Development of a Peroral Vocal Fold Injection Training System

Although trainees often receive adequate training in operative vocal fold (VF) injections under anesthesia, their experience with awake in-office injections is usually more limited. This is due to the increased skill required and a lack of patient tolerance. Multiple models exist to help trainees become more familiar with awake percutaneous VF injections, but there is a paucity of simulation models for the awake peroral approach. We designed and built a low-cost, easily replicated model to allow trainees to develop some of the fundamental skills required to perform in-office peroral VF injections.

Survey.

Single-center tertiary medical center.

After building the model, medical students and otolaryngology residents were recruited for participation in the study. The Michigan Standard Simulation Experience Scale (MiSSES) was used to assess participants' comfort with peroral VF injections before using the model. Participants then performed five injections and completed the remaining portion of the MiSSES to assess the simulation's efficacy, fidelity, and educational value.

Nineteen participants completed the study. Nearly all (18/19) reported poor confidence with peroral VF injections before participating. After using the model, participants rated it as having realistic features and reported improved confidence and ability with peroral VF injections. The overall simulation experience was rated as 4.8/5.

This low-cost, reproducible model improved participants' confidence and ability with peroral VF injections. It can be used to teach trainees some the basic skills of in-office peroral VF injection and is a valuable addition to an otolaryngology educational curriculum.