ENT Head and Neck Surgery, Flinders Medical Centre, Bedford Park, SA, Australia.
Department of Surgery, Flinders University, Adelaide, SA, Australia.
Clin Otolaryngol. 2018 Jun;43(3):812-822. doi: 10.1111/coa.13052. Epub 2018 Jan 4.
Simulation provides a safe and effective opportunity to develop surgical skills. A variety of endoscopic sinus surgery (ESS) simulators has been described in the literature. Validation of these simulators allows for effective utilisation in training.
To conduct a systematic review of the published literature to analyse the evidence for validated ESS simulation.
Pubmed, Embase, Cochrane and Cinahl were searched from inception of the databases to 11 January 2017.
Twelve thousand five hundred and sixteen articles were retrieved of which 10 112 were screened following the removal of duplicates. Thirty-eight full-text articles were reviewed after meeting search criteria. Evidence of face, content, construct, discriminant and predictive validity was extracted.
Twenty articles were included in the analysis describing 12 ESS simulators. Eleven of these simulators had undergone validation: 3 virtual reality, 7 physical bench models and 1 cadaveric simulator. Seven of the simulators were shown to have face validity, 7 had construct validity and 1 had predictive validity. None of the simulators demonstrated discriminate validity.
This systematic review demonstrates that a number of ESS simulators have been comprehensively validated. Many of the validation processes, however, lack standardisation in outcome reporting, thus limiting a meta-analysis comparison between simulators.
模拟为发展手术技能提供了安全有效的机会。文献中已经描述了各种内窥镜鼻窦手术（ESS）模拟器。这些模拟器的验证允许在培训中有效利用。
对已发表的文献进行系统综述，以分析经过验证的 ESS 模拟的证据。
从数据库建立之初到 2017 年 1 月 11 日，在 Pubmed、Embase、Cochrane 和 Cinahl 上进行了检索。
检索到 12516 篇文章，其中 10112 篇经过重复去除后进行了筛选。在满足搜索标准后，对 38 篇全文文章进行了审查。提取了表面、内容、结构、区分和预测有效性的证据。
分析中包括 20 篇描述 12 种 ESS 模拟器的文章。其中 11 种模拟器已经过验证：3 种虚拟现实、7 种物理台式模型和 1 种尸体模拟器。7 种模拟器具有表面有效性，7 种具有结构有效性，1 种具有预测有效性。没有一种模拟器具有区分有效性。
本系统评价表明，许多 ESS 模拟器已经得到了全面验证。然而，许多验证过程在结果报告中缺乏标准化，从而限制了模拟器之间的荟萃分析比较。
