Training and Surgical Simulation in Skull Base Surgery: a Systematic Review

Abstract

Simulation devices and training protocols are being developed across all surgical fields to teach trainees and optimize learning to improve performance when operating on live patients. This article presents a review of the available literature specific to training and simulation in endoscopic endonasal skull base surgery. A systematic review of the literature was performed on simulation and training in endoscopic endonasal skull base surgery. The level of evidence, simulation fidelity, and the level of learning effectiveness (Kirkpatrick scale) were assessed for each available study. Thirty studies were included in the review. One study describes a validated training program for training in skull base surgery. The other included studies of present simulation training using cadaveric models, 3D-printed models, virtual reality trainers, or a combination of these modalities. The overall level of learning effectiveness and level of evidence from these studies are low. The level of evidence and fidelity of simulators in endoscopic skull base surgery has improved over the years, but high-quality studies are needed to demonstrate the effectiveness of these learning methods on surgical training.