Role of residents' experience in cadaver dissection during the mucormycosis epidemic.

Abstract

Dear Editor, We read with great interest the recent review by Singh et al.[1] wherein they have provided guidelines for cadaver dissection training programs with emphasis on common oculoplastic surgical procedures. The commentary by Bhattacharjee and Venkatraman has summarized the advantages offered by the simulation of operating room environments and surgical approaches used during cadaver dissection.[2] In another commentary, Ali has discussed that integration of cadaver dissection may help in flattening of the steep learning curve that fellows in oculoplastic surgery often face.[3] In this context, we would like to add to the aforesaid authors’ comments by highlighting the importance of cadaver dissection in transcutaneous retrobulbar amphotericin B (TRAMB) injection, orbital debridement (OD), and orbital exenteration (OE). OE is considered a mutilating surgical procedure otherwise reserved for relentlessly progressive neoplastic disorders or extensive facial trauma with unfavorable eye involvement.[4] This rare procedure had been increasingly performed when there was a surge in cases of rhino-orbito-cerebral mucormycosis during the coronavirus disease (COVID) pandemic, especially in the past year.[5,6] First-hand experience of cadaver dissection was obtained by the first author (PN) as a postgraduate student in ophthalmology early on in his training as a first year junior resident in 2017. Areas of emphasis included anatomy of the extraocular muscles, orbital apex, paranasal sinuses, and skull base. When he became a senior resident, his cognitive and psychomotor skills gained from cadaver dissection were applied when he was called on to participate in multidisciplinary teams for the management of mucormycosis in COVID and post-COVID patients, performing TRAMB, OD, and OE procedures with confidence. We believe that cadaver dissection should be integrated as a part of the curriculum in all institutes imparting MD/MS/Diploma training in Ophthalmology. This could have been instrumental in supporting residents in performing OD and OE during the mucormycosis epidemic when shortage of manpower was evident across the country. We hope that medical education committees will make this a compulsory part of competency-based postgraduate education in ophthalmology in coming years. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.