Validation of a laryngeal dissection module for phonomicrosurgical training.

Abstract

To validate the use of a new phonomicrosurgical trainer called the laryngeal dissection module. The module used synthetic, multilayered vocal folds inside a model larynx mounted on a platform, a microscope, and microsurgical instruments. The study was designed to test the module's ability to differentiate novices from expert surgeons and to test the module's ability to improve novice performance with training. Expert (n = 5) and novice (n = 21) phonomicrosurgeons were instructed to remove a superficial ovoid lesion from a synthetic, right vocal fold. The task was assessed for total errors, total operating time, and injury to the superficial peripheral tissue, the lesion, and the deep tissue. Novice and expert performance was compared using an independent samples t test and a Fisher exact test. Subsequently, novices completed three practice trials and a posttraining trial, which was assessed for improvement compared with pretraining performance using a Wilcoxon signed rank test. Experts completed the task with fewer total errors than novices (P < .001) and made fewer injuries to the oval lesion (P = .01). Novices improved performance with training, making fewer total errors in the posttraining trial (P = .003), reducing injury to the superficial peripheral tissue (P = .02), and taking less time to complete the task (P = .04). The laryngeal dissection module was validated as a surgical trainer. It was able to differentiate expert versus novice performance, and it improved novice performance through training.