ENTtoday

Literature Review: A Roundup of Important Recent Studies

Simulator Training Can Accelerate Resident Learning

Does use of an endoscopic sinus surgery simulator improve performance of surgical trainees?

Background: Surgical training has traditionally been based upon the tenets of “watch one, do one, teach one,” in which residents learn through participation in the management of patients. This study was undertaken to determine whether use of a simulator could accelerate learning.

Study design: A group of 14 otolaryngology residents and six attending surgeons participated. Trainees performing a limited number of sinus surgery procedures in patients were compared with those using the simulator. The surgical tasks that were completed were videotaped. The control group assisted in two additional endoscopic sinus surgery cases, while the experimental group worked with a simulator.

Setting: This research was undertaken through collaboration of two university-based residency programs in New York City.

Synopsis: The authors report that simulator-trained residents can at least match the surgical performance of residents trained traditionally in the operating room. Simulator training can propel a novice resident forward in his technical skills. Further, the authors report that significant disparity existed among the participating residents regarding the number of trials needed to obtain proficiency.

Bottom line: The study demonstrates that simulator training can contribute to and potentially accelerate resident skills. These findings will impact the future of surgical training.

Reference: Fried MP, Kaye RJ, Gibber MJ, et al. Criterion-based (proficiency) training to improve surgical performance. Arch Otolaryngol Head Neck Surg. 2012;138:1024-1029.

—Reviewed by Jonas Johnson, MD

FDG-PET Indicative of Hypoxic Status

Does assessment of maximum standardized uptake values (SUVmax) predict outcome in patients with T2 tongue cancer?

Background: Two-[(18)F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) is widely employed for pre-clinical staging in head and neck oncology. Prior studies have suggested that high-level FDG uptake is associated with poor prognosis. This study was undertaken to determine whether FDG-PET could be used as a marker predicting tumor hypoxia.

Study design: Patients treated for T2 oral tongue cancer who had undergone pre-treatment FDG-PET were enrolled. All patients were treated with primary surgery. Adjuvant radiation was used as needed. Immunohistochemical evaluation of paraffin-embedded specimens was undertaken for markers of hypoxia including HIF-1α, CA-9 and GLUT-1.