Skip to main content

Advertisement

SpringerLink
Log in

The advantages of modified Thiel technique in head and neck surgical anatomy teaching

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

Thiel’s body preservation method allows the donor body to retain color and soft tissue that are similar to those of a living individual. Since its initial description, the technique has not been developed much. Here, we propose a simpler protocol applied to the head and neck, making the technique easier, cheaper, and more accessible to a greater number of medical schools.

Methods

The modified Thiel technique was applied to three heads separated from the body, followed by 6 h of perfusion and 6 weeks of fixation. This technique was compared with formalin (three heads) and freeze (three heads) preservations during academic training in head and neck surgery. Anatomical dissections included a parotid gland dissection, a submandibular gland dissection, an otologic and an endonasal dissection. Twelve surgeons blindly assessed the three types of preservations using a standardized questionnaire.

Results

The modified Thiel technique made possible better quality of dissection and tissue identification, with the exception of endonasal dissection. Concerning the endonasal dissection, the modified Thiel technique ranked best for smell, but all other criteria ranked lower than the freezing method. For the submandibular and parotid gland dissections, the modified Thiel technique was ranked best, with statistically significant differences (p < 0.002) for all items. The modified Thiel technique also ranked significantly better during otologic surgery regarding the quality of the skin/eardrum, bone, and muscle, and the smell.

Conclusion

This study demonstrated that the modified Thiel technique is an embalming technique which improves the quality of head and neck surgical anatomy education.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and material

Caen anatomy laboratory.

Code availability

R software.

References

  1. Balta J, Cronin M, Cryan JF, Mahony SMO (2015) Human preservation techniques in anatomy: a 21st century medical education perspective. Clin Anat 28:725–734

    Article  Google Scholar 

  2. Balta J, Lamb C, Soames RW (2015) A pilot study comparing the use of Thiel- and formalin-embalmed cadavers in the teaching of human anatomy. Anat Sci Educ 8(1):86–91

    Article  Google Scholar 

  3. Benkhadra M, Gerard J, Genelot D et al (2011) Is Thiel’s embalming method widely known? A world survey about its use. Surg Radiol Anat 33:359–363

    Article  Google Scholar 

  4. Bilge O, Celik S (2017) Cadaver embalming fluid for surgical training courses: modified Larssen solution. Surg Radiol Anat 39(11):1263–1272

    Article  Google Scholar 

  5. Coleman R, Kogan I (1998) An improved low-formaldehyde embalming fluid to preserve cadavers for anatomy teaching. J Anat 192(3):443–446

    Article  Google Scholar 

  6. Dubach P, Mantokoudis G, Banz Y, Herrmann G, Caversaccio M (2010) Hydrodissection for subperichondrial septoplasty—an experimental anatomical study. Rhinology 48:195–200

    CAS  PubMed  Google Scholar 

  7. Eisma R, Lamb C (2013) From formalin to Thiel embalming: what changes? One Anatomy Department’s experiences. Clin Anat 26(5):564–571

    Article  CAS  Google Scholar 

  8. Frithioff A, Sølvsten M, Steven S, Wuyts A (2017) European status on temporal bone training : a questionnaire study. Eur Arch Otorhinolaryngol 275(7):1–7

    Google Scholar 

  9. Groscurth P, Eggli P, Kapfhammer J, Rager G, Hornung J, Fasel JD (2001) Gross anatomy in the surgical curriculum in Switzerland: improved cadaver preservation, anatomical models, and course development. Anat Rec 265:254–256

    Article  CAS  Google Scholar 

  10. Hammer N, Löffler S, Bechmann I, Steinke H, Hädrich C, Feja C (2015) Comparison of modified Thiel embalming and ethanol-glycerin fixation in an anatomy environment: potentials and limitations of two complementary techniques. Anat Sci Educ 8(1):74–85

    Article  Google Scholar 

  11. Hassan N, Akhter R, Al-Aubaidy H, Flatau A (2017) Undergraduate dental students ’ perceptions of head and neck anatomy teaching in Australia. Eur J Dent Educ 22(3):1–6

    Google Scholar 

  12. Hauptmann M, Stewart P, Lubin J et al (2009) Mortality from lymphohematopoietic malignancies and brain cancer among embalmers exposed to formaldehyde. J Natl Cancer Inst 101(24):1696–1708

    Article  CAS  Google Scholar 

  13. Hayashi S, Homma H, Naito M et al (2014) Saturated salt solution method: a useful cadaver embalming for surgical skills training. Medicine (Baltimore) 93(27):1–10

    Article  Google Scholar 

  14. Hölzle F, Franz E, Lehmbrock J et al (2012) Thiel embalming technique : a valuable method for teaching oral surgery and implantology. Clin Implant Dent Relat Res 14(1):121–126

