This prospective study investigated which steps of cortical mastoidectomy were challenging for 10 medical students and 10 intermediate surgeons (surgical trainees) compared to 10 experienced expert surgeons. Each participant performed cortical mastoidectomy on eight different virtual temporal bone models. The 10 expert surgeons also completed a questionnaire on the level of difficulty of teaching the items on the validated Melbourne Mastoidectomy Scale (MMS). Statistical comparisons showed that the medical students were able to define the mastoid and enter the antrum. The intermediate group found challenges related to sigmoid sinus and semicircular canal dissection. The experts found it challenging to teach tasks related to facial nerve and exposing the middle fossa plate, but the intermediate group performed these tasks well. The virtual reality temporal bone model used in the study may be a confounder as it differs from real-life fidelity and visual cues. It is worth exploring whether younger, less experienced surgeons, due to their familiarity with video gaming, found it easier to perform tasks on the virtual reality temporal bone dissection. Nevertheless, this study suggests a possible method for training residents with targeted feedback.
Challenging steps of virtual cortical mastoidectomy
Reviewed by Gauri Mankekar
How difficult is it to learn different steps of a cortical mastoidectomy?
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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