Phonosurgery Simulation

In the last twenty years, public demand for increased medical safety has nurtured the development of research in surgery simulation. Many studies have confirmed that surgical procedure simulation has great value for medical safety and economical surgery education. Phonosurgery combines microsurgery and endoscopic surgery technology, both of which require experience in manipulative skills and have small margins of operative success. Traditional phonosurgical training in the OR supplies only procedural videos for observation, and it is rare for novices to have the opportunity to perform procedures themselves. A standard phonosurgery simulation system is not currently available, and no metric exists to quantitatively measure phonosurgery motion characteristics.In this project, we developed a phonosurgery simulation motion-tracking workstation and characteristic motion parameters. We quantitatively studied motion during phonosurgery using a man-made material task to optimize phonosurgical ergonomics and investigate the skill-learning procedure.This dissertation is composed of 5 sections:Chapter One sketches current trends and research findings, including those in laparoscopic surgery simulation, laryngeal dissection frame and virtual surgery simulations, and finally presents the study thesis.In Chapter Two, we developed the phonosurgery simulation station and motion parameters and designed the man-made material task, including resolution testing, system setting and calibration. We employed this system to quantitatively compare phonosurgical motion characteristics between experts and novices, and found the phonosurgery simulation system was reliable in studying phonosurgery motion.In Chapter Three, we studied the effect of arm support position on manipulative ability in phonosurgery. Quality and motion characteristics were significantly different under different arm support positions. Forearm support showed the best results for control of motion during phonosurgery.In Chapter Four, we employed CUSUM (Cumulative Summation Analysis) to study individual and group learning procedures and learning curve on a head-mounted microscope with phonosurgery simulation. We found that the shortest learning time was 140 minutes and that most subjects plateaued after an initial learning time of 400 minutes.In Chapter Five, we discuss future developments in phonosurgery simulation, including the need for further work in motion-tracking simulation, virtual simulation and the use of animal models in such simulations.