Virtual reality simulation-based training in otolaryngology

VR simulators will gain wider place in medical education in order to ensure high quality surgical training. The integration of VR simulators into residency programs is actually required more than ever in the era after the pandemic. In this review, the literature is reviewed for articles that reported validation results of different VR simulators designed for the field of otolaryngology. A total of 213 articles searched from Pubmed and Web of Science databases with the key words "virtual reality simulation" and "otolaryngology" on January 2022 are retrieved. After removal of duplicates, 190 articles were reviewed by two independent authors. All the accessible articles in english and which report on validation studies of virtual reality systems are included in this review. There were 33 articles reporting validation studies of otolaryngology simulators. Twenty one articles reported on otology simulator validation studies, eight articles reported rhinology simulator validation studies and four articles reported on pharyngeal and laryngeal surgery simulators. Otology simulators are shown to increase the performance of the trainees. In some studies, efficacy of simulators has been found comparable to cadaveric bone dissections and trainees reported that VR simulators was very useful in facilitating the learning process and improved the learning curves. Rhinology simulators designed for endoscopic sinus surgery are shown to have the construct validity to differentiate the surgeons of different level of expertise. Simulators in temporal bone surgery and endoscopic sinus surgery can mimic the surgical environment and anatomy along with different surgical scenarios, thus can be more implemented in surgical training and evaluation of the trainees in the future. Currently there are no validated surgical simulators for pharyngeal and laryngeal surgery.