Postgraduate Centre, University Hospital Monklands, NHS Lanarkshire, Airdrie, Scotland. UK.
Department of ENT, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales, UK.
J Laryngol Otol. 2022 Feb;136(2):141-145. doi: 10.1017/S002221512200010X. Epub 2022 Jan 10.
Three-dimensional endoscopes provide a stereoscopic view of the operating field, facilitating depth perception compared to two-dimensional systems, but are not yet widely accepted. Existing research addresses performance and preference, but there are no studies that quantify anatomical orientation in endoscopic ear surgery.
Participants (n = 70) were randomised in starting with either the two-dimensional or three-dimensional endoscope system to perform one of two tasks: anatomical orientation using a labelled three-dimensional printed silicone model of the middle ear, or simulated endoscopic skills. Scores and time to task completion were recorded, as well as self-reported difficulty, confidence and preference.
Novice surgeons scored significantly higher in a test of anatomical orientation using three-dimensional compared to two-dimensional endoscopy (p < 0.001), with no significant difference in the speed of simulated endoscopic skills task completion. For both tasks, there was lower self-reported difficulty and increased confidence when using the three-dimensional endoscope. Participants preferred three-dimensional over two-dimensional endoscopy for both tasks.
The findings demonstrate the superiority of three-dimensional endoscopy in anatomical orientation, specific to endoscopic ear surgery, with statistically indistinguishable performance in a skills task using a simulated trainer.
与二维系统相比，三维内窥镜提供了手术视野的立体视图，有助于深度感知，但尚未被广泛接受。现有研究解决了性能和偏好问题，但没有研究量化内窥镜耳部手术中的解剖方位。
将参与者（n = 70）随机分为两组，分别使用二维或三维内窥镜系统执行以下两项任务之一：使用中耳的标记三维打印硅树脂模型进行解剖方位测试，或模拟内窥镜技能。记录得分和完成任务的时间，以及自我报告的难度、信心和偏好。
在使用三维内窥镜进行的解剖方位测试中，新手外科医生的得分明显高于二维内窥镜（p < 0.001），而在模拟内窥镜技能任务完成速度方面没有显著差异。对于这两个任务，使用三维内窥镜时，自我报告的难度较低，信心增加。参与者更喜欢三维内窥镜进行这两项任务。
这些发现表明，三维内窥镜在解剖方位方面具有优势，特别是在内窥镜耳部手术中，使用模拟训练器进行技能任务的表现无统计学差异。
