An Integrated (Microscopic/Endoscopic) Dissection Ear Surgery Course

Traditionally, otologic surgical training consisted of microscopic cadaveric dissections. However, during the last decades the endoscope has significantly changed the surgical perspective in the otologic field. Thus, the modern ear and lateral skull base surgeon should master the entire spectrum of endoscopic and microscopic approaches, with the aim of tailoring the procedure and guaranteeing the best possible functional outcome. This work proposes a step-by-step guided and illustrated dissection course, including indications for the setup of the cadaver lab and the integration of the microscope and endoscope to enhance the use of both instruments. The alternation of the endoscope and microscope allows the novice to train the correct handling of the instruments in the surgical field under both optical views. This aspect is of utmost importance since it is not advisable to start off a technique without practicing the other one, as both are important and complementary in the modern otologic surgery setting.

Traditionally, otologic surgical training consisted of microscopic cadaveric dissection in order to develop both transcanal and transmastoid procedures. However, during the last decades the endoscope has significantly changed the surgical perspective. Nowadays, a consistent number of patients can benefit from minimally invasive endoscopic ear surgeries^1,2,3,4,5,6. Thus, the modern otologic surgeon should master the entire spectrum of both endoscopic and microscopic approac....

The following protocol follows the guidelines of our institution's human research ethics committee. The ethics committee approved the protocol.

1. Preparation of the specimen

1. Position a vacuum mattress on the dissection table and cover it with a sterile and resorbable blanket. Lay the anatomical specimen in a surgical position on the mattress with the head rotated to the contralateral side.
2. Cover the specimen with a blanket sparing the external ear an.......

We organized two dissection courses at the University Hospital of Modena, Italy during the COVID pandemic period, to enhance the learning process of the ENT residents. In fact, the activity of most of Otorhinolaryngology Departments significantly reduced during the above-mentioned period, impacting the academic activities for residents who were also involved in the intensive care units when needed¹⁹. A preliminary study of the CT scan images of every specimen was conducted. Thereafter, a total of .......

The proposed integrated microscopic and endoscopic dissection course manual is thought to maximize the capability to perform different otologic approaches on a single anatomic specimen. By alternating the two instruments, the trainee can perform a stepwise dissection that preserves the anatomical landmarks needed for the further surgical steps, enhancing the use of the microscope and the endoscope. In fact, the modern ear and lateral skull base surgeon should master the entire spectrum of these approaches to tailor the i.......

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