• Phonomicrosurgery;
  • surgical assessment;
  • surgical training;
  • simulated model;
  • Video-Based Phonomicrosurgery Instrument Tracking System


To investigate the use of the Video-Based Phonomicrosurgery Instrument Tracking System to collect instrument position data during simulated phonomicrosurgery and calculate motion metrics using these data. We used this system to determine if novice subject motion metrics improved over 1 week of training.

Study Design

Prospective cohort study.


Ten subjects performed simulated surgical tasks once per day for 5 days. Instrument position data were collected and used to compute motion metrics (path length, depth perception, and motion smoothness). Data were analyzed to determine if motion metrics improved with practice time. Task outcome was also determined each day, and relationships between task outcome and motion metrics were used to evaluate the validity of motion metrics as indicators of surgical performance.


Significant decreases over time were observed for path length (P < .001), depth perception (P < .001), and task outcome (P < .001). No significant change was observed for motion smoothness. Significant relationships were observed between task outcome and path length (P < .001), depth perception (P < .001), and motion smoothness (P < .001).


Our system can estimate instrument trajectory and provide quantitative descriptions of surgical performance. It may be useful for evaluating phonomicrosurgery performance. Path length and depth perception may be particularly useful indicators.

Level of Evidence

NA Laryngoscope 124:2332–2337, 2014