Abstract
OBJECTIVE
To determine the efficacy of computed tomographic image-guided endoscopic surgery in the hands of inexperienced surgeons.
STUDY DESIGN
Four second-year otolaryngology residents, with no prior experience performing ethmoidectomies, performed endoscopic sinus surgery (ESS) on formalin-fixed human cadaveric specimens with and without the aid of computer-assisted surgery (CAS).
METHODS
Each resident was asked to identify critical sinus, orbital, and skull base structures while performing a total ethmoidectomy and multiple sinusotomies. Their surgical accuracy (percentage of correctly identified structures), total operative time, and incidence of major complications were recorded for each side. A total of 16 sides were evaluated (8 with and 8 without CAS). Statistical significance between groups was determined by means of Pearson's chi2 analysis.
RESULTS
Statistical analysis showed a significant difference (P = .001) in the mean accuracy of identifying critical anatomical landmarks between the CAS (97%) and non-CAS (76.8%) groups. Although not statistically significant, operative time appeared to be longer in the group using CAS (average of 67 vs. 80 min). Three major intracranial complications were documented only in the group not using CAS.
CONCLUSIONS
Although, unquestionably, a thorough knowledge of the anatomy remains essential for performing ESS, CAS improves surgical accuracy and reduces the risk of major intracranial or intraorbital complications for residents. In additional, our data suggest that this technology may enhance surgical efficiency and improve the learning curve by reducing operative time (below one's normal baseline) while maintaining a greater than 90% accuracy in identifying critical anatomical landmarks.
TY - JOUR
T1 - Efficacy of computed tomographic image--guided endoscopic sinus surgery in residency training programs.
AU - Casiano,R R,
AU - Numa,W A,Jr
PY - 2000/8/15/pubmed
PY - 2000/8/29/medline
PY - 2000/8/15/entrez
SP - 1277
EP - 82
JF - The Laryngoscope
JO - Laryngoscope
VL - 110
IS - 8
N2 - OBJECTIVE: To determine the efficacy of computed tomographic image-guided endoscopic surgery in the hands of inexperienced surgeons. STUDY DESIGN: Four second-year otolaryngology residents, with no prior experience performing ethmoidectomies, performed endoscopic sinus surgery (ESS) on formalin-fixed human cadaveric specimens with and without the aid of computer-assisted surgery (CAS). METHODS: Each resident was asked to identify critical sinus, orbital, and skull base structures while performing a total ethmoidectomy and multiple sinusotomies. Their surgical accuracy (percentage of correctly identified structures), total operative time, and incidence of major complications were recorded for each side. A total of 16 sides were evaluated (8 with and 8 without CAS). Statistical significance between groups was determined by means of Pearson's chi2 analysis. RESULTS: Statistical analysis showed a significant difference (P = .001) in the mean accuracy of identifying critical anatomical landmarks between the CAS (97%) and non-CAS (76.8%) groups. Although not statistically significant, operative time appeared to be longer in the group using CAS (average of 67 vs. 80 min). Three major intracranial complications were documented only in the group not using CAS. CONCLUSIONS: Although, unquestionably, a thorough knowledge of the anatomy remains essential for performing ESS, CAS improves surgical accuracy and reduces the risk of major intracranial or intraorbital complications for residents. In additional, our data suggest that this technology may enhance surgical efficiency and improve the learning curve by reducing operative time (below one's normal baseline) while maintaining a greater than 90% accuracy in identifying critical anatomical landmarks.
SN - 0023-852X
UR - https://www.unboundmedicine.com/medline/citation/10942126/Efficacy_of_computed_tomographic_image__guided_endoscopic_sinus_surgery_in_residency_training_programs_
DB - PRIME
DP - Unbound Medicine
ER -
