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Estimating Cognitive Workload Using Task-Related Pupillary Responses in Simulated Drilling in Cochlear Implantation.

Hana Vrzáková1, Jesse Tapiala2, Matti Iso-Mustajärvi3

  • 1School of Computing, University of Eastern Finland, Joensuu, Finland.

The Laryngoscope
|July 11, 2024
PubMed
Summary
This summary is machine-generated.

Task-evoked pupillary responses (TEPR) reveal workload fluctuations during temporal bone drilling. Objective monitoring of these psychomotor skills aids in assessing surgical trainee progress and expertise acquisition.

Keywords:
microsurgical drillingmicrosurgical eye trackingposterior tympanotomytemporal bone

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Area of Science:

  • Otorhinolaryngology
  • Surgical Education
  • Medical Simulation

Background:

  • Temporal bone drilling is crucial for cochlear implant surgery, requiring complex psychomotor skills beyond technical proficiency.
  • Understanding the impact of workload and psychomotor skills on surgical performance is essential for effective training.

Purpose of the Study:

  • To investigate the relationship between workload, psychomotor skills, and performance during temporal bone drilling.
  • To evaluate the utility of task-evoked pupillary responses (TEPR) as an objective measure of workload in surgical training.

Main Methods:

  • 22 medical students performed transmastoid-posterior tympanotomy (TMPT) and round window niche drilling on 3D-printed temporal bone models.
  • Task-evoked pupillary responses (TEPR) metrics, including Average Pupil Size (APS), Index of Pupil Activity (IPA), and Low/High Index of Pupillary Activity (LHIPA), were recorded.
  • TEPR metrics and drilling times were correlated with performance in key surgical phases.

Main Results:

  • TEPR measures showed significant differences across drilling phases, reflecting anticipated workload variations.
  • Enlarging the facial recess was the longest drilling phase.
  • IPA indicated increased workload during posterior canal wall thinning, while APS showed higher workload during bony overhang drilling.

Conclusions:

  • TEPR metrics provide objective insights into workload and skill acquisition during temporal bone drilling.
  • Continuous monitoring of psychomotor skills using TEPR can support competency-based medical residency programs.
  • Findings aid in developing objective assessments for surgical expertise.