Effectiveness of Artificial Needle Water Drop for Mastoidectomy: an Innovation in Krabi Hospital - ประสิทธิผลเข็มหยดนำประดิษฐ์ใช้ในผู้ป่วย ผ่าตัดกรอกระดูกมาสตอยด์ โรงพยาบาลกระบี

Abstract

           Mastoidectomy in patients with mastoiditis is an important operation because it can prevent hearing loss and central nervous system infections. There were several cases of mastoidectomy in Krabi hospital each year, and the trend is rising. The important risks of this surgery are bone necrosis and injury to vessel and nerve nearby due to heat from drilling process. Droping water into drilling area during the operation can reduce heat effect and prevent further injury. However hand drills used in Krabi hospital do not have water dropping needle, therefore an assistant has to be assigned to drop water; and the process is usually not precise. The objective of this study was to develop and evaluate the effectiveness of a water dropping
needle set developed for mastoidectomy. The whole study was devided into 2 steps: (1) development of the needle set and (2) effeciency testing comparing the outcomes of use of the needle set with the routine water dropping procedure. The step 1 involved curvings and modifications of 4-inch metal needles to fit with the anatomy of mastoid bone and the direction of water dropping. Such process came up with 4 configurations of the needles; and after trials with mannikin, the forth configuration was found to be the
most precise for the operation. For the step 2 with was conducted during January 2002 to December 2012, the needle set was tested in mastodectomy operation, comparing the efficiency with the routine procedure. Ten patients were devided into 2 groups, one with the innovation set and the other with the regular needle. Precision of water dropping and user’s satisfaction were compared between the 2 groups. It was found that the innovation needle group had better precision of water dropping to the desired operative
area than that of the regular needle group (100.0% vs 50.0%). Both surgeon and assistant had express more satisfaction over the innovation needle set. Many benefits were identified. Firstly, the innovation set reduced the number of assistant nurse in the operative field. Secondly, there was no complication during the use. Lastly, the hospital saved at least 200 thousand bahts with would have been useed to purchase a new mastoidectomy machine that is equipped with a water dropping apparatus.

Key words: modified water dropping needle, mastoidectomy, effectiveness