Ex vivo ovine model for pediatric flexible endoscopy training

Area of Science:

• Otolaryngology
• Medical Simulation
• Pediatric Endoscopy

Background:

• Limited opportunities exist for medical trainees to develop pediatric endoscopy skills.
• A realistic simulation model is needed to enhance pediatric endoscopy training.
• Fresh animal tissue offers a potential solution for surgical simulation.

Purpose of the Study:

• To develop a simulation model for pediatric flexible endoscopy using fresh sheep head and neck tissue.
• To evaluate the efficacy of this model for training nasopharyngolaryngoscopy and transnasal intubation.

Main Methods:

• Fresh head and neck tissue from five pre-pubescent sheep (4 months old) were collected post-euthanasia.
• Tissue was stored for 1-5 days at 5°C.
• Flexible nasopharyngolaryngoscopy and transnasal endoscopic intubation were performed on the tissue specimens.

Main Results:

• The ovine pediatric airway anatomy was studied and compared to human pediatric anatomy.
• Medical students, supervised by a pediatric otolaryngologist, performed the procedures.
• Key anatomical differences between sheep and human pediatric airways were identified.

Conclusions:

• Sheep airway anatomy, despite proportional differences, closely mimics pediatric endoscopy in terms of appearance, texture, and tactile feedback.
• The simulation effectively replicates challenges such as secretions and "whiteout" phenomena encountered in pediatric procedures.
• Transnasal intubation simulation provides a realistic experience of navigating the larynx and guiding an endotracheal tube.