Phoniatrics Unit, Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Voice. 2012 May;26(3):351-7. doi: 10.1016/j.jvoice.2011.04.002. Epub 2012 Jan 31.
Animal models for training of surgical skills were widely used for a long time in the education of medical practitioners. It is recognized, however, that endolaryngeal microsurgery requires highly refined skills to handle the delicate structures of the vocal folds under the microscope. The availability of fresh human laryngeal specimens is markedly restricted by legal and hygienic issues. The aim of this work was to report on the design of a feasible and effective model to provide the much needed skills in an animal laryngeal model that is as close as possible to the human vocal fold structure. In the initial phase of the research, three animal larynges were studied: porcine/pig, bovine/calf, and ovine/sheep larynges. The pig/porcine larynx was chosen for this experimental training model because it closely resembled the human laryngeal/glottal configurations. A study was carried out on 10 porcine/pig larynges to assess the dimensions of the glottis and study the histology of the layered structure of the vocal fold. The study was pursued to confirm the resemblance of this animal specimen to the human vocal fold. A wooden box with a black finished interior was prepared with an acrylic bed at its floor. This bed allows placement of the porcine/pig larynx. The design of the box allows the endoscopic exposure of the porcine/pig larynx through a rubber diaphragm. The darkness and confinement of the box, apart from the light of the endoscope, approximates the situation in live endoscopy. The operating microscope is then used to expose the glottis. Routine fine microlaryngeal instruments were used for training in the prescribed skills.
动物模型在医学从业者的培训中长期以来被广泛应用于手术技能的培训。然而,人们认识到,喉内显微手术需要高度精细的技能来在显微镜下处理声带的精细结构。由于法律和卫生问题,新鲜的人体喉标本的可用性受到明显限制。本研究旨在报告一种可行且有效的模型设计,该模型旨在提供在动物喉模型中急需的技能,该模型尽可能接近人类声带结构。在研究的初始阶段,研究了三种动物的喉部:猪/猪、牛/小牛和羊/绵羊。由于猪/猪的喉部与人类喉部/声门的结构非常相似,因此选择了猪/猪的喉部作为这种实验训练模型。对 10 个猪/猪的喉部进行了研究,以评估声门的尺寸并研究声带的分层结构的组织学。进行这项研究是为了确认这种动物标本与人类声带的相似性。准备了一个内部为黑色的木制盒子,其地板为有机玻璃床。这个床可以放置猪/猪的喉部。盒子的设计允许通过橡胶隔膜对猪/猪的喉部进行内窥镜检查。除了内窥镜的光线外,盒子的黑暗和封闭环境使情况接近活体内窥镜检查。然后使用手术显微镜暴露声门。常规的精细显微喉镜器械用于培训规定的技能。