Exploring the Ovine Anatomy: A Comprehensive Study of the Sheep's Head for Basic Training in Functional Endoscopic Sinus Surgery.

INTRODUCTION: Training young doctors in functional endoscopic sinus surgery requires dedicated centers for cadaveric dissections. However, ethical constraints have limited cadaver availability. Alternative anatomical models, like the ovine model, are being explored for effective training, offering easier procurement and resembling human head anatomy. This study aims to demonstrate that the ovine model is useful for endoscopic sinus surgery training, highlighting the anatomical, imaging, histological, and endoscopic aspects. METHODS: Three adult Native Romanian Turcana sheep's heads were obtained fresh and frozen from a local slaughterhouse. Using a helical scanner, CT scans were performed, and anatomical structures in the images were carefully labeled. Two heads frozen at -20°C were serially sectioned, with one cut sagittally, dividing the skull, and the other head sectioned transversely with 2.5 cm thickness. Sectional photographs were taken. The third sheep's head underwent endoscopy, and samples from the septal mucosa and inferior turbinate were collected for histopathology examination. The specimens were processed, stained, and examined by a pathologist. RESULTS: The study successfully highlighted the gross anatomy, CT imaging aspects, histological characteristics of sheep nasal mucosa, and endoscopic features, demonstrating the similarity of the sheep's head to human anatomy, making it a suitable anatomical training model for endoscopic sinus surgery. CONCLUSION: The use of sheep's heads as substitutes for human cadaver heads in nasal surgery simulations presents a promising avenue for research. The anatomical similarities and cost-effectiveness make sheep's heads a practical choice for certain aspects of nasal surgery investigation. However, researchers must approach this methodology with a thorough understanding of its limitations, including anatomical and biomechanical differences. Validation studies comparing outcomes with human models are crucial to establishing reliability. The sheep's head anatomical model provides a highly valuable experience for young trainees in endoscopic sinus surgery. Despite encountering several challenges, including some anatomical differences, considering its advantageous attributes renders it an ideal material for mimicking surgical procedures in functional endoscopic sinus surgery.

Sheep's Head as an Anatomic Model for Basic Training in Endoscopic Sinus Surgery.

Background and Objectives: This study aims to establish the sheep head as a viable anatomical model for training in functional endoscopic sinus surgery through comprehensive anatomical examination and training-based assessment of participants' satisfaction. Materials and Methods: Participants were divided into three groups according to their prior experience in endoscopic sinus surgery; in total, 24 participants were included. Each participant in the study was assigned to perform the designated procedures on a single sheep's head. Following the completion of the procedures, each participant was provided with a 14-item comprehensive satisfaction questionnaire with a scale attributed from 1 to 5. The normality of distribution was checked by applying the Shapiro-Wilk Test. The Kruskal-Wallis test was applied to compare study group sentiment of agreement towards individual procedures. Results: No significant differences were noted between the answers of the different groups. For the resident group, the average satisfaction score was 4.09 ± 0.54; junior specialist group 4.00 ± 0.55; for the senior specialist group overall satisfaction average score was 4.2 ± 0.77. Conclusions: The sheep's head can be successfully used for learning and practicing manual skills and the use of instruments specific to functional endoscopic sinus surgery. Moreover, the sheep head model can be used for training in other diagnostic or surgical procedures in the field of otorhinolaryngology, such as endoscopy of the salivary glands, open laryngotracheal surgery, or in otologic surgery, but also in other different surgical fields such as neurosurgery, ophthalmology or plastic surgery. Despite the differences between the ovine model and human anatomy, it provides a resourceful and cost-effective model for beginners in endoscopic nasal surgery.

Vertigo Associated with Otosclerosis and Stapes Surgery-A Narrative Review.

Otosclerosis is a pathological condition affecting the temporal bone, and is characterized by remodelling of the labyrinthine bone tissue through a dynamic process of osteolysis and osteogenesis. This condition progressively leads to hearing loss, tinnitus, and vertigo. Stapedotomy, a surgical procedure involving the removal of the stapes superstructure and its replacement with a prosthesis, is the treatment of choice to improve hearing in individuals with otosclerosis. However, vestibular dysfunction is a significant complication associated with this procedure, which can occur intraoperatively or postoperatively, ranging from the immediate postoperative period to weeks, months, or even years after surgery. This paper aims to provide a comprehensive review of the most important causes of vertigo associated with otosclerosis and stapes surgery with the goal of minimizing the incidence of this complication. Understanding the underlying factors contributing to vertigo in this context is crucial for the prevention and effective management of vertigo in patients undergoing stapedotomy.