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World J Methodol. Sep 26, 2015; 5(3): 144-148
Published online Sep 26, 2015. doi: 10.5662/wjm.v5.i3.144
Lamb’s head: The model for novice education in endoscopic sinus surgery
Neven Skitarelić, Ranko Mladina
Neven Skitarelić, Department of Otorhinolaryngology Head and Neck Surgery, General Hospital Zadar, Department of Health Studies, University of Zadar, 23000 Zadar, Croatia
Ranko Mladina, Department for Otorhinolaryngology Head and Neck Surgery, Clinical Hospital Centre Zagreb, Faculty of Medicine, University of Zagreb, 1000 Zagreb, Croatia
Author contributions: Skitarelić N and Mladina R made substantial contributions with respect to the conception and design, acquisition of data and analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and approving the final version to be published.
Conflict-of-interest statement: None to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Neven Skitarelić, MD, PhD, Professor, Department of Otorhinolaryngology Head and Neck surgery, General Hospital Zadar, Department of Health Studies, University of Zadar, Put Murvice 33, 23000 Zadar, Croatia. neven.skitarelic@zd.t-com.hr
Telephone: +385-23-505178 Fax: +385-23-312724
Received: April 22, 2015
Peer-review started: May 11, 2015
First decision: June 9, 2015
Revised: August 11, 2015
Accepted: September 1, 2015
Article in press: September 2, 2015
Published online: September 26, 2015
Processing time: 146 Days and 21.1 Hours
Abstract

Structured training in endonasal endoscopic sinus surgery (EESS) and skull base surgery is essential considering serious potential complications. We have developed a detailed concept on training these surgical skills on the lamb’s head. This simple and extremely cheap model offers the possibility of training even more demanding and advanced procedures in human endonasal endoscopic surgery such as: frontal sinus surgery, orbital decompression, cerebrospinal fluid-leak repair followed also by the naso-septal flap, etc. Unfortunately, the sphenoid sinus surgery cannot be practiced since quadrupeds do not have this sinus. Still, despite this anatomical limitation, it seems that the lamb’s head can be very useful even for the surgeons already practicing EESS, but in a limited edition because of a lack of the experience and dexterity. Only after gaining the essential surgical skills of this demanding field it makes sense to go for the expensive trainings on the human cadaveric model.

Keywords: Endonasal; Endoscopic; Sinus surgery; Skull base; Learning; Training; Lamb’s head

Core tip: Structured training in endonasal endoscopic sinus surgery (EESS) and skull base surgery is essential considering serious potential complications. We have developed a detailed concept on training these surgical skills on the lamb’s head. This simple and extremely cheap model offers the possibility of training even more demanding and advanced procedures in human EESS such as: frontal sinus surgery, orbital decompression, cerebrospinal fluid-leak repair followed also by the naso-septal flap, etc. Unfortunately, the sphenoid sinus surgery cannot be practiced since quadrupeds do not have this sinus. Still, despite this morphological limitation, it seems that the lamb’s head can be very useful model.