A Novel Adenoidectomy Training System.

Abstract

Young residents find mirror-guided adenoidectomy difficult. Inexperienced trainees must learn to focus a headlight beam, work upside-down and backward in a small space and thoroughly ablate adenoid tissue-all new skills. We present an adenoidectomy training system that is low-cost, easy to construct, and is focused on these basic adenoidectomy skills. Prospective experimental study. This training suite includes three stations each targeting a different skill. The first employs a mannequin head with exposed nasopharynx. It trains the student to coordinate a headlight and mirror while touching a series of targets with a curved probe. At the second station participants electrodessicate (or microdebride) an anchored piece of veal thymus. The third station combines both sets of skills as participants ablate thymus in a simulated nasopharynx (30 mm rectangular aluminum tube) constrained within a Crow-Davis retractor, using a headlight, mirror, and suction electrosurgical electrode (or microdebrider). To evaluate the training system's efficacy, we assessed the performance of 10 surgically naïve medical student volunteers before and after 15 minutes of practice using a validated rating scale used for adenoidectomy. There was significant improvement in adenoidectomy skill scores after practicing. Overall scores were higher, time taken to touch a series of targets with a headlight and mirror was less and amount of tissue ablated at the final station was greater (P < .05). This novel adenoidectomy training system is inexpensive and easy to build. Practice with the model resulted in statistically significant improvement in adenoidectomy skill scores for inexperienced student surgeons. 3 Laryngoscope, 132:2056-2062, 2022.