Acquisition of endoscopic nasal surgery skills with a lamb's head model

Abstract Objectives: To evaluate the acquisition of surgical skills by otolaryngology residents and established the minimum number of dissections of a lamb's model to be performed before practicing on human patients. Methods: Nineteen second-year otolaryngology residents performed ten dissections each, five on each nasal cavity, always practicing the same three surgical procedures on the lamb model. Each student's training lasted 2-months, and the entire training intervention lasted 4-years, over four generations of residents. All dissections were recorded and were selected at random for examination by two independent otolaryngology surgeons, who were otherwise not involved in the research. Assessment of the 190 dissections used an instrument validated for surgical training of medical residents. Results: To a 1% significance level, statistical analysis revealed increased performance and satisfactory results were observed after the sixth dissection. Furthermore, after the eighth dissection, skill acquisition was relevant and sustained. Conclusion: Training in endoscopic nasal surgery on a lamb's head model improves surgical skills and handling of surgical instruments. Our results showed the relevance of the lamb model for training in otolaryngology surgery, impacting on patient safety. Level of evidence: 2.

Ten Years Follow Up of Patients with Tinnitus and Normal Hearing.

OBJECTIVE: To describe the natural history of tinnitus in normal hearing patients. STUDY DESIGN: This is a prospective longitudinal observational study. SETTING: Tertiary University Hospital. METHODS: In 2009 we studied 68 patients with significant tinnitus and normal hearing (Study Group-SG) compared to 46 patients with normal hearing and no tinnitus (Control Group-CG). We have been able to contact and recruit 24 patients from SG (35.3 %) and ten patients from CG) (21.74%) in 2019. Both groups were submitted to conventional audiometry, Distortion Product Otoacoustic Emissions (DPOAE), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) and Beck`S Depression and Anxiety Scales (BDS, BAS). These measures were compared with the same ones performed ten years ago in the same groups of patients. The software SPSS for windows version 21 was used. P values <0.05 were considered significant. Student t test was used to compare SG and CG results in 2019 and to compare 2009 and 2019 outcomes.. RESULTS: Hearing loss, especially in the higher frequencies, were significantly worse in SG compared to GC in 2019. DPOAE were significantly worse in SG and CG in 2019 however CG had more abnormal results than SG. These results suggest that outer hair cells lesions are not the only determinant for tinnitus and hearing loss development. CONCLUSIONS: These results suggest that outer hair cells lesions are not the only determinant for tinnitus and hearing loss development.

Acquisition of endoscopic nasal surgery skills with a lamb's head model.

OBJECTIVES: To evaluate the acquisition of surgical skills by otolaryngology residents and established the minimum number of dissections of a lamb's model to be performed before practicing on human patients. METHODS: Nineteen second-year otolaryngology residents performed ten dissections each, five on each nasal cavity, always practicing the same three surgical procedures on the lamb model. Each student's training lasted 2-months, and the entire training intervention lasted 4-years, over four generations of residents. All dissections were recorded and were selected at random for examination by two independent otolaryngology surgeons, who were otherwise not involved in the research. Assessment of the 190 dissections used an instrument validated for surgical training of medical residents. RESULTS: To a 1% significance level, statistical analysis revealed increased performance and satisfactory results were observed after the sixth dissection. Furthermore, after the eighth dissection, skill acquisition was relevant and sustained. CONCLUSION: Training in endoscopic nasal surgery on a lamb's head model improves surgical skills and handling of surgical instruments. Our results showed the relevance of the lamb model for training in otolaryngology surgery, impacting on patient safety.

Group therapy for patients with tinnitus at the University of Brasilia Medical School.

UNLABELLED: Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. MATERIALS AND METHODS: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI) and the Hospital Depression and Anxiety Scale (HAD), before and after the treatment. We held six structured sessions according to the principles of tinnitus retraining therapy associated with behavioral cognitive techniques. RESULTS: 27 patients started and 19 finished the treatment (8 were taken off). 47.4% men, mean age of 47.6. THI results before and after treatment were respectively: functional: 29 and 14, emotional 24 and 10 and catastrophic 12 and 5 and the HAD scale: anxiety 2 and 9 and depression 10 and 6. CONCLUSION: The treatment described is effective in improving tinnitus symptoms.

Sucesso no tratamento do zumbido com terapia em grupo / Group therapy for patients with tinnitus at the University of Brasilia Medical School

Embora os tratamentos em grupos para o zumbido sejam uma área bem documentada na literatura internacional, até onde sabemos nunca foram realizados no Brasil. Este estudo apresenta uma experiência bem-sucedida de um tratamento em grupo para zumbido baseado na terapia de retreinamento do zumbido aliada com as técnicas cognitivo-comportamentais. O objetivo deste estudo é avaliar pacientes com zumbido antes e depois do tratamento em grupo estruturado baseado da terapia de retreinamento do zumbido e na terapia cognitivo comportamental. Material e método: Estudo coorte prospectivo: 27 sujeitos aplicaram-se para a pesquisa. Responderam ao inventário do Handicap do Zumbido (THI) e à escala da Ansiedade e Depressão Hospitalar (HAD),antes e depois do tratamento. Foram realizadas 6 sessões estruturadas segundo os princípios da terapia de retreinamento do zumbido associada com técnicas cognitivo-comportamentais. Resultados: 27 pacientes iniciaram e 19 terminaram o tratamento (8 excluídos). 47,4 por cento homens, média das idades 47.6. O resultado do THI antes e depois do tratamento foi respectivamente: funcionais, 29 e 14; emocional, 24 e 10; e catastrófico, 12 e 5; a escala HAD: ansiedade, 12 e 9 e depressão, 10 e 6. Conclusão: O tratamento descrito é efetivo na melhora do zumbido.

Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. Materials and methods: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI) and the Hospital Depression and Anxiety Scale (HAD), before and after the treatment. We held six structured sessions according to the principles of tinnitus retraining therapy associated with behavioral cognitive techniques. Results: 27 patients started and 19 finished the treatment (8 were taken off). 47.4 percent men, mean age of 47.6. THI results before and after treatment were respectively: functional: 29 and 14, emotional 24 and 10 and catastrophic 12 and 5 and the HAD scale: anxiety 2 and 9 and depression 10 and 6. Conclusion: The treatment described is effective in improving tinnitus symptoms.