The 70-degree telescope as a teaching tool for cleft palate repair and pharyngoplasty surgery

The 70-degree telescope as a teaching tool for cleft palate repair and pharyngoplasty surgery. Jabbour, N, Chinnadurai, S, Wootten, C., Cofer, S., & Goudy, S. International Journal of Pediatric Otorhinolaryngology, August, 2014.
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Objective: To determine the optimum positioning of a 70-degree telescope to provide a maximum view of the palate and posterior pharynx for observers while minimally obstructing the direct view of a surgeon. Design: Simulator testing of clinical protocol. Setting: Simulation center of an academic tertiary care children's hospital. Interventions: The palate and pharynx of an infant airway mannequin was exposed with a Dingman mouthgag. A 4 mm, 70-degree endoscope was secured to the Mayo stand to provide a projected image of the simulated operative procedure. Various positions of the 70-degree telescope were photodocumented by manipulating the angle of the scope, the extension past the lower lip, and the distance of the scope tip away from the midline. Using a 4-point Likert scale, three surgeons rated the randomized photos from both the direct operative view and the projected endoscopic view. Results: Average rating for the adequacy of the view for pharyngeal surgery was 2.4/4.0 and for palate surgery was 3.1/4.0 (p = .001). Only 4 of 22 scope positions were rated as minimally obstructive to direct view by all three surgeons. Only 1 position - scope parallel and just lateral to the tongue blade - was rated as minimally obstructive and adequate for both pharyngeal and palatal surgery by all three surgeons. Conclusions: In training centers, a 70-degree telescope attached to a Mayo stand may be useful for teaching and assessing cleft palate and pharyngoplasty surgery, while providing minimal obstruction to direct view by the surgeon. © 2014 Elsevier Ireland Ltd. All rights reserved.

@article{jabbour_70-degree_2014,
title = {The 70-degree telescope as a teaching tool for cleft palate repair and pharyngoplasty surgery},
issn = {0165-5876},
doi = {10.1016/j.ijporl.2014.07.032},
abstract = {Objective: To determine the optimum positioning of a 70-degree telescope to provide a maximum view of the palate and posterior pharynx for observers while minimally obstructing the direct view of a surgeon. Design: Simulator testing of clinical protocol. Setting: Simulation center of an academic tertiary care children's hospital. Interventions: The palate and pharynx of an infant airway mannequin was exposed with a Dingman mouthgag. A 4 mm, 70-degree endoscope was secured to the Mayo stand to provide a projected image of the simulated operative procedure. Various positions of the 70-degree telescope were photodocumented by manipulating the angle of the scope, the extension past the lower lip, and the distance of the scope tip away from the midline. Using a 4-point Likert scale, three surgeons rated the randomized photos from both the direct operative view and the projected endoscopic view. Results: Average rating for the adequacy of the view for pharyngeal surgery was 2.4/4.0 and for palate surgery was 3.1/4.0 (p = .001). Only 4 of 22 scope positions were rated as minimally obstructive to direct view by all three surgeons. Only 1 position - scope parallel and just lateral to the tongue blade - was rated as minimally obstructive and adequate for both pharyngeal and palatal surgery by all three surgeons. Conclusions: In training centers, a 70-degree telescope attached to a Mayo stand may be useful for teaching and assessing cleft palate and pharyngoplasty surgery, while providing minimal obstruction to direct view by the surgeon. © 2014 Elsevier Ireland Ltd. All rights reserved.},
journal = {International Journal of Pediatric Otorhinolaryngology},
author = {Jabbour, N and Chinnadurai, S and Wootten, CT and Cofer, SA and Goudy, SL},
month = aug,
year = {2014},
keywords = {Pharynx}
}

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Design: Simulator testing of clinical protocol. Setting: Simulation center of an academic tertiary care children's hospital. Interventions: The palate and pharynx of an infant airway mannequin was exposed with a Dingman mouthgag. A 4 mm, 70-degree endoscope was secured to the Mayo stand to provide a projected image of the simulated operative procedure. Various positions of the 70-degree telescope were photodocumented by manipulating the angle of the scope, the extension past the lower lip, and the distance of the scope tip away from the midline. Using a 4-point Likert scale, three surgeons rated the randomized photos from both the direct operative view and the projected endoscopic view. Results: Average rating for the adequacy of the view for pharyngeal surgery was 2.4/4.0 and for palate surgery was 3.1/4.0 (p = .001). Only 4 of 22 scope positions were rated as minimally obstructive to direct view by all three surgeons. Only 1 position - scope parallel and just lateral to the tongue blade - was rated as minimally obstructive and adequate for both pharyngeal and palatal surgery by all three surgeons. Conclusions: In training centers, a 70-degree telescope attached to a Mayo stand may be useful for teaching and assessing cleft palate and pharyngoplasty surgery, while providing minimal obstruction to direct view by the surgeon. © 2014 Elsevier Ireland Ltd. 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