Revisit to Dissection in Ent and its Impact on Students-Juniper publishers
JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF HEAD NECK & SPINE SURGERY
Introduction
Cadaveric dissection of Temporal bone and nose &
para nasal sinuses held during the otorhinolaryngology and head &
neck surgery postings had a good impact on the student’s understanding
and orientation to the subject. Despite the advent of modern technology
and evolving teaching methods cadaveric dissection continues to remain a
corner stone of anatomy curriculum [1].
The students were not exposed to the microscope
guided dissection of temporal bone, Para nasal sinuses and the
surrounding structures during their course in Anatomy. Learning about
ear and paranasal sinuses back then was more through two dimensional
pictures from the books and various atlases. But during our clinical
postings we were given the chance to watch microscopic guided cadaveric
dissection of temporal bone which was performed by our head of the unit.
We got the opportunity of learning the shape and
orientation of the structures of temporal bone. Starting from the
external ear, tympanic membrane, middle ear ossicles, oval and round
windows, intra temporal course of facial nerve, chorda tympani nerve,
muscles like tensor tympani and stapedius muscle, mastoid, inner ear
structures like semicircular canals cochlea were all clearly shown and
explained by our professor. He also explained us certain surgical
procedures with the indications, contraindications and complications of
the procedures. During the endoscope guided nose and paranasal sinus
dissection we were explained the anatomy of turbinate’s, meatuses,
ethmoidal and maxillary sinuses, cavernous sinus, internal carotid
artery and the related surgical procedures. When we went through the
textbook following the session, there was easy and clear understanding.
In our discussion session, which was held by another
teacher in order to have an unbiased result, the students whohad
attended the session had answered better than those who
had not. Though some of the students had answered, they could
not answer the deeper questions to which the students who had
attended answered. So, the students who had not attended the
session felt the need of dissection and had asked for a repeat
session. In the repeat session all the students irrespective of the
phase were allowed and shared the knowledge.
Dissection gave a better view of structures compared to
surgical procedures as the structures obstructing the view can
be removed in dissection.
From the student’s perspective dissection makes anatomy
more interesting and long-lasting knowledge [2] thorough
knowledge of anatomy is required for us to understand the
pathophysiology of various disorders involving temporal
bone and paranasal sinuses and head and neck areas elicit
proper history, proper methodological examination, to arrive
at clinical diagnosis and for treatment aspect of diseases. So,
these dissection sections during our clinical postings deepenour understanding of anatomy and provide three-dimensional
perspective of structures thereby improving our skills in
history taking clinical examination and understanding surgical
procedures [2]. We also performed well in the subsequent
internal examination (Figure 1-3).
Students opinion is taken in the form of a feedback
questionnaire and the result is as follows
Result
i. 68.2 percent of the students strongly agree that
cadaveric dissection is interesting.
ii. 59.1 percent of the students strongly agree that
knowledge of the temporal bone anatomy helps in clinical
posting.
iii. 54.5 percent students disagreed, and 36.4 percent
students strongly disagreed that cadaveric dissection is
more difficult than textbook anatomy.
iv. 40.9 percent of students strongly agreed, and
45.5 percent of students agreed that teaching of clinical
correlation where ever relevant is been done in dissection
session.
v. 54.5 percent of students strongly agreed, and 45.5
percent of students agreed that flow of dissection clearly
explained the content which helped them to understand the
anatomy well.
vi. 68.2 percent students strongly agreed that explanation
given to clarify the temporal bone contents is satisfactory
vii. 77.3 percent of students strongly agreed that the
teacher had encouraged students to ask questions and give
answers during dissection.
viii. 63.6 percent students strongly agreed that
demonstrations were in a way that stimulated interest in the
subject.
ix. 40.9 percent students strongly agreed and 31.8 percent
of them agreed that assessment conducted in the form of
written examinations served the purpose to make them
aware of their grasp of the subject.
x. 40.9 percent of the students agreed, and 36.4 percent
of the students strongly agreed assessment conducted in
the form of viva voce helped them to improve their subject
knowledge application and skills.
Students are looking forward for more dissection classes.
Microscopic dissection if made part of the curriculum more
students can be benefitted
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