Phenomenological tissue fracture modeling for an Endoscopic Sinus and Skull Base Surgery training system based on experimental data

An update on simulation training in rhinology: a systematic review of evidence

BACKGROUND

Rhinological procedures demand a high degree of technical expertise and anatomical knowledge. Because of limited surgical opportunities, ethical considerations and the complexity of these procedures, simulation-based training has become increasingly important. This review aimed to evaluate the effectiveness of simulation models used in rhinology training.

METHODS

Searches were conducted on PubMed, Embase, Cochrane and Google Scholar for studies conducted between July 2012 and July 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis ('PRISMA') protocol defined a final list of articles. Each validated study was assigned a level of evidence and a level of recommendation based on the Oxford Centre of Evidence-Based Medicine classification.

RESULTS

Following exclusions, 42 articles were identified which encompassed six types of simulation models and 26 studies evaluated validity. The rhinological skills assessed included endoscopic sinus surgery (n = 28), skull base/cerebrospinal fluid leak repair (n = 14), management of epistaxis and/or sphenopalatine artery ligation (n = 8), and septoplasty and septorhinoplasty (n = 6). All studies reported the beneficial impact of their simulation models on trainee development.

CONCLUSION

Simulation training in rhinology is a valuable adjunct to traditional surgical education. Although evidence is of moderate quality, the findings highlight the importance of simulation-based training in rhinology training.

A validation study of a virtual-based haptic system for endoscopic sinus surgery training

BACKGROUND

The development of endoscopic sinus surgery (ESS) training simulators for clinical environment applications has reduced the existing shortcomings in conventional teaching methods, creating a standard environment for trainers and trainees in a more accurate and repeatable fashion.

MATERIALS AND METHODS

In this research, the validation study of an ESS training simulator has been addressed. It is important to consider components that guide trainees to improve their hand movements control in the orbital floor removal in an ESS operation. Therefore, we defined three tasks to perform: pre-experiment learning, training, and evaluation. In these tasks, the critical regions introduced in the virtual training environment are forbidden to be touched. Recruiting 20 participants, divided into two groups, we investigated the performance metrics: quality (the percentage of the realism for the generated force for orbital floor removal and the usefulness of the proposed training system for the surgical educational curricula.), efficiency (time, path length), and safety (touching the goal and forbidden wall).

RESULTS

All recruited participants answered a post-evaluation questionnaire regarding their perceptions of training system realism, potential educational benefits, and practiced skills. We investigate the differences between groups' performance metrics by utilizing the analysis of variance-Kruskal-Wallis test. Acquired results indicate that training before the actual process of the surgery has a significant effect on the accuracy and validity of the process for surgeons.

CONCLUSIONS

Utilizing a standardized environment, trainers and trainees are able to carry out a process with regular features. In addition to traditional education methods, trainees can learn the risk of surgical operations. The training simulators can, also, provide a standard method for assessing the skills of surgical and medical students.