目的:尽管耳内镜手术(EES)越来越受欢迎,缺乏证据来指导学员将EES引入实践。这篇综述旨在评估EES的培训,包括最佳的入门程序,训练方法,学习曲线,以及EES能力的确定。此外,这项审查旨在确定这些主题中需要进一步澄清的任何领域。
方法:对Pubmed,Embase和Cochrane图书馆于2022年6月进行。原创文章,系统评价,和关于EES培训的荟萃分析报告,引入实践,学习曲线,包括能力评估。
方法:根据JoannaBriggs研究所指南进行了范围审查,并根据PRISMA范围审查指南进行了报告。对按主题分组的结果进行了定性评估。
结果:28项研究符合纳入标准,在质量评估上有24个评级为“一般”或“良好”。手术模拟是11项研究中使用的最常见的训练方法。建议最多的入门手术是鼓室成形术,这在五项研究中得到了提倡。用于测量EES学习曲线的结果和方法存在异质性,过度依赖手术时间.目前,在EES程序中没有关于能力的可靠定义。
结论:手术模拟似乎是EES的有益训练方法。然而,明显缺乏客观数据来描述EES的最佳入门程序或能力评估。喉镜,2023年。
Despite the increasing popularity of Endoscopic Ear Surgery (EES), there is a lack of evidence to guide trainees as they introduce EES into practice. This
review aims to evaluate training in EES including the optimal introductory procedures, methods of training, the learning curve, and the determination of competency in EES. In addition, this
review seeks to identify any areas falling within these themes requiring further clarification.
A database search of Pubmed, Embase and the Cochrane Library was conducted in June 2022. Original articles, systematic reviews, and meta-analyses reporting on training in EES, introduction into practice, learning curves, and competency assessment were included.
A scoping
review was carried out in accordance with the Joanna Briggs Institute guidelines and reported according to PRISMA guidelines for scoping reviews. A qualitative assessment of results grouped thematically was performed.
Twenty-eight studies met the inclusion criteria, with 24 rating as \"fair\" or \"good\" on quality assessment. Surgical simulation was the most frequently described method of training as utilized in 11 studies. The most suggested introductory procedure was tympanoplasty which was advocated for in five studies. Heterogeneity existed in the outcomes and methodologies used to measure EES learning curves, with an overreliance on surgical times. No robust definition of competency in EES procedures exists at present.
Surgical simulation appears to be a beneficial training methodology for EES. However, there is a marked lack of objective data to describe the optimal introductory procedures or assessment of competency in EES. Laryngoscope, 133:3269-3278, 2023.