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Journal of Otolaryngology - Head and Neck Surgery
   [9 followers]  Follow    
  This is an Open Access Journal Open Access journal
     ISSN (Print) 1916-0216
     Published by Biomed Central Ltd. Homepage  [268 journals]   [SJR: 0.564]   [H-I: 11]
  • Comparison of cadaveric and isomorphic virtual haptic simulation in
           temporal bone training

    • Authors: Dana Wong, Bertram Unger, Jay Kraut, Justyn Pisa, Charlotte Rhodes, Jordan Hochman
      First page: 31
      Abstract: Background: Virtual surgery may improve learning and provides an opportunity for pre-operative surgical rehearsal. We describe a novel haptic temporal bone simulator specifically developed for multicore processing and improved visual realism. A position locking algorithm for enhanced drill-bone interaction and haptic fidelity is further employed. The simulation construct is evaluated against cadaveric education. Methods: A voxel-based simulator was designed for multicore architecture employing Marching Cubes and Laplacian smoothing to perform real-time haptic and graphic rendering of virtual bone.Ten Otolaryngology trainees dissected a cadaveric temporal bone (CTB) followed by a virtual isomorphic haptic model (VM) based on derivative microCT data. Participants rated 1) physical characteristics, 2) specific anatomic constructs, 3) usefulness in skill development and 4) perceived educational value. The survey instrument employed a Likert scale (1-7). Results: Residents were equivocal about the physical properties of the VM, as cortical (3.2 ± 2.0) and trabecular (2.8 ± 1.6) bone drilling character was appraised as dissimilar to CTB. Overall similarity to cadaveric training was moderate (3.5 ± 1.8). Residents generally felt the VM was beneficial in skill development, rating it highest for translabyrinthine skull-base approaches (5.2 ± 1.3). The VM was considered an effective (5.4 ± 1.5) and accurate (5.7 ± 1.4) training tool which should be integrated into resident education (5.5 ± 1.4). The VM was thought to improve performance (5.3 ± 1.8) and confidence (5.3 ± 1.9) and was highly rated for anatomic learning (6.1 ± 1.9). Conclusion: Study participants found the VM to be a beneficial and effective platform for learning temporal bone anatomy and surgical techniques. They identify some concern with limited physical realism likely owing to the haptic device interface. This study is the first to compare isomorphic simulation in education. This significantly removes possible confounding features as the haptic simulation was based on derivative imaging.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:31
      PubDate: 2014-10-13T12:00:00Z
      DOI: 10.1186/s40463-014-0031-9
      Issue No: Vol. ${item.volume} (2014)
       
  • Metabolic tumour volume as a prognostic factor for oral cavity squamous
           cell carcinoma treated with primary surgery

    • Authors: Han Zhang, Hadi Seikaly, Jonathan Abele, Dean Jeffery, Jeffrey Harris, Daniel O¿Connell
      First page: 33
      Abstract: Background: Metabolic tumour volume (MTV) obtained from pre-treatment 18 F-fluorodeoxydeglucose positron emission tomography with computed tomography (PET-CT) has been validated as an independent predictive factor of outcomes in head and neck cancer patients (HNC) treated with primary chemoradiotherapy (CRT). However its role in patients treated with primary surgery has not yet been studied.ObjectiveTo evaluate the prognostic value of MTV in patients treated with primary surgery for oral cavity squamous cell carcinoma (OCSCC).MethodDemographic and survival data was obtained from patients diagnosed with OCSCC from 2008–2012 in Alberta, Canada. All patients included in the study had PET-CT scan before curative surgical resection. MTV and maximum standardized uptake value (SUVmax) value was delineated from pre-treatment PET-CT scans using Segami Oasis software (Columbus, OH). MTV and SUVmax were divided into intertertile thirds before statistical analysis to allow for in-group comparison of survival. Results: A total of 80 patients were analyzed using SPSS ver. 20.0 (SPSS Inc, Chicago, IL). Five-year overall, and disease-free survival using Kaplan-Meier curves were 70% and 73% respectively. When the combined SUVmax (tumour primary and locoregional metastasis) was evaluated, it failed to predict overall (HR = 1.0, p = 0.99) or disease-free survival (HR = 1.0, p = 0.227).Conversely an increase in MTV of 17.5 mL (difference between the highest and lowest MTV tertile) was associated with a 12.4 fold increase in risk of disease recurrence (p 
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:33
      PubDate: 2014-10-13T12:00:00Z
      DOI: 10.1186/s40463-014-0033-7
      Issue No: Vol. ${item.volume} (2014)
       
  • Eyelid and brow asymmetry in patients evaluated for upper lid
           blepharoplasty

