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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*
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: [email protected]

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.

Type
Main Articles
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.

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