A Myringotomy and Ventilating Tube Applicator: New Look at a Five-Century-Old Procedure

Abstract

Objective: To fabricate a single instrument that can be used to perform myringotomy and insert a pressure equalizing tube at almost the same time.
 
 Methods: 
 Study Design: Surgical Instrumentation
 Setting: Tertiary Private Hospital
 Subject: A chicken egg membrane was used as a tympanic membrane model
 
 Result: The fabricated instrument was able to perforate the egg membrane and apply the modified polyethylene pressure equalizing tube in less than one minute without complications.
 
 Conclusion: The prototype applicator can facilitate myringotomy and pressure equalizing (PE) tube insertion at only a fraction of the time it usually takes to do the standard myringotomy and subsequent ventilating tube insertion.
 
 Keywords: Myringotomy, pressure equalizing tube, ventilating tube, acute otitis media, otitis media with effusion, polyethylene tube

Simulation Platform for Myringotomy with Ventilation Tube Insertion in Adult Ears

“…In 2015, Amable and Sia-Vargas fabricated an instrument that can perform both myringotomy and ventilation tube insertion using chicken egg membrane as a model for the tympanic membrane. 4 However, the model used in their study does not mimic the EAC anatomy. In addition, using chicken egg membrane for educational purposes might be impractical as it is too soft and fragile making it difficult to handle compared to the tympanic membrane.…”

“…Numerous simulation platforms for MVTI have already been made internationally and locally using various materials with different levels of replicability, validity and cost. [1][2][3] There have also been a number of innovations to make this procedure simpler and less traumatic for the patient such as the use of a self-made tube with a corresponding applicator, 4,5 performing the procedure endoscopically 6 and using an optical myringotomy knife. 7 However, there is a need to evaluate and improve a trainee's dexterity in performing this basic procedure beginning with adult then in pediatric ears.…”