Search

The process of learning new surgical technical skills is vital to the career of a surgeon. The acquisition of these new skills is influenced greatly by visual-spatial ability (VSA) and may be difficult for some learners to rapidly assimilate. In many cases, the role of VSA on the acquisition of a novel technical skill has been explored; however, none have probed the impact of a three-dimensional (3D) video learning module on the acquisition of new surgical skills. The first aim of this study is to capture spatially complex surgical translational flaps using 3D videography and incorporate the footage into a self-contained e-learning module designed in line with the principles of cognitive load theory. The second aim is to assess the efficacy of 3D video as a medium to support the acquisition of complex surgical skills in novice surgeons as evaluated using a global ratings scale. It is hypothesized that the addition of depth in 3D viewing will augment the learner's innate visual spatial abilities, thereby enhancing skill acquisition compared to two-dimensional viewing of the same procedure. Despite growing literature suggesting that 3D correlates directly to enhanced skill acquisition, this study did not differentiate significant results contributing to increased surgical performance. This topic will continue to be explored using more sensitive scales of measurement and more complex "open procedures" capitalizing on the importance of depth perception in surgical manipulation.

Background: Surgical excision is a mainstay of treatment for non‐melanoma skin cancer (NMSC); improving margin delineation can reduce the need for further monitoring/treatment. The objective of this pilot study was to determine if near‐infrared radiation (NIR) application to skin causes visible changes in normal and NMSC skin, to help delineate margins. Materials/Methods: Eleven biopsy‐proven NMSC lesions were included. The skin was then heated under a 175W NIR heating bulb; margins were traced onto acetate film before and after heating. Lesions were then randomly assigned to excision based on pre‐ or post‐heating margins. Composite images were generated by overlaying the heat and no‐heat lesion contours. All specimens were sent for histopathology. Results: The range of closest margins in the control group was 2.0‐3.0 mm with a median of 2.0 mm; the range in the intervention group was 4.0‐9.0 mm with a median of 5.0 mm. Composite images showed larger heat contours when the initial lesion was larger. There was a statistically significant difference between the two groups. Overall, NIR light caused visible hyperaemia to skin, and more intense erythema to malignant skin lesions. Conclusion: Near‐infrared light may have use in an outpatient setting for skin cancer delineation, possibly reducing the rate of positive margins. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Otolaryngology -- Head & Neck Surgery is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article describes a direct nasolabial lift technique for the functional reconstruction of the lower face. It explains the causes and other surgical options available for facial paralysis, which is a complication of the cancer of the head and neck. The new surgical technique involves the outlining of a crescent or triangle at the superior edge of the nasolabial crease and uses local anesthetic. Results of the application of this procedure to four patients who seek palliative restoration of oral competence are also detailed.

Background: Topical photodynamic therapy (PDT) is a successful treatment for nonmelanotic skin cancers (NMSCs). Nevertheless, surgical excision continues to be the gold standard treatment. Cervicofacial excision often results in functional and aesthetic impairment. We hypothesize that topical PDT as a neoadjuvant therapy to surgical excision may reduce tumour size and subsequently decrease local morbidity., Objective: To determine the utility of PDT in reducing the NMSC area for the purpose of surgical excision., Method: A prospective cohort study., Results: Thirty-three basal cell carcinomas with a mean area of 523.11 ± 120.93 mm² and 26 squamous cell carcinomas with a mean area of 357.53 ± 61.96 mm² were included. Of these lesions, 22 demonstrated a complete curative response after an average of two PDT treatments, which were then confirmed with histologically negative biopsies. The remaining lesions demonstrated a partial response to topical PDT with a maximum reduction in lesion area following an average of three PDT treatments of at least 88% (p < .05). These lesions were then excised with clear histologic margins. Follow-up at 1 year for all lesions demonstrated no locoregional recurrence., Conclusions: This is the first study to investigate the efficacy of neoadjuvant topical PDT in the management of NMSC. The results suggest that for NMSC not demonstrating a complete curative response to PDT, neoadjuvant PDT can substantially reduce tumour burden, allowing for less morbid surgical excisions with histologically clear margins.