021; 13:e14775. [PMID: 34094740 PMCID: PMC8169099 DOI: 10.7759/cureus.14775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Emergency cricothyrotomy is a critical, yet infrequently performed and time-sensitive procedure that requires practice in order to be reliably completed in emergent airway situations. Many physicians never have the opportunity to practice this rarely performed but highly impactful procedure during their training due to a lack of an affordable, high-fidelity training model. In this study, the educational impact and realism of a new synthetic cricothyrotomy training model (high-fidelity emergency cricothyrotomy, HiFEC) were compared with those of a standard porcine explant model. Methodology A total of thirty-one attending physicians from four medical specialties were recruited on a volunteer basis to participate in a cricothyrotomy simulation workshop. Participants were randomly assigned to complete the initial workshop using one of the two models but had the opportunity to practice on both trainers. Pre- and post-workshop comfort level as well as the realism of the models were surveyed using questionnaires and evaluated using a five-point Likert scale. Results Improvements in self-reported comfort levels were seen in both the porcine group (p = 0.0014) and HiFEC group (p = 0.0036) as well as overall (p < 0.001). The realism rating of both training models was similar with a median score of 4 on a five-point Likert scale. When comparing the cost of conducting our workshop using these models, the synthetic model saved over $650. Conclusions Given the similar realism of the models and the improvement in participant comfort level, the synthetic HiFEC trainer is an effective and more affordable alternative training model for emergency cricothyrotomies.
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Affiliation(s)
- Tina T Jing
- Department of Emergency Medicine, Albert Einstein College of Medicine, Bronx, USA
| | - Sharan J Shah
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Bronx, USA
| | - Nicholas B Dadario
- Department of Emergency Medicine, Robert Wood Johnson Medical School, New Brunswick, USA
| | - Farrukh N Jafri
- Department of Emergency Medicine, White Plains Hospital, White Plains, USA
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Milner TD, Okhovat S, McGuigan M, Clement WA, Kunanandam T. Feasibility of ovine and porcine models for simulation training in parotid surgery and facial nerve dissection. Eur Arch Otorhinolaryngol 2020; 277:1167-1175. [PMID: 31915918 DOI: 10.1007/s00405-020-05782-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/02/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To assess and compare the feasibility of using ovine and porcine models as surgical simulation training tools for otolaryngology trainees performing parotid surgery and facial nerve dissection. METHODS Trainees performed parotid surgery (total parotidectomy, retrograde facial nerve dissection and facial nerve grafting) on an ovine and porcine model. Participants completed a 22-item, five-point Likert scale questionnaire on each model, assessing three validation domains; face validity (FV), global content validity (GCV) and task-specific content validity (TSCV). Data were prospectively collected and analysed using descriptive and non-parametric statistics. RESULTS Twelve trainees completed two consecutive parotidectomies and facial nerve dissections on an ovine and porcine model. Twenty-four dissections were completed. Validation questionnaires were completed for each model by all trainees. The ovine model achieved median validation threshold scores (≥ 4/5) for all aspects of FV, GCV and TSCV. The porcine model did not achieve validation threshold scores for any aspect of the validation questionnaire. Comparison of the ovine and porcine model demonstrated that the ovine model was statistically superior to the porcine model across most validation criteria excluding realistic appearance of skin, identification and ligation of the trans-oral parotid duct and facial nerve grafting. CONCLUSION Adequate experience with facial nerve dissection during parotid surgery is vital to ensuring good outcomes and avoiding complications. This study is the first to compare validity of two animal models for simulation training in parotid surgery and facial nerve dissection. We have validated the ovine model as a useful tool for simulation training and advocate its incorporation into otolaryngology training programmes.
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Affiliation(s)
- Thomas D Milner
- Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.
| | - Saleh Okhovat
- Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - Mark McGuigan
- Department of Otolaryngology, Head and Neck Surgery, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - William A Clement
- Department of Otolaryngology, Head and Neck Surgery, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - Thushitha Kunanandam
- Department of Otolaryngology, Head and Neck Surgery, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
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Cheng PC, Cho TY, Hsu WL, Lo WC, Wang CT, Cheng PW, Liao LJ. Training Residents to Perform Tracheotomy Using a Live Swine Model. EAR, NOSE & THROAT JOURNAL 2019; 98:E87-E91. [PMID: 30974995 DOI: 10.1177/0145561319840835] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A tracheotomy is a basic operation for the otorhinolaryngologist. According to reports from the United States and from our experience, there has been a steady decline in the number of tracheostomies performed by young resident doctors. Due to concerns for inadequate training of young residents, we developed a tracheotomy course consisting of a lecture, a live animal model, and questionnaires. The aim of this study was to evaluate the effectiveness of this training model. Twelve volunteer resident doctors joined the training course and, following a lecture by a senior surgeon, practiced tracheostomies with a 4-month-old female swine weighing 32 kg. We recorded the procedure time, blood loss, and complications. The doctors' procedural competence was recorded using questionnaires before and after the training. All operations were completed within 30 minutes, and the blood loss was less than 5 ml. There were no serious acute complications. After the training, young residents had improved scores on surgical landmark recognition, overall procedural competence, confidence in performing the procedure, and understanding of the surgical procedures and equipment (P < .05). Our findings reveal that an animal model-based tracheotomy course is an effective training model for young resident doctors.
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Affiliation(s)
- Ping-Chia Cheng
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Tsung-Yi Cho
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Wan-Lun Hsu
- 2 Genomics Research Center, Academia Sinica, Taipei
| | - Wu-Chia Lo
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei.,3 Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei
| | - Chi-Te Wang
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Po-Wen Cheng
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Li-Jen Liao
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei.,4 Department of Electrical Engineering, Yuan Ze University, Taoyuan
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Tube MIC, Spencer-Netto FAC, Oliveira AIPD, Holanda ACD, Barros BLDS, Rezende CCG, Cavalcanti JPG, Batista MA, Campos JM. Surgical model pig ex vivo for venous dissection teaching in medical schools. Acta Cir Bras 2017; 32:157-167. [PMID: 28300878 DOI: 10.1590/s0102-865020170208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/24/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate a method for development of surgical skills in medical students simulating venous dissection in surgical ex vivo pig model. METHODS Prospective, analytical, experimental, controlled study with four stages: selection, theoretical teaching, training and assessment. Sample of 312 students was divided into two groups: Group A - 2nd semester students; Group B - students of 8th semester. The groups were divided into five groups of 12 students, trained two hours per week in the semester. They set up four models to three students in each skill station assisted by a monitor. Teaching protocol emergency procedures training were applied to venous dissection, test goal-discursive and OSATS scale. RESULTS The pre-test confirmed that the methodology has not been previously applied to the students. The averages obtained in the theoretical evaluation reached satisfactory parameters in both groups. The results of applying OSATS scale showed the best performance in group A compared to group B, however, both groups had satisfactory medium. CONCLUSION The method was enough to raise a satisfactory level of skill both groups in venous dissection running on surgical swine ex vivo models.
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Tube MIC, Netto FACS, Costa E, Lafayette DDSA, Lima GADFCA, Menezes JISD, Aires VGB, Ferraz ÁAB, Campos JM, Moraes Neto FRD. Chest drainage teaching and training for medical students. Use of a surgical ex vivo pig model. Acta Cir Bras 2016; 31:353-63. [DOI: 10.1590/s0102-865020160050000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/12/2016] [Indexed: 11/21/2022] Open
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