Acquisition of surgical skills for endonasal skull base surgery: a training program.

Full Abstract

INTRODUCTION:
Endonasal surgery represents a radical change in the practice of cranial base surgery and requires the acquisition of new knowledge and surgical skills. The optimal training program for surgeons has not been established.

METHODS:
We reviewed our experience with endonasal cranial base surgery from 1998 to 2006 to develop a training plan for the acquisition of surgical skills. It consists of a modular and incremental approach to endonasal skull base surgery that is designed to train surgeons to function as a team, learn endoscopic skull base anatomy, and develop fundamental endoscopic skills.

RESULTS:
Stages of training are established for the otolaryngologist-head and neck surgeon and the neurosurgeon that are based on level of technical difficulty, potential risk of vascular and neural injury, and unfamiliar endoscopic anatomy. Mastery of each level is recommended before attempting procedures at a higher level.

CONCLUSIONS:
Standardization of training and the adoption of a modular, incremental training program are expected to facilitate the training of endonasal surgeons in both surgical specialties. Adherence to such a program during the growth phase of endoscopic skull base surgery may decrease the risk of complications as the surgeon's knowledge and surgical expertise develop.

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Author information

Author/s: Snyderman, Carl (C); Kassam, Amin (A); Carrau, Ricardo (R); Mintz, Arlan (A); Gardner, Paul (P); Prevedello, Daniel M (DM);

Affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. snydermanch(-atsign-)upmc.edu

Journal and publication information

Publication Type: Journal Article

Journal: The Laryngoscope (Laryngoscope), published in United States. (Language: eng)

Reference: 2007-Apr; vol 117 (issue 4) : pp 699-705

Dates: Created 2007/04/12; Completed 2007/05/17;

PMID: 17334263, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Arteriovenous Malformations - radiography; surgery
Brain Stem - pathology; surgery
Cerebral Angiography
Clinical Competence
Decompression, Surgical - methods
Education - standards
Endoscopy - methods
Humans
Learning

Optic Nerve Injuries - etiology; surgery
Orbital Fractures - complications; surgery
Otorhinolaryngologic Surgical Procedures - education; methods
Paranasal Sinuses - radiography; surgery
Pituitary Neoplasms - pathology; surgery
Skull Base
Sphenoid Bone - blood supply; surgery
Spinal Cord Compression - pathology; surgery
Tomography, X-Ray Computed

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