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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Background Eustachian tube dysfunction (ETD) is a common clinical condition encountered by otolaryngologists. The severity and duration of symptoms range from the mild and transient to the chronic and severe along with secondary pathologies. Balloon dilation eustachian tuboplasty (BDET) as a treatment, was first described in 2010 and has been studied extensively. This study evaluates the efficacy and safety of BDET in an Australian cohort. Methods Retrospective chart review on all patients who underwent BDET from September 2016 to March 2020 was performed. The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ‐7) was chosen as the primary outcome measure. Secondary outcome measures included subjective global assessment of presenting symptoms, ability to perform Valsalva maneuver and tympanometry. Any complications related to the procedures were reported. Results One hundred and nineteen eustachian tube operations were included in this study. The patient cohort showed statistically significant improvement of mean EDTQ‐7 score from 0.7 to 2.9. Improvement in EDTQ‐7 was achieved in 83.9% of the cases. All patients in the baro‐challenge‐induced subgroup achieved improvement in ETDQ‐7 score. Complete resolution of symptoms with an ETDQ <2.1 was achieved in 37.1% of the cohort. There were no adverse safety events associated with the procedures. Conclusion BDET resulted in improvement of the EDTQ‐7 score in most of patients in this Australian cohort with no reported complications. BDET was most successful in baro‐challenge‐induced subgroup with universal improvement. Lower success rates were seen in patients with secondary pathology from their ETD.