Endoscopic sinus surgery training courses: benefit and problems - a multicentre evaluation to systematically improve surgical training

Background: The aim of this multicentre study was to systematically analyse the strengths and weaknesses in the surgical trai- ning for endoscopic sinus surgery (ESS) and identify measures that may improve training. Methodology: Using a structured questionnaire, 133 participants of ESS courses in seven centres in Germany, Switzerland and Australia were asked about their experiences during their dissection courses and how they perceived their course could be impro- ved. Results: Gaining confidence in handling of instruments and endoscopes was only a problem for participants with little experi- ence in ESS. The majority of the participants, independent from their level of training, considered infundibulotomy and anterior ethmoidectomy as the easiest dissection steps, whilst surgery of the frontal sinus posed a considerable challenge for many surge- ons even those with a higher level of training. Participants with and without ESS experience thought that emphasis on anatomy was the most important improvement that could be made during their surgical training. Virtually all participants stated that the course improved their anatomical knowledge, their surgical skills and their confidence when performing ESS. Conclusions: ESS dissection courses are considered beneficial by surgical trainees. Participants felt that more emphasis on sinus anatomy in conjunction with private study is essential to maximize their skills in surgical dissection. For beginners with ESS, an infundibulotomy and anterior ethmoidectomy were thought to be the best initial procedures to help develop endoscopic surgical skills.