    • Authors: Kristian Macdonald, Adrian Mendez, Robert Hart, S Taylor
      First page: 36
      Abstract: IntroductionIn evaluation for blepharoplasty, patients often desire improved cosmesis and/or correction of visual field deficits. However, patients are usually unaware of eyelid or brow asymmetry. Furthermore, the prevalence of eyelid and brow asymmetry is infrequently reported in the medical literature.PurposeTo determine the prevalence of brow and eyelid asymmetry in patients evaluated for upper lid blepharoplasty. Methods: One hundred consecutive patients evaluated for upper lid blepharoplasty were included in the study. Standard pre-operative photographs were taken of all patients using consistent background and photographic equipment. Two of the authors (KM & AM) independently recorded the margin pupil (MPD), central eyebrow (CED), nasal eyebrow (NED) and temporal eyebrow (TED) distances. To test the inter-observer reliability, the senior author (SMT) recorded the same measurements for 10% of randomly selected patients. We calculated 95% confidence intervals to compare symmetry between the right and left sides. Results: One hundred patients (94 female, mean age 57.7) were included in the study. The average MPD, CED, NED and TED distances were 0.55 mm (95% CI 0.45-0.65), 1.77 mm (95% CI 1.47-2.07), 1.34 mm (95% CI 1.14-1.54), and 1.78 mm (95% CI 1.50-2.06), respectively. Ninety-three percent of patients had at least one asymmetric measurement of greater than 1 mm. Seventy-five percent of patients studied had at least one measurement greater than 2 mm while 37 percent had at least one greater than 3 mm. Conclusion: Brow and eyelid asymmetry is common in patients being evaluated for upper lid blepharoplasty. The facial plastic surgeon should identify and document facial asymmetry pre-operatively, and discuss it with prospective blepharoplasty patients. This will improve informed consent and patient expectations.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:36
      PubDate: 2014-10-02T00:00:00Z
      DOI: 10.1186/s40463-014-0036-4
      Issue No: Vol. ${item.volume} (2014)
       
  • Gesture-controlled interactive three dimensional anatomy: a novel teaching
           tool in head and neck surgery

    • Authors: Jordan Hochman, Bertram Unger, Jay Kraut, Justyn Pisa, Sabine Hombach-Klonisch
      First page: 38
      Abstract: Background: There is a need for innovative anatomic teaching tools. This paper describes a three dimensional (3D) tool employing the Microsoft Kinect™. Using this instrument, 3D temporal bone anatomy can be manipulated with the use of hand gestures, in the absence of mouse or keyboard. Methods: CT Temporal bone data is imported into an image processing program and segmented. This information is then exported in polygonal mesh format to an in-house designed 3D graphics engine with an integrated Microsoft Kinect™. Motion in the virtual environment is controlled by tracking hand position relative to the user’s left shoulder. Results: The tool successfully tracked scene depth and user joint locations. This permitted gesture-based control over the entire 3D environment. Stereoscopy was deemed appropriate with significant object projection, while still maintaining the operator’s ability to resolve image details. Specific anatomical structures can be selected from within the larger virtual environment. These structures can be extracted and rotated at the discretion of the user. Voice command employing the Kinect’s™ intrinsic speech library was also implemented, but is easily confounded by environmental noise. Conclusion: There is a need for the development of virtual anatomy models to complement traditional education. Initial development is time intensive. Nonetheless, our novel gesture-controlled interactive 3D model of the temporal bone represents a promising interactive teaching tool utilizing a novel interface.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:38
      PubDate: 2014-10-07T00:00:00Z
      DOI: 10.1186/s40463-014-0038-2
      Issue No: Vol. ${item.volume} (2014)
       
  • `The air that we breathe¿: assessment of laser and electrosurgical
           dissection devices on operating theater air quality

    • Authors: Matthew Brace, Elizabeth Stevens, S Taylor, Sarah Butt, Zhennan Sun, Licai Hu, Megan Borden, Neeraj Khanna, James Kuchta, Jonathan Trites, Robert Hart, Mark Gibson
      First page: 39
      Abstract: ObjectivesTo measure changes in air quality during surgery. Methods: Operating room (OR) and hallway air quality was continuously monitored over a 3-month period. Rooftop monitoring was used to control for environmental changes and to account for the infiltration of outdoor air pollutants. Air quality measurements were correlated with operative times and electro-dissection equipment used. Results: OR air is cooler and drier compared to the adjacent hallway. Volatile organic compounds and other gases are below indoor air exposure limit guidelines. Lasers create greater 2.5 μm particulate matter (PM2.5) mass concentration, and greater fine and coarse particle number than cautery or cold tissue dissection. Cautery produces more ultrafine particles (UFP) than other dissection techniques. OR air has lower particle counts than outdoor environmental air by virtue of air conditioning HEPA filtration. Conclusion: Compared to the outside air, operating room air has lower particle counts. Lasers produce higher concentrations of PM2.5 mass and, fine and coarse particle number counts. Cautery produces higher concentrations of UFP number counts than other modalities and warrants consideration of the use of masks with ultrafine particle filtration capacity. Operating room air is consistently cooler with decreased humidity, which may cause airway irritation.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:39
      PubDate: 2014-10-13T12:00:00Z
      DOI: 10.1186/s40463-014-0039-1
      Issue No: Vol. ${item.volume} (2014)
       
  • The McGill simulator for endoscopic sinus surgery (MSESS): a validation
           study

