Objective Assessment of a Bimanual Technique for Access to the Nasal Cavity and Anterior Skull Base

Abstract

Introduction: Access to the nasal cavity and anterior skull base is often achieved using an endoscopic technique. The current “orthodox” technique preferred by many otolaryngologists is one-handed: the surgeon holds the endoscope in one hand and uses an instrument in the other hand. This technique does have its limitations, particularly when bleeding may cause obstruction of the operative view. Authors have described the use of two surgeons or a camera holder to enable bimanual surgery in the nasal cavity and anterior skull base. A novel method of measuring surgical efficiency has been developed by the Imperial College London, using real-time dexterity motion analysis to compare the two operative methods with statistical significance. The Imperial College Surgical Assessment Device (ICSAD) had never previously been used in any skull base or otolaryngology procedure.