ENT Residents Benefit from a Structured Operation Planning Approach in the Training of Functional Endoscopic Sinus Surgery

Abstract

Background and Objectives: Preoperative planning utilizing computed tomographies (CT) is of utmost importance in functional endoscopic sinus surgery (FESS). Frequently, no uniform documentation and planning structures are available to residents in training. Consequently, overall completeness and quality of operation planning may vary greatly. The objective of the present study was to evaluate the impact of a structured operation planning (SOP) approach on the report quality and user convenience during a 4-day sinus surgery course. Materials and Methods: Fifteen participant were requested to plan a FESS procedure based on a CT scan of the paranasal sinuses that exhibited common pathological features, in a conventional manner, using a free text. Afterwards, the participants reevaluated the same scans by means of a specifically designed structured reporting template. Two experienced ENT surgeons assessed the collected conventional operation planning (COP) and SOP methods independently with regard to time requirements, overall quality, and legibility. User convenience data were collected by utilizing visual analogue scales. Results: A significantly greater time expenditure was associated with SOPs (183 s vs. 297 s, p = 0.0003). Yet, legibility (100% vs. 72%, p < 0.0001) and overall completeness (61.3% vs. 22.7%, p < 0.0001) of SOPs was significantly superior to COPs. Additionally, description of highly relevant variants in anatomy and pathologies were outlined in greater detail. User convenience data delineated a significant preference for SOPs (VAS 7.9 vs. 6.9, p = 0.0185). Conclusions: CT-based planning of FESS procedures by residents in training using a structured approach is more time-consuming while producing a superior report quality in terms of detailedness and readability. Consequently, SOP can be considered as a valuable tool in the process of preoperative evaluations, especially within residency.

Development of an optimized preoperative computed tomography imaging checklist for endoscopic sinus surgery utilizing a systematic review of the literature and the modified Delphi method

“…Results from the systematic review of literature are summarized in Figure 2. After review of six databases, 86 unique records were identified and 12 were ultimately selected for inclusion in the initial checklist [6][7][8][9][15][16][17][18][19][20][21][22] (Table 1). Of note, none of the selected reports had evidence of content validity for the items included in their respective checklists.…”

Residency Education Practices in Endoscopic Skull Base Surgery

“…There is a shortage of literature on skull base residency education, but current research suggests widespread model-based training or the use of simulation and cadavers. 1 Due partly to the coronavirus disease 2019 (COVID-19) pandemic, there has been increased interest in the more creative methods of training residents in skull base surgical techniques. The COVID-19 pandemic exacerbated issues for many surgical specialty residents who found their training lacking structure or guidance.…”

Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability

“…Several studies were able to demonstrate that structured reporting (SR) improves the report quality and time efficiency of HNS by standardizing its content for various educational levels 8 13 14 15 . Furthermore, SR can be considered a valuable tool to improve preoperative evaluation of CT scans in the context of functional endoscopic sinus surgery, both by radiologists and otolaryngologists 16 17 . Due to the standardized structure, SR is associated with a decreased likelihood of missing or misinterpreting key structures, potentially resulting in misdiagnosis.…”