RESUMO
OBJECTIVE: Myringotomy and tympanostomy tube insertion (MT) is a common surgical procedure. Although surgical simulation has proven to be an effective training tool, an anatomically sound simulation model for MT is lacking. We developed such a model and assessed its impact on the operating room performance of senior medical students. STUDY DESIGN: Prospective randomized trial. METHODS: A randomized single-blind controlled study of simulation training with the MT model versus no simulation training. Each participant was randomized to either the simulation model group or control group, after performing an initial MT procedure. Within two weeks of the first procedure, the students performed a second MT. All procedures were performed on real patients and rated with a Global Rating Scale by two attending otolaryngologists. Time to complete the MT was also recorded. RESULTS: Twenty-four senior medical students were enrolled. Control and intervention groups did not differ at baseline on their Global Rating Scale score or time to complete the MT procedure. Following simulation training, the study group received significantly higher scores (P=.005) and performed the MT procedure in significantly less time (P=.034). The control group did not improve their performance scores (P>.05) or the time to complete the procedure (P>.05). CONCLUSION: Our surgical simulation model shows promise for being a valuable teaching tool for MT for senior medical students. Such anatomically appropriate physical simulators may benefit teaching of junior trainees.
Assuntos
Competência Clínica , Ventilação da Orelha Média/educação , Modelos Anatômicos , Miringoplastia/educação , Adulto , Canadá , Educação de Graduação em Medicina , Humanos , Ventilação da Orelha Média/métodos , Variações Dependentes do Observador , Otolaringologia/educação , Método Simples-Cego , Estudantes de Medicina , Adulto JovemAssuntos
Técnicas Cosméticas , Contaminação de Medicamentos , Ácido Hialurônico/análogos & derivados , Agulhas/microbiologia , Contagem de Colônia Microbiana , Relação Dose-Resposta a Droga , Contaminação de Equipamentos , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Subcutâneas , Lábio/efeitos dos fármacos , Probabilidade , Medição de Risco , Envelhecimento da PeleRESUMO
OBJECTIVE: The goals of this study were to determine whether the toxicity of cisplatin, a chemotherapeutic alkylating agent, could be reduced by the use of amifostine and to determine whether amifostine alone could cause ototoxicity. STUDY DESIGN: Prospective, animal study. METHODS: Auditory brainstem response click threshold, latencies, and blood work were used to measure ototoxicity, nephrotoxicity, and myelotoxicity before and 4 weeks after treatment. Groups of guinea pigs received either cisplatin alone (30 mg/kg), amifostine (1000 mg/kg), cisplatin plus amifostine (1000 mg/kg), or no agent. RESULTS: Amifostine reduced the hearing loss caused by cisplatin for many animals. Amifostine partially protected against cisplatin-induced ototoxicity and renal toxicity. We did not find evidence for myelotoxicity owing to cisplatin in this sample. CONCLUSION: Amifostine may have a role in reducing toxicity or permitting larger doses of cisplatin to be given, but toxicity can still be significant even with protection.
