Face and Content Validity of Tympanostomy Tube Simulator With Variable Canal Size

Simulators allow junior otolaryngology residents to practice the delicate procedure of pressure equalization tube (PET) insertion. However, most simulators lack the ability to mimic the differing anatomic complexities between patients, such as variable external auditory canal (EAC) size. We developed a novel low-cost, medium-fidelity 3-dimensional-printed PET simulator with different EAC sizes to better reflect procedure complexity. Additionally, a variety of materials were tested to mimic the elastic modulus of the tympanic membrane, with "Press'n Seal" cling film being chosen for its cost-effectiveness and tactile similarity. Ten otolaryngologists performed PET insertion on both EAC sizes followed by a survey to assess face and content validity. Results indicated both high face and content validity, with most participants agreeing the simulator provided a realistic experience and would be useful for training. While our study has a small sample size, our PET simulator adds a unique and valuable addition to PET training.