A 21-gauge syringe needle technique for malleus skeletonization and middle ear dissection.

BACKGROUND

Middle ear micro-dissection steps-such as malleus skeletonization, removal of soft tissue from the stapes suprastructure, and chorda tympani dissection-require a high level of precision to prevent ossicular luxation, sensorineural hearing loss, or taste disturbances that can be caused by excessive mechanical forces or dulled surgical instruments.

METHOD: An accesible and low-cost micro-instrument was developed by firmly inserting the hub of a standard, disposable 21-gauge hypodermic syringe needle onto the back end of a standard otological micro-instrument handle. The needle tip, featuring a sharp apex and bidirectional beveled sharp edges, functions as a disposable micro-knife alternative through tangential and saw-like micro-movements. Thus, it can come to the surgeon's aid in situations where pointed picks, sickle knives, and micro-blades become dull for various reasons and fail to provide sufficient sharpness.

CONCLUSION

This accessible technique provides a consistently sharp cutting edge in every case, facilitating safe tangential incisions and offering a practical option for delicate otologic dissections.