Simulation Training for Vascular Emergencies in Endoscopic Sinus and Skull Base Surgery

Otolaryngol Clin North Am. 2016 Jun;49(3):877-87. doi: 10.1016/j.otc.2016.02.013.


Carotid artery injury during endonasal surgery is a feared and potentially catastrophic complication. Simulation training provides the opportunity for a realistic experience with management of major vascular injuries. The sheep model of carotid artery injury reproduces the challenges of dealing with vascular emergencies during endoscopic sinus and skull base surgery, which include working in narrow nasal confines, high-flow/high-pressure vascular injury, and the immediately challenging surgical field. Simulated vascular emergencies allow for research and development; training using various surgical techniques to control the field, including hemostatic products or direct vascular closure techniques; and consequently improved patient care and outcomes.

Keywords: Carotid artery injury; Endoscopic; Hemostasis; Simulation; Transsphenoidal.

Publication types

  • Review

MeSH terms

  • Carotid Artery Injuries* / etiology
  • Carotid Artery Injuries* / surgery
  • Clinical Competence
  • Endoscopy / adverse effects*
  • Endoscopy / methods
  • Hemostasis, Surgical / education
  • Hemostasis, Surgical / methods
  • Humans
  • Intraoperative Complications* / etiology
  • Intraoperative Complications* / surgery
  • Otolaryngology / education*
  • Otorhinolaryngologic Surgical Procedures / adverse effects*
  • Otorhinolaryngologic Surgical Procedures / methods
  • Simulation Training / methods*
  • Skull Base / surgery