Myringotomy Ear Simulation Model

Abstract

Objectives: Myringotomy and ventilation tube insertion is a common otolaryngologic surgical procedure with a steep learning curve for residents. Incorrect placement of incisions and external ear canal trauma are common complications when residents begin learning the procedure. With increasingly conservative guidelines on indications of myringotomy tubes, residents have less opportunities to refine this skill on real patients. The objective is to create a learner-centric myringotomy simulator. Methods: Although the concept of simulation training in myringotomy is not new, we aim to reduce the learning curve by introducing learner-guided features on a simulation model. Some of these include landmarks such as the handle of malleus, the anterior inferior quadrant guide, and modified instruments as part of the simulation. Working with the National University of Singapore, Division of Industrial Design team, a 3-dimensional library of different variants of ear models, including modified ear canals for teaching, was created. We created a platform to house the different components including an auricle, an external ear canal, and a disposable tympanic membrane with landmarks. Results: The model is accurate with realistic consistency to mimic soft tissues encountered in the myringotomy procedure. The simulator allows for variance in anatomy between the side of the ear and also between adult and pediatric sizes. Conclusions: Our model can be used to train otolaryngology residents and will be employed as a proof-of-concept model for the purpose of simulation training.