Training model for salvage procedures in endoscopic stapes surgery.

Fernandez, Ignacio Javier; Bonali, Marco; Yacoub, Abraam; Ghirelli, Michael; Fermi, Matteo; Presutti, Livio; Caversaccio, Marco; Anschuetz, Lukas (2021). Training model for salvage procedures in endoscopic stapes surgery. European archives of oto-rhino-laryngology, 278(4), pp. 987-995. Springer 10.1007/s00405-020-06166-6

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The learning curve in endoscopic stapes surgery, is flat and long. There is limited space during training for advanced and salvage procedures, which could be necessary in unexpected intraoperative scenarios. The aim of the present study is to develop an ex-vivo animal model for training in salvage and advanced procedures in endoscopic stapes surgery METHODS: After defining the difficult intraoperative scenarios requiring a salvage procedure during stapes surgery, we used the ovine model to create those intraoperative situations. After assessing the suitability of the model for that purpose, it was validated by subjective feedback rating (scale from 1 to 10) and by comparing the relevant anatomical structures for stapes surgery with the human. Finally, an optimal sequence of surgical steps was defined.


8 Fresh frozen lamb heads (16 ears) were studied. The selected intraoperative scenarios were: floating footplate, footplate fracture, luxation of the incus or necrosis of the long process, overhanging facial nerve, obliterative otosclerosis. The simulation resulted feasible and close to real. The mean overall rating for surgical scenarios ranged from 7.5 to 8.8 for residents and was consistent with the rating of senior surgeons, ranging from 7.67 and 9.0. Anatomical measures of the oval window area resulted similar between the ovine and the human.


The ex-vivo ovine model is a suitable model for training in salvage and advanced procedures in exclusively endoscopic stapes surgery. The model can be used both for the training and maintenance of the acquired advanced skills in endoscopic stapes surgery.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Yacoub, Abraam; Caversaccio, Marco and Anschütz, Lukas Peter


600 Technology > 610 Medicine & health








Stefan Weder

Date Deposited:

28 Apr 2021 18:25

Last Modified:

28 Apr 2021 18:34

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Advanced procedures in stapes surgery Animal model Complications in stapes surgery Endoscopic ear surgery Stapes surgery Surgical training




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