Stan Constantin, Blebea Cristina, Tănase Mihai I, Ujvary Peter L, Tănase Mara, Pop Septimiu Sever, Maniu Alma A, Cosgarea Marcel, Rădeanu Doinel G
Department of ENT, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Department of Surgical Clinical, "Lower Danube" University, Faculty of Medicine and Pharmacy, Galati, ROU.
Cureus. 2024 Feb 3;16(2):e53529. doi: 10.7759/cureus.53529. eCollection 2024 Feb.
Training young doctors in functional endoscopic sinus surgery requires dedicated centers for cadaveric dissections. However, ethical constraints have limited cadaver availability. Alternative anatomical models, like the ovine model, are being explored for effective training, offering easier procurement and resembling human head anatomy. This study aims to demonstrate that the ovine model is useful for endoscopic sinus surgery training, highlighting the anatomical, imaging, histological, and endoscopic aspects.
Three adult Native Romanian Turcana sheep's heads were obtained fresh and frozen from a local slaughterhouse. Using a helical scanner, CT scans were performed, and anatomical structures in the images were carefully labeled. Two heads frozen at -20°C were serially sectioned, with one cut sagittally, dividing the skull, and the other head sectioned transversely with 2.5 cm thickness. Sectional photographs were taken. The third sheep's head underwent endoscopy, and samples from the septal mucosa and inferior turbinate were collected for histopathology examination. The specimens were processed, stained, and examined by a pathologist.
The study successfully highlighted the gross anatomy, CT imaging aspects, histological characteristics of sheep nasal mucosa, and endoscopic features, demonstrating the similarity of the sheep's head to human anatomy, making it a suitable anatomical training model for endoscopic sinus surgery.
The use of sheep's heads as substitutes for human cadaver heads in nasal surgery simulations presents a promising avenue for research. The anatomical similarities and cost-effectiveness make sheep's heads a practical choice for certain aspects of nasal surgery investigation. However, researchers must approach this methodology with a thorough understanding of its limitations, including anatomical and biomechanical differences. Validation studies comparing outcomes with human models are crucial to establishing reliability. The sheep's head anatomical model provides a highly valuable experience for young trainees in endoscopic sinus surgery. Despite encountering several challenges, including some anatomical differences, considering its advantageous attributes renders it an ideal material for mimicking surgical procedures in functional endoscopic sinus surgery.
培训年轻医生进行功能性鼻内镜鼻窦手术需要有专门的尸体解剖中心。然而,伦理限制使得尸体来源有限。人们正在探索如绵羊模型等替代解剖模型,以进行有效的培训,因为这些模型获取更容易且与人类头部解剖结构相似。本研究旨在证明绵羊模型对于鼻内镜鼻窦手术培训是有用的,突出其解剖学、影像学、组织学和内镜方面的特点。
从当地一家屠宰场获取了三个成年罗马尼亚本土图尔卡纳绵羊的新鲜冷冻头部。使用螺旋扫描仪进行CT扫描,并仔细标记图像中的解剖结构。将两个在-20°C冷冻的头部进行连续切片,一个沿矢状面切开,将颅骨分开,另一个头部以2.5厘米的厚度进行横切。拍摄切片照片。对第三个绵羊头部进行内镜检查,并采集鼻中隔黏膜和下鼻甲的样本进行组织病理学检查。标本经过处理、染色后由病理学家进行检查。
该研究成功突出了绵羊鼻腔的大体解剖、CT成像特点、鼻黏膜的组织学特征以及内镜特征,证明了绵羊头部与人体解剖结构的相似性,使其成为鼻内镜鼻窦手术合适的解剖学培训模型。
在鼻外科手术模拟中使用绵羊头部替代人类尸体头部是一个有前景的研究途径。解剖学上的相似性和成本效益使绵羊头部成为鼻外科手术某些方面研究的实际选择。然而,研究人员必须充分了解其局限性,包括解剖学和生物力学差异,才能采用这种方法。与人体模型比较结果的验证研究对于确定可靠性至关重要。绵羊头部解剖模型为年轻的鼻内镜鼻窦手术学员提供了非常有价值的经验。尽管遇到了一些挑战,包括一些解剖学差异,但考虑到其有利特性,它仍是模拟功能性鼻内镜鼻窦手术操作的理想材料。