Extracranial cored method of human monobloc temporal bone harvest

Abstract Purpose Surgical skills requires a combinaison of anatomical knowledge and manual skills. Donated bodies remain an armament for teaching temporal bone dissection. Temporal bone skills courses are often organized with a single, massed block of practice, using head or temporal bones specimens. Ethical considerations limit body segmentation, and temporal bone harvesting can be difficult and time consuming. We describe a simple technique of harvesting temporal bone specimens from human cadaver called “the extracranial cored method” (CM). Then, we qualitatively validated the harvested specimens during a surgical training course Methods A 63mm hole saw and 63mm core drilling machine were used to harvest monobloc of two temporal bones without calvarium section. Then just two complementary bone cuts were necessary passing through the dorsum sellae and the posterolateral aspect of the foramen magnum. Subsequently, specimens harvested were evaluated during temporal bone surgical course by sixteen participants (senior and fellow group) Results The CM was assessed on 8 human cadavers. In all cases, two temporal bone specimens could be obtained in good macroscopic conditions. All sixteen temporal bones specimens were harvested in less than 60 minutes .No cosmetic deformities were noted after harvest. All temporal bones were found to be intact and in optimal condition for surgical course. For the qualitative, all items scored above 4 on a 5-point Likert scale, except for odor in the fellow group (mean score 3.3 ± 0.55 vs. 5 in the senior group; p = 0.0011). The macroscopic appearance was rated lower in the MD group compared to the fellow group (4.2 ± 0.95 vs. 4.8 ± 0.33; p = 0.036). All participants considered the presentation of the temporal bone to be ethical. In the MD group, the most preferred model was the fully segmented head, followed by the temporal bone (p = 0.826). In the fellow group, the temporal bone was rated as the best model Conclusion The CM is a rapid, efficient, and reproducible harvesting technique that allows the extraction of two temporal bone specimens per cadaver with minimal bone cuts, without sectioning the calvarium and respecting cosmetic aspect. It is well-suited for use in otologic training courses, although it presents certain limitations for approaches involving the internal auditory canal