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Feasibility of ovine and synthetic temporal bone models for simulation training in endoscopic ear surgery

  • S Okhovat (a1), T D Milner (a1) and A Iyer (a1)



Comparing the feasibility of ovine and synthetic temporal bones for simulating endoscopic ear surgery against the ‘gold standard’ of human cadaveric tissue.


A total of 10 candidates (5 trainees and 5 experts) performed endoscopic tympanoplasty on 3 models: Pettigrew temporal bones, ovine temporal bones and cadaveric temporal bones. Candidates completed a questionnaire assessing the face validity, global content validity and task-specific content validity of each model.


Regarding ovine temporal bone validity, the median values were 4 (interquartile range = 4–4) for face validity, 4 (interquartile range = 4–4) for global content validity and 4 (interquartile range = 4–4) for task-specific content validity. For the Pettigrew temporal bone, the median values were 3.5 (interquartile range = 2.25–4) for face validity, 3 (interquartile range = 2.75–3) for global content validity and 3 (interquartile range = 2.5–3) for task-specific content validity. The ovine temporal bone was considered significantly superior to the Pettigrew temporal bone for the majority of validity categories assessed.


Tympanoplasty is feasible in both the ovine temporal bone and the Pettigrew temporal bone. However, the ovine model was a significantly more realistic simulation tool.


Corresponding author

Author for correspondence: Mr Thomas Milner, Department of Otolaryngology, Head and Neck Surgery, University Hospital Monklands, Monkscourt Ave, Airdrie ML6 0JS, Scotland, UK E-mail:


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Mr T Milner takes responsibility for the integrity of the content of the paper



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1Kiringoda, R, Kozin, ED, Lee, DJ. Outcomes in endoscopic ear surgery. Otolaryngol Clin North Am 2016;49:1271–90
2Doğan, S, Bayraktar, C. Endoscopic tympanoplasty: learning curve for a surgeon already trained in microscopic tympanoplasty. Eur Arch Otorhinolaryngol 2017;274:1853–810.1007/s00405-016-4428-0
3Sturm, LP, Windsor, JA, Cosman, PH, Cregan, P, Hewett, PJ, Maddern, GJ. A systematic review of skills transfer after surgical simulation training. Ann Surg 2008;248:166–79
4Sutherland, LM, Middleton, PF, Anthony, A, Hamdorf, J, Cregan, P, Scott, D et al. Surgical simulation: a systematic review. Ann Surg 2006;243:291300
5Awad, Z, Ahmed, S, Taghi, AS, Ghufoor, K, Wareing, MJ, Patel, N et al. Feasibility of a synthetic temporal bone for training in mastoidectomy: face, content, and concurrent validity. Otol Neurotol 2014;35:1813–18
6Gocer, C, Eryilmaz, A, Genc, U, Dagli, M, Karabulut, H, Iriz, A. An alternative model for stapedectomy training in residency program: sheep cadaver ear. Eur Arch Otorhinolaryngol 2007;264:1409–1210.1007/s00405-007-0437-3
7Cordero, A, del mar Medina, M, Alonso, A, Labatut, T. Stapedectomy in sheep: an animal model for surgical training. Otol Neurotol 2011;32:742–7
8Schnabl, J, Glueckert, R, Feuchtner, G, Recheis, W, Potrusil, T, Kuhn, V et al. Sheep as a large animal model for middle and inner ear implantable hearing devices: a feasibility study in cadavers. Otol Neurotol 2012;33:481–9
9Awad, Z, Taghi, A, Sethukumar, P, Tolley, NS. Construct validity of the ovine model in endoscopic sinus surgery training. Laryngoscope 2015;125:539–4310.1002/lary.24927
10The R Project for Statistical Computing. In: [24 September 2019]
11Cordero, A, Benítez, S, Reyes, P, Vaca, M, Polo, R, Pérez, C et al. Ovine ear model for fully endoscopic stapedectomy training. Eur Arch Otorhinolaryngol 2015;272:2167–74
12Mantokoudis, G, Huth, ME, Weisstanner, C, Friedrich, HM, Nauer, C, Candreia, C et al. Lamb temporal bone as a surgical training model of round window cochlear implant electrode insertion. Otol Neurotol 2016;37:52–6
13Anschuetz, L, Bonali, M, Ghirelli, M, Mattioli, F, Villari, D, Caversaccio, M et al. An ovine model for exclusive endoscopic ear surgery. JAMA Otolaryngol Head Neck Surg 2017;143:2452
14Seibel, VA, Lavinsky, L, De Oliveira, JA. Morphometric study of the external and middle ear anatomy in sheep: a possible model for ear experiments. Clin Anat 2006;19:503–9
15Seibel, VA, Lavinsky, L, Irion, K. CT-scan sheep and human inner ear morphometric comparison. Braz J Otorhinolaryngol 2006;72:370–6
16Bhutta, MF. A review of simulation platforms in surgery of the temporal bone. Clin Otolaryngol 2016;41:539–45
17Takahashi, K, Morita, Y, Ohshima, S, Izumi, S, Kubota, Y, Yamamoto, Y et al. Creating an optimal 3D printed model for temporal bone dissection training. Ann Otol Rhinol Laryngol 2017;126:530–6


Feasibility of ovine and synthetic temporal bone models for simulation training in endoscopic ear surgery

  • S Okhovat (a1), T D Milner (a1) and A Iyer (a1)


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