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Am J Rhinol. 2003 Sep-Oct;17(5):283-90.

Virtual simulator as a training tool for endonasal surgery.

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Department of Otorhinolaryngology, Head, and Neck Surgery, Inselspital, University of Bern, Switzerland.



Virtual simulation could be an important tool for medical and surgical training as well as education. The efficacy of a simulator for endoscopic nasal procedures in a training program was evaluated.


The simulator is a medical and scientific tool for visualizing and interacting with three-dimensional volumetric data. Twenty endonasal operations with chronic rhinosinusitis were simulated by two 3rd-year residents and proctored by the senior surgeon 1 day before the actual surgery was performed with an endoscope and computer-aided surgery. A questionnaire was established.


The surgical simulator may provide a better understanding of the morphology of the paranasal sinuses with a minor impact on performance of endoscopy by junior residents. Disadvantages identified were time consumption, absence of force feedback, and subtle handling of the joysticks.


The virtual simulator allows the nonendoscopically nasal trained surgeon to understand and practice endonasal surgery using real-patient data but failed to make an impact on operating room performance. Furthermore, the simulator's effectiveness was limited by the absence of force feedback, subtle handling of the joysticks, and considerable time consumption.

[Indexed for MEDLINE]

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