Educational Benefit of the Three-Dimensional Exoscope Versus Operating Microscope in Otologic Surgery

ObjectiveTo compare observation of otologic surgery using a traditional operating microscope (OM) and a three-dimensional exoscope.Study DesignProspective, nonrandomized, noncontrolled study.SettingTertiary care center.MethodsSenior medical students and otolaryngology trainees observing otologic surgery performed with OM and exoscope were asked to complete a questionnaire comparing the two experiences. The key variables were image clarity, depth perception, observer's level of motion sickness during the surgery, the participant's understanding of middle ear anatomy, and their overall preference between OM and exoscope.ResultsTwenty-two observers participated in the study. Subjective clarity of the image was significantly better with the exoscope compared with the OM (9.7 +/- 0.6 versus 6.9 +/- 1.7, p = 0.0004) as well as the depth perception (9.25 +/- 0.87 versus 5 +/- 2.69, p = 0.0007). Observers subjectively had an improved understanding of middle ear anatomy after observing an exoscopic surgery, but not a microscopic surgery. All but one observer preferred the exoscope.ConclusionThe three-dimensional exoscope may be a valuable educational tool for teaching trainees otologic surgery. More objective studies are needed in the future to assess the degree of improvement.