gms | German Medical Science

Background: Learning the necessary surgical steps for tympanoplasty is a long process which mainly depends on the surgeons experience and dexterity. Using the active training model ADTM, it is possible to study and optimize the techniques for reconstruction of both ossicular chain and eardrum while monitoring the quality of reconstruction.

Methods: During practical training with the ADTM, the surgeon first positions a partial middle ear prosthesis on the stapes head and reconstructs the tympanic membrane. Following this, the sound transmission is measured and the surgeon receives a real-time audio feedback (via headphones), enabling him to assess and, if necessary, optimize the quality of the reconstruction. 88 surgeons trained this procedure with ADTM and evaluated the ADTM using 15-items-questionaire.

Results: The evaluation result was 7.94 out of 10 for the anatomic exactness of ADTM (scale: 1-worst grade, 10-best grade). In comparison to the real surgical situation, the grade was 7.52 for ADTM and the general model properties had been rated very highly (grade 7.55). Stratified according to experience (>/< 100 tympanoplasties) no statistically significant differences were found. All surveyed surgeons considered training with the ADTM to have a lasting positive effect (grade 8.85) on their reconstruction technique, in part due to the quality monitoring provided by live feedback.

Conclusion: The properties of the ADTM and the effect of training with the model were rated favourably by the surveyed surgeons. The real-time acoustic feedback is deem highly benefitial, with 81% of participants interested in using it in their daily routine. 95% of the reconstructions performed in the study were improved using the acoustic feedback.

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