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The utility of intraoperative navigation of the temporal bone for otolaryngology resident training
Zachary G Schwam1,2, Vivian Z Kaul1,2, Maura K Cosetti1,2,3,4
1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York, U.S.A.
Objectives:
To determine whether image guidance improves dissection quality among residents in the temporal bone lab and to gauge their reactions to its use.
Methods:
Prospective cohort study of nine otolaryngology residents who dissected cadaveric temporal bones with and without image guidance in the temporal bone laboratory. Quality of dissection was measured with the Welling scale. A survey was administered assessing their interactions with the navigation system.
Results:
There was no significant difference in quality of dissection for the majority of structures or number of major errors with use of image guidance. Dissection quality of the tegmen (4.67 vs. 5.67, P = .034) and sinodural angle (0.83 vs. 1.56, P = .005) was superior in the non-navigation specimens. The majority of residents reported increased confidence with locating several critical anatomic structures and found the system intuitive to use. Nearly all thought it would be helpful in revision cases or for aural atresia.
Conclusion:
Image guidance did not improve quality of temporal bone dissection or number of major errors in this cohort of residents, but the majority found it intuitive and increased confidence in finding several structures. Navigation systems may play an important adjunctive role in resident education and further work is required to determine its optimal use.
Level Of Evidence:
NA Laryngoscope, 130:E368-E371, 2020.
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