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Cholesteatoma in three dimensions: a teaching tool and an aid to improved pre-operative consent

Published online by Cambridge University Press:  25 November 2009

D P Morris  and
R G Van Wijhe
D P Morris*
Affiliation:
The Ear and Auditory Research Laboratory, Department of Anatomy and Neurobiology, Dalhousie University, Nova Scotia, Canada Division of Otolaryngology, Department of Surgery, Capital Health, Halifax, Nova Scotia, Canada
R G Van Wijhe
Affiliation:
Division of Otolaryngology, Department of Surgery, Capital Health, Halifax, Nova Scotia, Canada
*
Address for correspondence: Dr David P Morris, Assistant Professor, Division of Otolaryngology, Room 3037, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, Nova Scotia, B3H 1V7, Canada. Fax: 902 473 1260 E-mail: dp.morris@dal.ca
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Abstract

Background:

Otological surgeons face two recurring challenges. Firstly, we must foster an appreciation of the complex, three-dimensional anatomy of the temporal bone in order to enable our trainees to operate safely and independently. Secondly, we must explain to our patients the necessity for surgery which carries the potential for serious complication.

Methods:

Amira® software was applied to pre-operative computed tomography images of temporal bones with cholesteatoma, to create three-dimensional computer images. Normal structures and cholesteatoma were displayed in a user-friendly, interactive format, allowing both trainee and patient to visualise disease and important structures within the temporal bone.

Results:

Three cases, and their three-dimensional computer models are presented. Zoom, rotation and transparency functions complemented the three-dimensional effect.

Conclusion:

These three-dimensional models provided a useful adjunct to cadaveric temporal bone dissection and surgical experience for our residents' teaching programme. Also, patients with cholesteatoma reported a better understanding of their pre-operative condition when the models were used during the consenting process.

Keywords

Computer ModelsCholesteatomaTemporal Bone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 126 - 131
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented in part as a poster at the 30th Midwinter Research Meeting of the Association for Research in Otolaryngology, 5–9 February 2006, Baltimore, Maryland, USA. Presented in full at the 60th Annual Meeting of the Canadian Society of Otolaryngology – Head and Neck Surgery, 14–17 May 2006, Kelowna, British Columbia, Canada, the 4th International Symposium on Middle Ear Mechanics in Research and Otology, 27–30 July 2006, Zurich, Switzerland, and the 8th International Conference on Cholesteatoma and Ear Surgery, 15–20 June 2008, Antalya, Turkey.

References

1Ni, Y, Sha, Y, Dai, P, Li, H. Quantitative morphology of facial nerve based on three dimensional reconstruction of temporal bone. Otolaryngol Head Neck Surg 2008;138:23–9CrossRefGoogle ScholarPubMed
2Wang, H, Northrop, C, Burgess, B, Liberman, MC, Merchant, SN. Three-dimensional virtual model of the human temporal bone: a stand-alone, downloadable teaching tool. Otol Neurotol 2006;27:452–7Google ScholarPubMed
3Jun, BC, Song, SW, Cho, JE, Park, CS, Lee, DH, Chang, KH et al. Three-dimensional reconstruction based on images from spiral high-resolution computed tomography of the temporal bone: anatomy and clinical application. J Laryngol Otol 2005;119:693–8CrossRefGoogle ScholarPubMed
4Qiu, MG, Zhang, SX, Liu, ZJ, Tan, LW, Li, QY, Li, K et al. Visualization of the temporal bone of the Chinese Visible Human. Surg Radiol Anat 2004;26:149–52Google ScholarPubMed
5Mason, TP, Applebaum, EL, Rasmussen, M, Millman, A, Evenhouse, R, Panko, W. Virtual temporal bone: creation and application of a new computer-based teaching tool. Otolaryngol Head Neck Surg 2000;122:168–73CrossRefGoogle ScholarPubMed
6Garg, AX, Norman, GR, Eva, KW, Spero, L, Sharan, S. Is there any real virtue of virtual reality?: the minor role of multiple orientations in learning anatomy from computers. Acad Med 2002;77:S97–9CrossRefGoogle ScholarPubMed
7Nicholson, DT, Chalk, C, Funnell, WRJ, Daniel, SJ. Can virtual reality improve anatomy education? A randomised controlled study of a computer-generated three-dimensional anatomical model. Med Educ 2006;40:1081–7CrossRefGoogle Scholar
8Nieder, GL, Nagy, F. Analysis of medical students' use of web-based resources for a gross anatomy and embryology course. Clin Anat 2002;15:409–18CrossRefGoogle ScholarPubMed
9Albera, R, Argentero, P, Bonziglia, S et al. Informed consent in ENT. Patient's judgement about a specific consensus form. Albera R, Argentero P, Bonziglia S, De Andreis M, Preti G, Palonta F, Canale A.Acta Otorhinolaryngol Ital 2005;25:304–11Google ScholarPubMed
10Cherry, J, Weir, R. Medicolegal and ethical aspects of ORL-HNS in the new millennium. J Laryngol Otol 2000;114:737–40CrossRefGoogle ScholarPubMed
11Haddow, K, Crowther, JA. Consent – who, what, where, when? Health Bull (Edinb) 2000;58:218–20Google ScholarPubMed
12Dawes, PJ, Kitcher, E. Informed consent: British otolaryngologists surveyed. Clin Otolaryngol Allied Sci 1999;24:198–207CrossRefGoogle ScholarPubMed
13Kubba, H. Reading skills of otolaryngology outpatients: implications for information provision. J Laryngol Otol 2000;114:694–6CrossRefGoogle ScholarPubMed
14Brown, TF, Massoud, E, Bance, M. Informed consent in otologic surgery: prospective study of risk recall by patients and impact of written summaries of risk. J Otolaryngol 2003;32:368–72CrossRefGoogle ScholarPubMed
15Tait, AR, Voepel-Lewis, T, Malviya, S. Presenting research information to children: a tale of two methods. Anesth Analg 2007;105:358–64CrossRefGoogle ScholarPubMed
16Morris, DP, Rothera, MP. The application of computer-enhanced imaging to improve preoperative counselling and informed consent in children considering bone anchored auricular prosthesis surgery. Int J Pediatr Otorhinolaryngol 2000;55:181–6CrossRefGoogle ScholarPubMed