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The identification of ear instruments is difficult.
Many of the instruments have surgical ends which can barely be seen. It is
a good idea to identify the instruments
before the ear case starts, using the operative microscope if necessary and
label them by writing on the mayo stand drapes. All of the pictures below
can be enlarged by clicking on them. The ends of the instruments are hard
to see and close-up pictures are provide for this purpose. However, the
close up pictures enlarge the instrument significantly and give a better view
than when using the naked-eye.
Click on pictures to enlarge
The most common
instruments are picks, cup forceps, alligator forceps and micro-scissors.
Picks: There are two types of handles for picks, straight and
angled. They can also be sharp or dull and of various lengths and angles.
pictures on the right show angled and straight handle picks.
the handle is angled the picks name also contains a direction, right left, up or
down. The same is true for cup-forceps, scissors and alligator
forceps. The direction is determined by holding the instrument as a
surgeon would. If the end of the instrument is bent to the left then the
pick is a left pick, to the right is a right pick, with similar names for up and
down instruments. The picture on the right shows a left pick.
are also named for their angles. Common angles are 45 and 90 degrees. The picture on the right
is a close-up of the hand held left pick shown above. The pick has an
angle of 45 degrees and is to the left. It is a short pick of about half a
millimeter. Thus, your surgeon may ask for a short (or half millimeter) 45
degree pick to the left. Note: The actual length of the picks
are seldom known and will vary between instruments because all are hand made and
each unique. Most ear sets have a long and a short pick and it is best to
refer to them in the fashion.
picture on the right shows two 90 degree picks of approximately one half and one
millimeter in length.
Forceps and scissors
are used to grasp tissue. There are two types of forceps: cups and
alligators. Cup forceps have two opposing small cups at the end of
the shaft which can grasp tissue. Alligator forceps have two long-flat
metal projections which oppose each other and can grasp tissue. Forceps
can be up down, right and left depending upon the direction the action end is
bent. Like picks, the direction is determined by holding the instrument as
a surgeon would. If it is bent to the left, it is a left forceps, to the
right a right forceps, etc. The picture on the right shows a left cup
The picture on the left shows a close up of left cup forceps.
forceps may be smooth (far right picture ) or serrated (near right picture).
can be large and used to cut the ear canal skin (pictures to the right) or small
and used to cut middle ear structures--two pictures shown below.
different types of handle actions are available. The most common
handle action is used by the instrument to the right. The upper finger
ring of the handle must be held stationary to steady the working head of the
View Animation of the Action of a Standard Otologic
a reverse action instrument, the lower finger ring is held steady. This
is a much more delicate instrument but allows the surgeon to stabilize his
hand while holding the instrument.
View Animation of the Action of a Hand-Stable Otologic Instrument.
An analogous instrument terminology and instrument types of picks, scissors
and forceps is used with micro-laryngeal instruments.
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