Balloon sinuplasty: does a model simulator improve ENT trainee competence?

Balloon sinuplasty is an established technique for treating chronic rhinosinusitis and its role in managing complicated acute rhinosinusitis (ARS) is emerging. Complicated ARS is a potentially life-threatening condition and balloon sinuplasty is not currently a competency required by UK otolaryngology trainees. To our knowledge, we are the first to investigate whether a balloon sinuplasty model simulator was able to improve trainee self-perceived competence.

A prospective, qualitative-based study was carried out including all candidates attending a national paediatric course rotating through our balloon sinuplasty model simulator station. Candidates returned a questionnaire to evaluate their experience.

Twenty feedback forms were returned. Candidates ranged from core trainees to consultants, with the majority being registrar or senior clinical fellow level (89.4%). Three candidates had previously performed balloon sinuplasty in adults and none in children. The number of candidates rating their understanding of how to perform balloon sinuplasty as ≥7 increased after the simulator experience from 9 of 20 (45%) to 20 of 20 (100%). Following the model simulator experience, 45% felt confident in performing balloon sinuplasty in adult patients and 25% in children. In all, 40% of candidates were confident in using balloon sinuplasty electively and 35% felt they would be able to use it in an emergency procedure.

Surgical confidence in performing balloon sinuplasty is generally low, especially among trainees. A balloon sinuplasty model simulator is able to improve this but further training and hands-on experience is required to facilitate translation of simulation acquired surgical skills to the operating theatre.