Tumor model for surgical simulation to assess a minimally invasive endoscopic approach for midcheek mass removal

Abstract

Introduction: The midcheek is considered one of the most important facial area due to its involvement in mimic expression and communication. Pathology of this district is complex due to the variety of soft tissue belonging to the face. We propose a surgical simulation, to assess the feasibility of a new minimally invasive endoscopic approach for midcheek mass removal.

Technical report: This study was performed on four cadavers, at the Anatomy Laboratory of the University of Tubingen. In all the cadavers 3 cm³ of Acquasil Dent Sply Ultra were injected via trans-cutaneous along the nasolabial fold to simulate a midcheek mass. Three incisions in concealed areas were performed to create an access to reach the anterior compartment of the face. By using the Optical Dissector with distal spatula and a 30° endoscope we provided a wide surgical window and a greater exposure to isolate, dissect and remove the midcheek tumor model safely.

Conclusion: The proposed endoscopic technique allowed us to visualize and preserve all the key anatomic structures of the midcheek region. Due to its nature, the suggested material may provide a valid tumor model for surgical training also in other districts.

Keywords: Midcheek mass; Minimally invasive endoscopic approach; Surgical training.