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EvEn ThE world’s number one billiards player, Efren “Bata” Reyes, uses a rake or bridge, locally termed as tiririt, to extend his reach on a shot and win many tournaments. The device, sometimes called a “rake” or simply “bridge” is used to extend a player’s reach on a shot where the cue ball is too far away to achieve accurate hand bridging (Figure 1). It is from this simple device that we drew inspiration to solve the problem of hand shaking or tremors that many ENT surgeons encounter when performing microlaryngeal surgeries. Microlaryngeal surgery is a delicate procedure which involves fine hand movements and skills. In a process which demands fine motor skills in a small operating field, steady and precise movement in instrument handling is difficult to achieve for many surgeons. The instrument, which we will fondly name the microlaryngeal tiririt, was designed to address the problem of shaky handling of instruments during microlaryngeal procedures. The microlaryngeal tiririt operates in similar principle to that of the billiard player’s bridge or rake when making a shot at the cue ball. By reducing the shaky handling of instruments, the surgeon can now focus on the precise microlaryngeal surgical procedure at hand. Brent P. Lavarias, MD Archimedes B. Bagnes, MD Gil M. Vicente, MD

Laryngeal Tiririt (Bridge): for Microlaryngeal Surgery Shake