    Article  Google Scholar 

  15. Janczyk P, Weigner J, Luebke-Becker A, Richardson K, Plendl J (2011) A pilot study on ethanol-polyethylene glycol-formalin fixation of farm animal cadavers. Berl Munch Tierarztl Wochenschr 124(5–6):225–227

    PubMed  Google Scholar 

  16. Kennel L, Martin DMA, Shaw H, Wilkinson T (2017) Learning anatomy through Thiel- vs. formalin-embalmed cadavers : student perceptions of embalming methods and effect on functional anatomy knowledge. Anat Sci Educ 11(2):166–174

    Article  Google Scholar 

  17. Krishnamurthy S, Powers S (1995) The use of fabric softener in neurosurgical prosections. Neurosurgery 36(2):35–38

    Article  Google Scholar 

  18. Leung BC, Williams M, Horton C, DA Cosker T (2020) Modernising anatomy teaching: which resources do students rely on? J Med Educ Curric Dev 7:238212052095515

    Article  Google Scholar 

  19. Macdonald G, Macgregor D (1997) Procedures for embalming cadavers for the dissecting laboratory. Proc Soc Exp Biol Med 215(4):363–365

    Article  CAS  Google Scholar 

  20. McMenamin PG (2008) Body painting as a tool in clinical anatomy teaching. Anat Sci Educ 1:139–144

    Article  Google Scholar 

  21. Nisa L, Teiga P, Da Cunha G, Roy B, Gunaydin R, Kishore S (2017) Refashioned lamb tissue as an animal model for training complex techniques of laryngotracheal stenosis surgery. Eur Arch Otorhinolaryngol 274(12):4169–4181

    Article  Google Scholar 

  22. Olewnik Ł, Wysiadecki G, Polguj M, Podgórski M, Jezierski H, Topol M (2017) Anatomical variations of the palmaris longus muscle including its relation to the median nerve—a proposal for a new classification. BMC Musculoskelet Disord 18(1):539

    Article  Google Scholar 

  23. Singh R, Tubbs RS, Gupta K, Singh M, Jones DG (2015) Is the decline of human anatomy hazardous to medical education/profession ? A review. Surg Radiol Anat 37(10):1257–1265

    Article  Google Scholar 

  24. Stefan U, Michael B, Werner S (2010) Effects of three different preservation methods on the mechanical properties of human and bovine cortical bone. Bone 47(6):1048–1053

    Article  CAS  Google Scholar 

  25. Takahashi K, Morita Y, Ohshima S et al (2017) Creating an optimal 3D printed model for temporal bone dissection training. Ann Otol Rhinol Laryngol 126(7):1–7

    Article  Google Scholar 

  26. Thiel W (2002) Ergänzung für die Konservierung ganzer Leichen. Ann Anat 184:267–269

    Article  Google Scholar 

  27. Tschernig T, Schlaud M, Pabst R (2000) Emotional reactions of medical students to dissecting human bodies: a conceptual approach and its evaluation. Anat Rec 261(1):11–13

    Article  CAS  Google Scholar 

  28. Wolff K, Kesting M, Mücke T, Rau A, Hölzle F (2008) Thiel embalming technique: a valuable method for microvascular exercise and teaching of flap raising. Microsurgery 28:273–278

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank to body donors.

Funding

Caen anatomy laboratory, 2 rue Rochambelles, 14032 Caen, France.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, CHU de Caen, 14000, Caen, France

    Maxime Humbert, Emmanuel Micault, Sylvain Moreau, Vincent Patron, Jérôme Bois & Martin Hitier

  2. Department of Anatomy, Normandy University and Head and Neck Surgery, Caen University Hospital, avenue de la Côte-de-Nacre, 14000, Caen, France

    Maxime Humbert, Sylvain Moreau & Martin Hitier

  3. INSERM, U1075, COMETE, 1400, Caen, France

    Martin Hitier

Authors
  1. Maxime Humbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emmanuel Micault
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sylvain Moreau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vincent Patron
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jérôme Bois
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martin Hitier
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MH: project development, data collection, and manuscript writing. EM: manuscript writing. SM: project development. VP: data collection, manuscript writing. JB: project development, manuscript writing. MH: manuscript writing.

Corresponding author

Correspondence to Maxime Humbert.

Ethics declarations

Conflict of interest

No conflicts of interest.

Ethics approval

Not applicable. In 2019 and in December 2021, the Local Bioethics Commission had judged their advice was not applicable because we respect the consent given by the donor during his life.

Consent to participate

Each donor agrees to the use of their body for research or training purposes.

Consent for publication

Yes.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Humbert, M., Micault, E., Moreau, S. et al. The advantages of modified Thiel technique in head and neck surgical anatomy teaching. Surg Radiol Anat 44, 345–352 (2022). https://doi.org/10.1007/s00276-022-02895-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-022-02895-x

Keywords

Search

Navigation