Development and Validation of a Modular Endoscopic Ear Surgery Skills Trainer

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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.

Study Design:

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.

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