Validation of a laryngeal dissection module for phonomicrosurgical training.

Emory University School of Medicine, Atlanta, Georgia, USA.
The Laryngoscope (Impact Factor: 1.98). 01/2009; 119(1):211-5. DOI: 10.1002/lary.20018
Source: PubMed

ABSTRACT To validate the use of a new phonomicrosurgical trainer called the laryngeal dissection module.
The module used synthetic, multilayered vocal folds inside a model larynx mounted on a platform, a microscope, and microsurgical instruments. The study was designed to test the module's ability to differentiate novices from expert surgeons and to test the module's ability to improve novice performance with training.
Expert (n = 5) and novice (n = 21) phonomicrosurgeons were instructed to remove a superficial ovoid lesion from a synthetic, right vocal fold. The task was assessed for total errors, total operating time, and injury to the superficial peripheral tissue, the lesion, and the deep tissue. Novice and expert performance was compared using an independent samples t test and a Fisher exact test. Subsequently, novices completed three practice trials and a posttraining trial, which was assessed for improvement compared with pretraining performance using a Wilcoxon signed rank test.
Experts completed the task with fewer total errors than novices (P < .001) and made fewer injuries to the oval lesion (P = .01). Novices improved performance with training, making fewer total errors in the posttraining trial (P = .003), reducing injury to the superficial peripheral tissue (P = .02), and taking less time to complete the task (P = .04).
The laryngeal dissection module was validated as a surgical trainer. It was able to differentiate expert versus novice performance, and it improved novice performance through training.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Multidisciplinary cooperation in health care requires a solid knowledge in the basic sciences for a common ground of communication. In speech pathology, these fundamentals improve the accuracy of descriptive diagnoses and support the development of new therapeutic techniques and strategies. The aim of this study is to briefly discuss the benefits of hands-on education on laryngeal anatomy and voice physiology in Brazilian graduate programs in speech pathology, as well as to describe a simple prototype that can be used as a useful educational tool for this purpose. The laryngeal anatomic support device was designed to provide a vertical frame to hold human or mammalian larynges with no preservation treatment, with the goal of allowing good visualization of the vocal folds during artificial phonation. The device was designed to provide the user the ability to manipulate the soft and cartilaginous structures of the larynx with near-natural biomechanical properties. The description of the project is detailed to allow the reproduction of this simple and inexpensive device. It may be used as an experimental feature in a variety of settings, from high-school programs to experimental research methods, and may suit a wide array of different educational models.
    Anatomical Sciences Education 03/2012; 5(4):241-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES/HYPOTHESIS: The primary objective of this study is to assess the adequacy of clinical and laboratory-based phonomicrosurgical training in otolaryngology residency programs using a self-report survey. The study aims to establish whether there is a need and desire for focused surgical training in phonomicrosurgery. STUDY DESIGN: Self-report Internet-based questionnaire. METHODS: An anonymous survey was sent to all current residents in otolaryngology training programs in the United States and Canada. For portions of the analysis, the residents were categorized into two groups-junior (R2 and R3) and senior (R4 and R5). RESULTS: One hundred ninety-one residents responded to the survey (USA: 166; Canada: 25), representing a 34.3% response rate. Approximately one-half of residents stated that their residency program includes a rotation during which the main emphasis is laryngology. Only 18.8% of residents were "very" satisfied with the phonomicrosurgery experience that their program offers and 21.6% of senior residents felt "very" comfortable performing a phonomicrosurgical removal of a vocal fold lesion. Whereas the vast majority of respondents found temporal bone laboratory training to be helpful, 82% had never performed laboratory training in phonomicrosurgery. The majority (87.4%) felt that their comfort level with phonomicrosurgery would increase if they had access to laboratory-based training. CONCLUSION: Our study suggests that there is a lack of emphasis on clinical and laboratory-based training in phonomicrosurgery and that there is a need and desire for focused surgical training in phonomicrosurgery. LEVEL OF EVIDENCE: Level 4.
    The Laryngoscope 04/2013; · 1.98 Impact Factor
  • The Laryngoscope 01/2014; · 1.98 Impact Factor