Abstract
Purpose
To assess and compare the feasibility of using ovine and porcine models as surgical simulation training tools for otolaryngology trainees performing parotid surgery and facial nerve dissection.
Methods
Trainees performed parotid surgery (total parotidectomy, retrograde facial nerve dissection and facial nerve grafting) on an ovine and porcine model. Participants completed a 22-item, five-point Likert scale questionnaire on each model, assessing three validation domains; face validity (FV), global content validity (GCV) and task-specific content validity (TSCV). Data were prospectively collected and analysed using descriptive and non-parametric statistics.
Results
Twelve trainees completed two consecutive parotidectomies and facial nerve dissections on an ovine and porcine model. Twenty-four dissections were completed. Validation questionnaires were completed for each model by all trainees. The ovine model achieved median validation threshold scores (≥ 4/5) for all aspects of FV, GCV and TSCV. The porcine model did not achieve validation threshold scores for any aspect of the validation questionnaire. Comparison of the ovine and porcine model demonstrated that the ovine model was statistically superior to the porcine model across most validation criteria excluding realistic appearance of skin, identification and ligation of the trans-oral parotid duct and facial nerve grafting.
Conclusion
Adequate experience with facial nerve dissection during parotid surgery is vital to ensuring good outcomes and avoiding complications. This study is the first to compare validity of two animal models for simulation training in parotid surgery and facial nerve dissection. We have validated the ovine model as a useful tool for simulation training and advocate its incorporation into otolaryngology training programmes.
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Acknowledgements
The authors would like to thank Dr Hannah Phylip for providing anatomical diagrams for the paper.
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All authors contributed to the study creation, with the following contributions listed: Conceptualisation: TDM, SO. Design: TDM, SO. Delivery of study: TDM, SO, Clement, Kunanandam. Analysis: TDM, SO, MM, Clement, Kunanandam. Manuscript preparation: TDM, SO, MM. Reviewing and editing: Clement, Kunanandam. Funding acquisition: Kunanandam.
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All the animal models were obtained from a licensed medical meat supplier compliant with all UK and EU regulations. The use of each model was performed within the criteria of STROBE guidelines and Animal Research: reporting In Vivo Experiments guidelines.
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Departmental approval was granted for use of animal tissue. No animal was specifically slaughtered for the purpose of this study.
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Milner, T.D., Okhovat, S., McGuigan, M. et al. Feasibility of ovine and porcine models for simulation training in parotid surgery and facial nerve dissection. Eur Arch Otorhinolaryngol 277, 1167–1175 (2020). https://doi.org/10.1007/s00405-020-05782-6
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DOI: https://doi.org/10.1007/s00405-020-05782-6