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Otol Neurotol. 2017 Sep;38(8):1193-1197. doi: 10.1097/MAO.0000000000001485.

Development and Validation of a Modular Endoscopic Ear Surgery Skills Trainer.

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*Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee †Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.



Endoscopic ear surgery (EES) is an emerging technique requiring single-handed dissection with limited depth perception. Current options for EES simulation and training are limited. Herein, we introduce a versatile, low-cost surgical skills trainer that aims to improve the fine motor control necessary for EES.


Prospective validation study.


Surgical simulation laboratory.


Seven subjects ranging in experience from medical students ("Novices") to experienced ear surgeons ("Experts") participated in the validation study. Experts (n = 3) were defined as performing >10 EES cases per year.


The skills trainer was constructed from a 3" diameter polyvinyl chloride pipe cap modified with two ports for instrument passage. A wooden platform was placed inside at an appropriate working distance for ear surgery. Eight interchangeable skills modules were fabricated on wooden squares (3 cm × 3 cm) using materials such as #19 wire brads, 1.6 mm glass beads, and 26-gauge jewelry wire. The material cost of this reusable model was $15. Subjects completed each skills module in triplicate, followed by a Likert-based survey.


Expert performance was superior to novices in 100% (8/8) of skills modules, i.e., threading beads on a wire (43 versus 127 s, p < 0.001) and placing a simulated prosthesis (13 versus 68 s, p = 0.01). Most participants (86%) agreed the trainer orientation was accurate and all participants (100%) were satisfied with the experience.


This low-cost modular task trainer may help fill a void in otologic training by allowing efficient, deliberate practice of validated exercises designed to improve fine motor control with EES instrumentation.

[Indexed for MEDLINE]

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