Development of a Microsurgical Simulator for Laryngeal Surgery: A Novel Training Device

To develop and validate a modular, low-cost, and anatomically realistic microsurgical simulator for endolaryngeal training, including CO₂ laser procedures and microsuturing.

We developed a dual-module simulator consisting of a laryngeal specimen fixation unit and a flexible laryngoscope holder. The device accommodates porcine larynges and enables adjustable exposure and instrument manipulation under microscopic or exoscopic visualization. Junior and senior otolaryngologists performed standardized tasks, including subepithelial vocal fold dissection, microsuturing, and CO₂ laser cordectomy. Participants completed a post-session Likert-scale survey assessing realism, usability, and perceived educational value.

Twenty one otolaryngologists evaluated the simulator. Across survey items, mean scores ranged from 4.29 to 4.95 (SD: 0.22-0.78), with 81.0%-100% agreement (Likert ≥ 4). Perceived training benefit was highest for hand-eye coordination (4.95 ± 0.22, 100%), basic instrumentation for microscopic laser surgery (4.95 ± 0.22, 100%), and bimanual dexterity (4.90 ± 0.30, 100%). Overall satisfaction with the model was high (4.71 ± 0.46, 100%).

This novel modular porcine-larynx simulator provides a practical platform for microlaryngeal skills training with high user-rated realism and educational utility. Its simple design, affordability, and adaptability may facilitate broader implementation in surgical education.

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