Scholp Austin J, Hoffman Matthew R, De Alarcon Alessandro, Gerber Mark E, Jiang Jack J, McMurray James Scott
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
OTO Open. 2020 Jul 31;4(3):2473974X20946268. doi: 10.1177/2473974X20946268. eCollection 2020 Jul-Sep.
Endoscopic cricoid expansion and reduction are newer approaches to the management of pediatric bilateral vocal fold immobility and postlaryngotracheal reconstruction glottic insufficiency, respectively. These procedures offer a less invasive, endoscopic alternative to procedures that typically required open management with a more prolonged recovery. These technically demanding procedures are currently performed only in select centers, and there is no currently described training model for practicing them. We present a modification to a laryngeal dissection station that allows for simulation of endoscopic cricoid reduction and expansion with excised larynges. The model allows trainees to practice endoscopic posterior cricoid exposure, incision of the cricoid cartilage, placement of a simulated costal cartilage graft for expansion, and endoscopic suturing for reduction. Development of simulators for procedures that are infrequently performed have the potential to help trainees reach surgical competency faster and more safely.
内镜下环状软骨扩张术和复位术分别是治疗小儿双侧声带麻痹和喉气管重建术后声门功能不全的新方法。这些手术提供了一种侵入性较小的内镜替代方案，以取代通常需要开放手术且恢复时间更长的治疗方法。这些技术要求较高的手术目前仅在特定中心开展，目前尚无关于实施这些手术的培训模式的描述。我们对一个喉部解剖工作站进行了改良，使其能够利用切除的喉部模拟内镜下环状软骨复位术和扩张术。该模型允许学员练习内镜下环状软骨后部暴露、环状软骨切开、放置模拟肋软骨移植物进行扩张以及内镜缝合进行复位。针对不常开展的手术开发模拟器，有可能帮助学员更快、更安全地达到手术胜任能力。
