Low-cost simulation training program for endoscopic sinus surgery: optimizing the basic skills level

Andrés Rosenbaum, Soledad Palma, Tamara Muñoz, Francisco García-Huidobro, Claudia González, Julián Varas, Claudio Callejas

Rhinology Online, Vol 4: 49 – 57, 2021



The purpose of this study is to develop and validate a low-cost simulation model and training program for the acquisition of basic skills in endoscopic sinus surgery.


Experimental study. An eight-task low-cost simulation model was developed based on feeding bottles. Junior residents, general otolaryngologists, and fellowship-trained rhinologists (experts) were recorded performing each task. Operative time and number of errors were measured. Videos were evaluated by two blinded experts using a validated global rating scale (GRS) and a specific rating scale (SRS). A group of residents completed a six-session training program and then were recorded and evaluated using the same methodology.


Twenty-five participants were recruited. Statistically significant higher scores in the GRS and SRS and lower operative
time and errors at higher levels of expertise were found. A significant correlation between SRS and GRS was found. Seven residents completed the training program. A significant improvement of SRS and GRS scores and reduction of operative time and errors were observed after training. Moreover, compared to experts, statistically significant fewer errors were made by residents after training, and no significant differences were found in terms of performance quality and operative time among these groups.


Our low-cost simulation model can be accurately used as a validated objective assessment and training tool for basic endoscopic skills necessary for FESS, and can be potentially used in any otolaryngology surgical training program for residents.