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Personal otolaryngology–head-and-neck wet lab

1 Department of ENT, Hatta Hospital, Dubai, UAE
2 Department of Pediatric, Hatta Hospital, Dubai, UAE

Correspondence Address:
Ammar Mohammed Haidar Shehadeh,
Hatta Hospital, Dubai
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2227-2437.248020

Objectives: To have professional surgical instrumentational skills in a low-cost, readily available, personal wet lab, instead of having it on a real patient in the operation theatre or in the costly cadaveric workshops. This study was conducted to assess the feasibility of sheep's head as a valid ear, nose and throat (ENT) surgical training model and to establish a small yet comprehensive ENT wet laboratory. Methods: Sheep's heads, already checked by the veterinarian and safe to use, were collected from the abattoir. However, neck surgery specimens were specifically requested from butchery with more neck tissue and intact skin. Surgical instruments were collected from medical exhibitions, online and the industrial market. With the help of cheap functional industrial instruments, a personal surgical laboratory was established. Ovine specimens were evaluated for human simulation. Moreover, the applicability of most ENT procedures and operations was assessed by a team of six ENT surgeons including three junior surgeons and three senior ENT surgical consultants. Results: Utilising simple basic surgical instruments, a wide variety of surgeries performed with very similar conditions to human operations. Endoscopic procedures include middle ear surgeries, laryngeal fissure, tracheal resection and laryngotracheal reconstruction. Open surgeries, facial nerve decompression, dissection and repair were also performed. Moreover, fibre-optic intubation, fibre-optic bronchoscopy and foreign-body extraction training were tried. Some structures are very similar to human ones; some show mild-to-moderate differences, whereas few structures are totally absent in the sheep head. The consistency of, skin, subcutaneous tissues and bone are remarkably similar to that seen in humans. Lamb's heads are good and accepted substitute models for cadaveric specimens. This personal laboratory could be (at a certain level) a good substitute solution to repeated cadaveric workshops. Personal wet laboratories low-cost training improves surgical skills and if followed by few human cadaveric workshops, could enable the surgeon to start human operations with lower complication rate and shorter intervention time. Conclusion: Province otolaryngologist must build up his own experience before practicing on humans. Using sheep tissues do not carry any risks for disease transmission and are ethically defensible. Structural fresh, ovine heads provide a readily available, anatomically compatible, affordable, model for training. It could hone dexterity, surgical skills and teamwork behaviour well before venturing into real patient training. Anatomical variations in sheep's head such as mastoid, paranasal sinuses and skull base are minimal and do not affect the applicability of most of the procedures.

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