Ear Instrument Test
Ear - Otology - Surgical Instruments Course, Kevin Kavanagh
  

 
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Catherine Kavanagh, 
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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.

The pictures on the right show angled and straight handle picks.   









If 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.



 


Picks 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. 

The picture on the right shows two 90 degree picks of approximately one half and one millimeter in length.


 


 

Forceps and scissors : 

Forceps 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 forceps.

  


The picture on the left shows a close up of left cup forceps.






Alligator forceps may be smooth (far right picture ) or serrated (near right picture).










Scissors 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.






       

 

Two 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 instrument.  View Animation of the Action of a Standard Otologic Instrument.


 
In 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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