Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Ann Otol Rhinol Laryngol. 2022 Nov;131(11):1224-1230. doi: 10.1177/00034894211059310. Epub 2021 Dec 7.
Temporal bone simulation is now commonly used to augment cadaveric education. Assessment of these tools is ongoing, with haptic modeling illustrating dissimilar motion patterns compared to cadaveric opportunities. This has the potential to result in maladaptive skill development. It is hypothesized that trainee drill motion patterns during printed model dissection may likewise demonstrate dissimilar hand motion patterns.
Resident surgeons dissected 3D-printed temporal bones generated from microCT data and cadaveric simulations. A magnetic position tracking system (TrakSTAR Ascension, Yarraville, Australia) captured drill position and orientation. Skill assessment included cortical mastoidectomy, thinning procedures (sigmoid sinus, dural plate, posterior canal wall) and facial recess development. Dissection was performed by 8 trainees (n = 5 < PGY3 > n = 3) using k-cos metrics to analyze drill strokes within position recordings. K-cos metrics define strokes by change in direction, providing metrics for stroke duration, curvature, and length.
-tests between models showed no significant difference in drill stroke frequency (cadaveric = 1.36/s, printed = 1.50/s, < .40) but demonstrate significantly shorter duration (cadaveric = 0.37 s, printed = 0.16 s, < .01) and a higher percentage of curved strokes (cadaveric = 31, printed = 67, < .01) employed in printed bone dissection. Junior staff used a higher number of short strokes (junior = 0.54, senior = 0.38, < .01) and higher percentage of curved strokes (junior = 35%, senior = 21%, < .01).
Significant differences in hand motions were present between simulations, however the significance is unclear. This may indicate that printed bone is not best positioned to be the principal training schema.
目前，颞骨模拟常用于增强尸体教育。这些工具的评估仍在进行中，触觉建模显示与尸体机会相比，运动模式不同。这有可能导致适应性技能发展不良。据推测，在打印模型解剖过程中，学员的钻头运动模式可能也表现出不同的手部运动模式。
住院医师使用从微 CT 数据和尸体模拟生成的 3D 打印颞骨进行解剖。一个磁位置跟踪系统（TrakSTAR Ascension，澳大利亚 Yarraville）捕获钻头的位置和方向。技能评估包括皮质乳突切除术、变薄程序（乙状窦、硬脑膜板、后管墙）和面神经隐窝发育。8 名受训者（n=5<PGY3<n=3）使用 k-cos 指标进行解剖，通过位置记录分析钻头冲程。k-cos 指标通过方向变化定义冲程，为冲程持续时间、曲率和长度提供指标。
-检验模型之间的差异，钻头冲程频率无显著差异（尸体=1.36/s，打印=1.50/s，<.40），但持续时间显著缩短（尸体=0.37/s，打印=0.16/s，<.01），打印骨解剖中使用的弯曲冲程比例更高（尸体=31，打印=67，<.01）。初级工作人员使用更多的短冲程（初级=0.54，高级=0.38，<.01）和更高比例的弯曲冲程（初级=35%，高级=21%，<.01）。
模拟之间存在手部运动的显著差异，但意义尚不清楚。这可能表明打印骨不是最佳的主要培训方案。