    • Authors: Rickul Varshney, Saul Frenkiel, Lily Nguyen, Meredith Young, Rolando Del Maestro, Anthony Zeitouni, Elias Saad, W Funnell, Marc Tewfik, National Research Council Canada
      First page: 40
      Abstract: Background: Endoscopic sinus surgery (ESS) is a technically challenging procedure, associated with a significant risk of complications. Virtual reality simulation has demonstrated benefit in many disciplines as an important educational tool for surgical training. Within the field of rhinology, there is a lack of ESS simulators with appropriate validity evidence supporting their integration into residency education. The objectives of this study are to evaluate the acceptability, perceived realism and benefit of the McGill Simulator for Endoscopic Sinus Surgery (MSESS) among medical students, otolaryngology residents and faculty, and to present evidence supporting its ability to differentiate users based on their level of training through the performance metrics. Methods: 10 medical students, 10 junior residents, 10 senior residents and 3 expert sinus surgeons performed anterior ethmoidectomies, posterior ethmoidectomies and wide sphenoidotomies on the MSESS. Performance metrics related to quality (e.g. percentage of tissue removed), efficiency (e.g. time, path length, bimanual dexterity, etc.) and safety (e.g. contact with no-go zones, maximum applied force, etc.) were calculated. All users completed a post-simulation questionnaire related to realism, usefulness and perceived benefits of training on the MSESS. Results: The MSESS was found to be realistic and useful for training surgical skills with scores of 7.97 ± 0.29 and 8.57 ± 0.69, respectively on a 10-point rating scale. Most students and residents (29/30) believed that it should be incorporated into their curriculum. There were significant differences between novice surgeons (10 medical students and 10 junior residents) and senior surgeons (10 senior residents and 3 sinus surgeons) in performance metrics related to quality (p 
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:40
      PubDate: 2014-10-24T12:00:00Z
      DOI: 10.1186/s40463-014-0040-8
      Issue No: Vol. ${item.volume} (2014)
       
  • Evaluation of a German version of the tonsil and adenoid health status
           instrument

    • Authors: Teresa Steinbichler, Birte Bender, Elisabeth Blassnigg, Herbert Riechelmann
      First page: 41
      Abstract: Background: To create and validate a German version of the Tonsil and Adenoid Health Status Instrument (TAHSI) for evaluation of tonsillectomy outcome in adult patients with chronic or recurrent tonsillitis.Subjects and methods46 healthy volunteers were assessed twice in a 6'week interval with the TAHSI questionnaire. Their results were compared with 45 patients suffering from chronic tonsillitis before tonsillectomy and 6'months following surgery. For internal consistency, Cronbach's alpha was calculated; to identify normal score values, the optimum cutoff between healthy and diseased individuals was identified with receiver operating characteristic analysis; and responsiveness was assessed using Guyatt's Responsiveness Index (GRI). Results: Cronbach's alpha for all questions was 0.92. Test- retest intraclass correlation coefficient was 0.89 (95% confidence interval 0.80-0.94 p'
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:41
      PubDate: 2014-10-31T00:00:00Z
      DOI: 10.1186/s40463-014-0041-7
      Issue No: Vol. ${item.volume} (2014)
       
  • Erratum: Validation of 1-hour post-thyroidectomy parathyroid hormone level
           in predicting hypocalcemia

    • Authors: Trung Le, Paul Kerr, Donna Sutherland, Pascal Lambert
      First page: 42
      Abstract: No abstract
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:42
      PubDate: 2014-11-20T12:00:00Z
      DOI: 10.1186/s40463-014-0042-6
      Issue No: Vol. ${item.volume} (2014)
       
  • Erratum: Is fluorine-18 fluorodeoxyglucose positron emission tomography
           useful for the thyroid nodules with indeterminate fine needle aspiration
           biopsy' a meta-analysis of the literature

    • Authors: Ningjian Wang, Hualing Zhai, Yingli Lu
      First page: 43
      Abstract: No abstract
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:43
      PubDate: 2014-11-14T12:00:00Z
      DOI: 10.1186/s40463-014-0043-5
      Issue No: Vol. ${item.volume} (2014)
       
  • Surgical management of primary hyperparathyroidism in Canada

    • Authors: Blair Williams, Jonathan Trites, S Taylor, Martin Bullock, Robert Hart
      First page: 44
      Abstract: Primary hyperparathyroisim is a relatively common condition, for which the standard treatment is surgical excision of one or more of the parathyroid glands. Primary hyperparathyroidism can be due to a single adenoma or multiple gland hyperplasia. In recent decades localizing imaging has improved and there has been a shift away from multiple gland exploration toward a single gland excision. There are, however, no practice guidelines regarding an optimal approach to this condition. This study shows that there is a high degree of variation in practices across Canada and a large amount of uncertainty in the approach to primary hyperparathyroidism.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:44
      PubDate: 2014-11-01T00:00:00Z
      DOI: 10.1186/s40463-014-0044-4
      Issue No: Vol. ${item.volume} (2014)
       
 
 
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