Learning Objectives:

Middle ear surgery requires thorough knowledge of middle-ear anatomy and great surgical precision. However, training tools remain limited: absence of animal model and lack of access to cadaveric temporal bone hampers the implementation of standardized program of training. It seems crucial to develop alternative methods for surgical training, such as virtual reality (VR) and simulator. The aim of our study was to assess face, content, construct validity of the Voxel-Man^® TempoSurg VR simulator.

Were included in the study 74 ENT surgeons, splitted in 2 groups according to their level of expertise: the expert group (n = 16) and the novice group (n = 58). The 2 groups benefited from a simple drilling task to familiarize them with the simulator and then performed four temporal bone dissection tasks. The performance of both groups were assessed by a global score and compared to assess the construct validity of the simulator. Finally, face and content validity were assessed using a five-point Likert-type scale. Experienced surgeons performed better (p < .01) and faster (p < .001) than novices. However, no differences in the bone volume removed and the number of injury to structures were found between the two groups. All experienced surgeons, except one would recommend the Voxel-Man simulator for anatomy learning (mean score 4.7). Most of them (87.5%) also thought that this simulator could be integrated in surgical training (mean score 4.1).

The Voxel-Man TempoSurg Virtual Reality Simulator constitutes an interesting complementary tool to traditional teaching methods for training in otologic surgery. Although some features require improvements, it allows trainees to acquire a good three-dimensional visualization of ear structures and to learn complex surgical skills. By its ability to distinguish different level of expertise, this simulator could be used as a certification tool, constituting a prior condition for performing real-life surgery.