Virtual Reality Simulator for Training in Myringotomy with Tube Placement

Huang, Caiwen; Agrawal, Sumit; Ladak, Hanif M.

doi:10.1007/s40846-016-0124-1

Cited by 11 publications

(13 citation statements)

References 51 publications

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“…An overview of the major features of the simulator is given here; in-depth technical details on the system can be found in a previous publication [ 22 ]. The simulator consists of 3 major components: the simulation software, a display system, and a haptic arm as shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

“…1 . The simulation software was developed in the Auditory Biophysics Laboratory at Western University [ 19 – 22 ]. The simulator runs on a Z420 Hewitt-Packard personal computer, equipped with an Intel(R) Xeon E5-1620 processor (Intel Corp., Sanata Clara, CA) and a NVIDIA Quadro 4000 graphics card (NVIDIA Corp., Santa Clara, CA).…”

Section: Methodsmentioning

confidence: 99%

“…Previously, we had tested individual software modules focusing on blade navigation [ 19 ], haptics [ 20 ] and tympanic membrane deformation and cutting [ 21 ]. Since this new simulator [ 22 ] refined each of these components, including the graphical representations of the ear and virtual tools, and included new features such as microscope handling, speculum positioning and tube insertion, the Myringotomy Surgery Simulation Scale (MS 3 ) used in previous publications [ 20 , 21 ] was modified to include these features. The questionnaire was divided into three sections (A, B, and C) with a total of 20 questions.…”

Section: Methodsmentioning

confidence: 99%

“…As recently reported [ 22 ], the Western myringotomy simulator has integrated the previous modules into a common software platform. Moreover, new software modules have been added to allow the user to adjust their surgical view through positioning and tilting of the virtual speculum and operative microscope, and to allow insertion of a ventilation tube into the myringotomy created in a deformable tympanic membrane.…”

Section: Introductionmentioning

confidence: 99%

“…Face validity refers to the degree to which a simulation appears like the real situation [ 23 ] and content validity measures whether the simulator would be appropriate or useful in training [ 24 , 25 ]. Although face validity has previously been established for individual software modules [ 19 – 21 ], validation testing has not been performed on the current integrated system, which simulates the entire procedure from microscope positioning to ventilation tube insertion [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Face and content validity of a virtual-reality simulator for myringotomy with tube placement

Huang

Cheng

Bureau

et al. 2015

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundMyringotomy with tube insertion can be challenging for junior Otolaryngology residents as it is one of the first microscopic procedures they encounter. The Western myringotomy simulator was developed to allow trainees to practice microscope positioning, myringotomy, and tube placement. This virtual-reality simulator is viewed in stereoscopic 3D, and a haptic device is used to manipulate the digital ear model and surgical tools.ObjectiveTo assess the face and content validity of the Western myringotomy simulator.MethodsThe myringotomy simulator was integrated with new modules to allow speculum placement, manipulation of an operative microscope, and insertion of the ventilation tube through a deformable tympanic membrane. A questionnaire was developed in consultation with instructing surgeons. Fourteen face validity questions focused on the anatomy of the ear, simulation of the operative microscope, appearance and movement of the surgical instruments, deformation and cutting of the eardrum, and myringotomy tube insertion. Six content validity questions focused on training potential on surgical tasks such as speculum placement, microscope positioning, tool navigation, ear anatomy, myringotomy creation and tube insertion. A total of 12 participants from the Department of Otolaryngology—Head and Neck Surgery were recruited for the study. Prior to completing the questionnaire, participants were oriented to the simulator and given unlimited time to practice until they were comfortable with all of its aspects.ResultsResponses to 12 of the 14 questions on face validity were predominantly positive. One issue of concern was with contact modeling related to tube insertion into the eardrum, and the second was with the movement of the blade and forceps. The former could be resolved by using a higher resolution digital model for the eardrum to improve contact localization. The latter could be resolved by using a higher fidelity haptic device. With regard to content validity, 64 % of the responses were positive, 21 % were neutral, and 15 % were negative.ConclusionsThe Western myringotomy simulator appears to have sufficient face and content validity. Further development with automated metrics and skills transference testing is planned.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Face and content validity of a virtual-reality simulator for myringotomy with tube placement

Huang

Cheng

Bureau

et al. 2015

Journal of Otolaryngology - Head & Neck Surgery

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A modular surgical simulator for microlaryngoscopy using standard instruments and the carbon dioxide laser

Bressler

Adkins

Dunham

et al. 2022

Laryngoscope Investig Oto

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Objective Build a microlaryngoscopy surgical simulator for endoscopic laryngeal surgery using standard microsurgical instruments and a CO2 laser. Study design Anatomical modeling, CAD design and 3D printed manufacturing. Subjects and methods We created a modular design for a microlaryngoscopy simulator in CAD software. Components include plastic and stainless‐steel models of a standard operating laryngoscope and a cassette system for mounting porcine or synthetic models of the vocal folds. All simulator parts, including the metallic laryngoscope model, were manufactured using 3D printing technology. Tumors were simulated in porcine tissue models by injecting a soy protein‐based tumor phantom. Residents and faculty in the Louisiana State University otolaryngology department evaluated the system. Each participant performed microlaryngoscopy with laser resection on a porcine larynx and cold instrument procedures on synthetic vocal folds. Participants scored the simulator using a 5‐point Likert scale. Results The microlaryngeal surgical simulator demonstrated in this project is realistic, economical, and easily assembled. We have included 3D printed parts files and detailed assembly instructions that will enable educators interested in surgical simulation to build the device. Participants in the simulator evaluation session felt that the simulator faithfully represented the procedure to resect vocal fold lesions using a CO2 laser. The synthetic model allows the trainee to develop hand‐eye coordination while using standard laryngeal instruments. Conclusions The simulator described herein will enable surgeons to acquire the surgical skills necessary to perform operative microlaryngoscopy prior to operating on live patients.

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Fracture behaviour of human skin in deep needle insertion can be captured using validated cohesive zone finite-element method

Mohammadi

Ebrahimian

Maftoon

2021

Computers in Biology and Medicine

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Virtual Reality Simulator for Training in Myringotomy with Tube Placement

Cited by 11 publications

References 51 publications

Face and content validity of a virtual-reality simulator for myringotomy with tube placement

Face and content validity of a virtual-reality simulator for myringotomy with tube placement

A modular surgical simulator for microlaryngoscopy using standard instruments and the carbon dioxide laser

Fracture behaviour of human skin in deep needle insertion can be captured using validated cohesive zone finite-element method

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