Myringotomy and Tympanostomy Tube Insertion Training Device: A Surgical Simulator

Abstract

Objectives:

(1) Develop a task simulator for myringotomy and pressure equalizing tube insertion. (2) Develop a simulator that can be used to hone a participant’s micro surgical skills.

Methods:

Study conducted from October to November 2013. A design for a model head with a core made up of wood and polyester body filling was made. The external facial features were replicated using molding clay. The pinna and the external auditory canal were then made from carved wood. The external auditory canals were continuous with the core of the head model. Rubber fittings were used to attach the wooden pinna to the head in order to allow some degree of mobility to the pinnae. A port at the occipital portion of the head was made that would accommodate a middle ear cartridge. A solution bottle’s cap was used to fabricate the middle ear cartridge. The tympanic membrane was simulated using a single sheet of polyethelene film. Myringotomy, tube insertion, and evacuation of middle ear fluid was done several times.

Results:

We were able to construct a simulator for doing myringotomy, evacuation of middle ear fluid, and tympanostomy tube insertion. The simulator was sturdy, easy to use, and economical.

Conclusions:

Simulators allow constant practice and objective evaluation of skills without risks to the patient under the hands of the surgeon still on the learning curve. The creation of this simulator is a step towards the improvement of surgical training, evaluation of residents, better health economics, and patient safety.