A Novel Tool for Application of Bone Wax in Neurotologic and Skull Base Surgery

Surgeries of the ear and lateral skull base frequently require the use of bone wax to seal off small vessels and to repair or prevent leakage of cerebrospinal fluid. Application of bone wax to the hard, wet, and irregular surface of the bone is challenging with conventional instruments due to the tendency of the wax to slip off the bone and the narrow surgical corridors of the lateral skull base. Here we present a novel surgical tool for bone wax application, comprised of a rigid core with a coating of softer material over the ends. We tested several combinations of 3D printed materials in cadaveric temporal bones simulating surgical conditions. The tool was superior to conventional methods of bone wax application for all material combinations tested. Further studies into optimal materials and additional applications are planned.