Author(s)
Jacqueline Tucker, MD MEd
Hanel W. Eberly, BS
Jessyka G. Lighthall, MD FACS
Neerav Goyal, MD MPH FACS
Affiliation(s)
University of Minnesota Department of Otolaryngology (Tucker), Penn State College of Medicine Department of Otolaryngology (Eberly, Lighthall, Goyal);
Abstract:
Background: The Erich arch bar system has been the standard for maxillomandibular fixation (MMF). Hybrid techniques have been proposed to improve application.
Learning Objectives: Discuss MMF techniques and utility of training using models.
Study objective: Improve trainee comfort with MMF using a model and assess perspectives.
Design Type: Unblinded crossover
Methods: During 2 hour-long training sessions, participants watched video demonstrations of Depuy Synthes MatrixWave (MW) system and Erich Arch bar (EAB) placement. Participants were timed while placing the systems on a model. Afterwards participants were graded on their performance by otolaryngology faculty and also filled surveys assessing their comfort with the model. Analyses using Mann-Whitney U tests and t-tests were completed.
Results: Twenty-six participants were included. There was a significant difference in time to complete MW placement compared to EAB for the first session (31 vs 54 minutes, p<0.001). There were no significant differences in time taken to place either system across sessions. Participants reported a significant difference between MW and EAB regarding comfort (3.63/5 vs 2.06/5 respectively, p<0.001) and ease of use (3.81/5 vs 1.67/5 respectively, p <0.001) during the first session only. Participant scores improved across sessions for both the EAB and MW regarding respect for tissue (2.45/5 vs 3.5/5, p=0.0255 EAB, 3.06/5 vs 4/5, p<0.001 MW), procedure knowledge (2/5 vs 3.67/5, p=0.002 EAB, 2.8/5 vs 4.08/5, p<0.001 MW), instrument handling (2.1/5 vs 3.33/5, p<0.001 EAB, 2.85/5 vs 4/5, p=0.001 MW), and flow of operation (2/5 vs 3.17/5, p=0.01 EAB, 2.9/5 vs 3.83/5, p=0.01 MW).
Conclusion: Participants completed MW placement in less time and reported higher comfort and ease of use as compared to EAB. Participant scores across various parameters improved over sessions for both techniques. Simulation may improve proficiency with techniques and MW may be more efficient and comfortable to implement.