Measuring the Forces of Middle Ear Surgery; Evaluating a Novel Force-Detection Instrument

Hypothesis: The forces applied to the middle ear structures during surgery are measurable. Background: Surgical forces applied to the middle ear are often cited as a cause of postoperative sensorineural hearing loss; however, no literature exists on how much total force is applied during common middle ear procedures. Methods: Using our novel middle ear surgical force sensor, we took measurements from 6 temporal bones of common middle ear manipulations. Results: Temporal bones of 3 males and 3 females yielded 72 measurements for an average peak applied force and 68 measurements for total applied force across 3 levels of operator experience. Statistically significant differences were seen between different levels of operator and how much force was applied, with senior operators using less force. Conclusion: We show it is possible to measure the applied forces in middle ear surgery and that some of these forces are very large. Larger forces are seen in destructive procedures and in procedures performed by inexperienced operators. This project is an important first step in investigating the association between surgically applied middle ear forces and postoperative sensorineural hearing loss.