ABSTRACT Objectives Frontal sinusotomy remains a technically challenging component of resident training in endoscopic sinus surgery. We hypothesize that the use of three‐dimensional (3D) surgical planning software improves resident performance, as measured by blinded supervising surgeon evaluations. This study aims to assess whether 3D planning software enhances resident performance during frontal sinusotomy in live surgical cases. Methods This is a prospective trial involving unblinded self‐evaluations and blinded evaluations from supervising surgeons. Participants alternated between an experimental and control arm. Participants were residents from their second through fifth year of residency, with a total of 9 participants included in the study. Results Forty‐one frontal sinusotomies were included. More challenging and less challenging cases were separated for analysis. Among more challenging procedures, blinded attendings rated resident performance on a scale of 1 to 100 on a number of parameters. They reported residents using 3D planning software were more prepared (77.1 vs. 67.3, p = 0.047), more atraumatic (78.2 vs. 59.1, p = 0.002), better cannulated the frontal sinus (77.0 vs. 51.5, p = 0.008), and participated in more of the procedure (53.6% vs. 30.1%, p = 0.05). On self‐evaluations, residents reported they were more prepared (82.6 vs. 55.3, p < 0.001), better cannulated the frontal sinus (77.9 vs. 47.4, p = 0.013), and better identified the frontal sinus drainage pathway on computed tomography imaging (82.1 vs. 51.9, p = 0.001) when utilizing 3D planning. Conclusions Resident performance in frontal sinusotomy was significantly improved when they prepared with 3D planning software prior to challenging frontal sinusotomy cases. Level of Evidence 2.
Kelly et al. (2026) studied this question.