A Novel Irrigation System That Decreases Fluid Consumption During Otologic and Neurotologic Surgery

To describe a novel sterile fluid irrigation system for otologic/neurotologic surgery and compare the consumption of fluid using different techniques to identify the most fluid-efficient system.

Patients undergoing cochlear implant (CI) or translabyrinthine skull base (TL) surgery at a tertiary referral center using different irrigation techniques from October 2022 to December 2024, with detailed intraoperative documentation of sterile fluid utilization.

CI or TL surgery using different irrigation techniques.

A comparison of the volume of sterile irrigation fluid (in liters [L]) used during CI or TL surgery across the following irrigation techniques: manual suction irrigation (MSI), automated cassette suction irrigation (ASI), and automated cassette drill irrigation (ADI). The Mann-Whitney U test was used to compare medians between groups.

For CI surgery, the median volume of sterile irrigation fluid used was 4 L [interquartile range (IQR): 4-4, n=10] for MSI, 2 L (IQR: 2-2.5, n=5) for ASI, and 0.5 L (IQR: 0.5-0.5, n=10) for ADI (P<0.01). For TL surgery, the median volume of sterile irrigation fluid used was 10 L (IQR: 10-10, n=7) for MSI, 5.45 L (IQR: 4-5.72, n=5) for ASI, and 1.5 L (IQR: 1-2, n=10) for ADI (P<0.01). There were no irrigation-related complications.

The volume of fluid irrigation used during otologic/neurotologic surgery varies widely depending on the technique used with ADI conserving the most fluid, followed by ASI and MSI, respectively. The novel ASI system promotes resource conservation, sustainability and surgical technologists' ease of use.