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Acceleration of Resident and Fellow Education of Rhinoplasty
Haruko C. Okada, MD
Ayesha Punjabi, BS
Matthew Brown, MD
Devra Becker, MD
Bahman Guyuron, MD FACS
University Hospitals Case Medical Center, Case Western Reserve University Department of Plastic Surg
2014-03-07
Presenter: Haruko Okada
Affidavit:
Director Name: Hooman Soltanian, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Rhinoplasty is difficult procedure for the surgeon to master as well as teach the learning surgical resident. There is no information known about what impact dedicated rhinoplasty mentorship can have or what aspects of the surgical planning residents may struggle grasp or understand.
Methods: Preoperative photographs with outlines of the planned changes were evaluated by residents who recorded the maneuvers that would be necessary to achieve the desired changes. Answers of both pre-rhinoplasty rotation residents and post-rhinoplasty rotation residents were compared with one another and the actual maneuvers performed to achieve the desired result.
Results. The mean summed score across all eight patients was 39.25 for pre-rotation and 75.25 for post-rotation residents (p=0.017) out of a maximum score of 117, indicating signficant differences in understanding between pre and post-rotation residents. Pre-rotation residents scored lower in selecting the correct osteotomies and the use of subdomal grafts. All residents scored lower in the use of interdomal versus transdomal suture selection and the need for soft tissue triangle resection.
Conclusions: After 1 on 1 mentorship in rhinoplasty residents had improved scores in use of osteotomies and footplate management compared to their more junior counterparts. All residents still struggle with tip maneuvers such as onlay grafts and tip sutures.
