Avtor/Urednik     Manestar, Darko; Lajtman, Zoran; Velepič, Mitja
Naslov     Izkušnje pri delu na modelu nosu in paranazalnih votlin za vajo FESS-a
Prevedeni naslov     Our experience with use of a model of the nose and paranasal cavities for fess training
Tip     članek
Vir     Med Razgl
Vol. in št.     Letnik 43, št. Suppl 3
Leto izdaje     2004
Obseg     str. 183-5
Jezik     slo
Abstrakt     In spite of standardisation of the functional endoscopic sinus surgery (FESS) procedure, this type of surgery may be risky in novice hands because the anatomy of paranasal sinuses is extremely complex. On the other hand, endonasal sinus surgery may cause severe complications even when performed by a skilled surgeon. This is easily explained by the close vicinity of many functionally important structures to the operative site. Surrounding structures at risk include the brain, orbital contents, nasolacrimal system, carotid artery, cavernous sinuses and optic nerves. As with all surgical disciplines, the relevant anatomy must be understood before an intervention can be contemplated. However, cadaver supply is often limited. The associated risks of novice surgeons performing FESS on living patients are self-evident. The complex surgical anatomy and advanced techniques required for FESS lead to the need for a model to help train novice sinus surgeons. A new anatomic model of the paranasal sinuses was developed by the Anatomic Department of Zurich. In a pilot study, the practicability of this model was evaluated by experienced surgeons from Switzerland, England and Croatia, with a special focus on its possible use in training and teaching. This model was regarded to be very close to a real human specimen. Future developments should focus on tissue quality and better pneumatisation of all ethmoidal cells. Then this new artificial anatomic model has the potential to become a realistic and easily available teaching tool in education for sinus surgery.
Izvleček     Kljub standardizaciji postopka uporabne endoskopske kirurgije sinusov (FESS) je lahko takšna kirurgija tvegana v rokah začetnika, ker je anatomija paranazalnih sinusov zelo zapletena. Pri endoskopski kirurgiji sinusov lahko pride do zapletov celo, če operira izkušen kirurg. To lahko pojasnimo z neposredno bližino uporabno pomembnih struktur v operiranem področju. Pred posegom moramo preučiti anatomske odnose s pomočjo CT-ja paranazalnih sinusov, ker so možgani, orbita, solzevodi in vidni živec, tj. okoliške strukture v možni nevarnosti. Zapletena kirurška anatomija in napredne tehnike, ki so potrebne za FESS, zahtevajo model, ki bi bil v pomoč začetniku v sinusni kirurgiji. Nov anatomski model paranazalnih sinusov je bil razvit na Anatomskem inštitutu v Zurichu po ideji prvega avtorja. Uporabnost modela so ocenili izkušeni endoskopski kirurgi Švice, Anglije in Hrvaške. Ocenjuje se uporabnost pri vaji oziroma učenju kirurških veščin. Ta model se odlikuje z veliko podobnostjo s pravim človekom, kar so zaključili tudi na kongresih, kjer je bil prikazan, ter na razstavi inovacij EUREKA v Bruslju 2002 (zlata medalja). Avtorji poudarjajo, da je treba prihodnji razvoj usmeriti v kakovost tkiv in boljšo prezračenost etmoidnih sinusov, da bo model postal realističen in lahko dostopen učni inštrument pri pouku operacije sinusov.
Deskriptorji     PARANASAL SINUSES
SURGERY, ENDOSCOPIC
MODELS, ANATOMIC