Middle ear infection is the most common reason children around the world see a doctor. Treatment involves surgery under general anaesthesia, so it requires an anaesthetist, operating theatre set-up, and substantial manpower support. Left untreated, it can lead to longterm hearing loss and difficulties in speech and learning.
Dr Lynne Lim was performing consultations and neck tumour surgery in a rural village in Cambodia in 2009 when she encountered a large number of children with untreated middle ear infections. Although able to remove neck lumps with just local anaesthesia, she could not drain fluid from eardrums without the appropriate tools and support. But inspiration struck after she had returned from the humanitarian mission and was watching her daughter getting her ears pierced. “The good lady used a handheld applicator. ‘Click, click’ and it was done. That was the aha moment,” she recounts.
To bring her vision to life, she recruited Gan Chee Wee, an engineer by training. Research and development alone took 10 years. As it was, the duo had to engage multidisciplinary engineers and design houses to assemble the software, sensors, proximity indicators, and many other internal components based on Lim’s clinical input. In addition, they had to partake in a never-ending cycle of prototyping, testing, gathering feedback from laboratory and cadaver experiments, and repeating the process to incorporate new information.
Today, CLiKX is the world’s first and only robotic, handheld surgical device for ear tube surgery. It inserts 1mm ear tubes with one click within one second. This means that ENT surgeons can in the future treat middle ear infections with just local anaesthesia and a headlight besides other basic surgical instruments.
To launch the product, Lim and Gan founded NousQ, a startup that designs, develops, manufactures, and commercialises medical technology and devices. The company has raised over half of its targeted US$6.5 million (S$8.7 million) Pre Series A funding and plans to enter pivotal FDA trials in the USA and introduce CLiKX to the market in 2026.
But much as there has been progress, the undertaking has been an uphill battle. Investors are still hesitant to invest in invasive surgery devices, Lim says, because they require a longer time to market due to clinical trials and regulatory approvals. Moreover, fewer investors can fill the lead investor role, so follow investors have have more difficulty joining. Then, there is a shrinking talent pool and funding limitations.
“There should be non-dilutive research grant funding and clinical trial sites available in the private sector. For a small country like Singapore, we’d do better if we encouraged a whole-country approach to innovation.”
Dr Lynne Lim on the need for greater support for local medtech entrepreneurs
More private-public collaborations, she continues, would change the game the way diversity has in the workplace and boards.
That said, every bit counts, and winning first place in the Science & Technology Pioneer category at the 2024 Cartier Women’s Initiative had her walking away with US$100,000. She intends to use the prize money to fund those who cannot afford CLiKX, a move that will also benefit NousQ since the clinical data will facilitate faster entry into the market. In the grander scheme of things, this will allow them to help more patients.
The multitude of challenges in medtech can make it easy to forget why one went into the field in the first place. So, Lim’s advice for medtech entrepreneurs is simple: “Keep in mind why you started. Who will do it if we don’t? If we’re successful, it can be extremely rewarding. The barriers to entry are high for competitors.”
Art director: Ed Harland
Videographer: Alicia Chong
Photographer: Mun Kong
Photographer’s assistant: Melvin Leong
Hair: Sarah Tan
Makeup: Keith Bryant Lee using Lancome
