Low Cost, Easy-to-Replicate Myringotomy Tube Insertion Simulation Model

Low Cost, Easy-to-Replicate Myringotomy Tube Insertion Simulation Model:



Publication date: Available online 3 January 2020

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Nicole Molin, Jerlon Chiu, Benjamin Liba, Glenn Isaacson

Abstract

Introduction

Simulation is an established part of modern surgical education. Several training centers have proposed different simulation models for myringotomy tube (MT) placement and validated their effectiveness in medical student and resident training. None is widely used. Early models were simple tubes that lacked important microsurgical elements. Newer simulators are more comprehensive, but are difficult and expensive to build. We present a MT placement simulator that is low cost, easy to construct with basic power tools and allows for acquisition of the most necessary MT placement skills.

Methods

The model incudes a rotating spherical “head”, a 4mm oval speculum, a drilled-out working shaft similar in size to the external auditory canal, and a realistic paper tympanic membrane target, set at an anatomically correct angle. To evaluate the model’s efficacy, we assessed the performance of 10 surgically naïve medical student volunteers before training and after 30 minutes of instruction with the model. Their speed was recorded and operative performance was assessed using a validated Global Rating Scale.

Results

After 30 minutes of practice on the model, there was significant improvement in MT placement skill scores and significant decrease in time for tube placement (p<0.05).

Conclusion

This MT placement simulation model is inexpensive and easy to build. Unlike existing planar models, it simulates patient head orientation, and requires realistic hand positioning on a 4mm speculum. Practice with the model for 30 minutes resulted in statistically significant improvement in MT placement skill scores for inexperienced student surgeons.