1 The goal of this book is to define the steps and core skills that should be practiced in the temporal bone laboratory to prepare you for further learning in the operating room. More senior trainees or practicing physicians can also upgrade their technical abilities by following recommended approaches to temporal bone surgery. An extensive body of research now tells us what has been known for some time: attaining competence in surgical training requires practice. Effective practice is achieved only through authentic experiences, experiences that give the trainee the opportunity to rehearse every aspect of a surgical procedure. On-going practice and self-directed learning in the temporal bone laboratory is advisable for surgeons with all levels of experience. Success at every technical step is built on that achieved in the previous steps. Temporal bone anatomy is presented in Chapter 2 with the goal of promoting the reader’s ability to navigate this region. Given its complex anatomy, and close tolerances, authentic practice in surgery of the temporal bone requires the ability to progressively and precisely expose critical structures surrounded by bone of varying density. Here, the tools of the trade (microscope, drill, dissecting instruments) and the specimen to be dissected should simulate the operating room as closely as possible. All expert ear surgeons will tell you that they learned their craft through dedicated, protected time in a temporal bone laboratory. We have tried to avoid relying heavily on the printed word. Through the language we use, the images we developed, and the organization of this text, we aim to avoid the common pitfalls of early training manuals. We have attempted to emphasize a step-wise approach. Indeed, there is no single stroke of the drill in mastering microsurgery of the temporal bone. Your learning curve requires that you assimilate several techniques, each of which is directly applied to a particular aspect of the dissection. The use of skill assessment tools presented in Chapter 7 may facilitate your teachers’ ability to measure your progress and provide you with formative feedback.
Introduction to Temporal Bone Dissection
Practice: The Key to Effective Surgery of the Temporal Bone
Use of the Surgical Microscope
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