Validated Assessment Tools for Reconstructing Facial Defects in Simulation. (23rd August 2013)

• Record Type: Journal Article
• Authors: Sajan, Javad A.; Hilger, Peter A.; Sidman, James D.; Walsh, William E.; Chaffin, Phillip L.; Reihsen, Troy; Sweet, Robert
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P44
• Page End: P45
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a38
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: 1) Create a 3D functional organosilicate model for assessing facial reconstruction that is valid and has high inter‐rater reliability. 2) Perform a prospective blinded study using 3D and 2‐dimensional (2D) models for evaluating facial reconstruction. Methods: A 3D organosilicate model of a human adult face was built with a corresponding 2D paper model. Surgical subspecialty trainees from six institutions prospectively drew a z‐plasty on the paper model and the organosilicate model. Next, the subjects each performed a z‐plasty on the organosilicate model with surgical instruments and suture. Three blinded reviewers rated two drawings and one scar revision per subject. Results: Forty‐three trainees encompassing 3 PGY1, 10 PGY2, 13 PGY3, 11 PGY4, 3 PGY5, and 3 PGY6 (fellows) completed the study. Subjects were placed into three groups, novices (PGY1+PGY2), intermediates (PGY3+PGY4), and experts (PGY5+PGY6). Experts performed better than intermediates and intermediates better than novices for performing the z‐plasty and drawing on the organosilicate model. This statistically significant difference between groups was determined by one‐way ANOVA (p =<.05) and Tukey post‐hoc test p=<.05 and showed substantial inter‐rater reliability agreement among the three raters with an average Cohen's Kappa=0.76. On the 2D paper model the experts performed better than novices (p=<.05); however, there was no difference between experts and intermediates (p=0.98). Conclusions: We have created a 3D organosilicate model for facial reconstruction that is valid and shows high inter‐rater reliability. The 3D model was able to detect a difference between experts and intermediates where the 2D model could not.