3D-printed pediatric endoscopic ear surgery simulator for surgical training

Authors

Samuel R. Barber, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.Follow
Elliott D. Kozin, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Electronic address: Elliott_Kozin@meei.harvard.edu.
Matthew Dedmon, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Brian M. Lin, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Kyuwon Lee, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Sumi Sinha, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Nicole Black, Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, USA.
Aaron K. Remenschneider, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Daniel J. Lee, Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

Document Type

Article

Abstract

INTRODUCTION: Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. METHODS: The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. RESULTS: All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p < 0.05) and average completion time for junior and senior residents (p < 0.05) suggest construct validity. CONCLUSIONS: A 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation.

Medical Subject Headings

Computer-Aided Design; Dissection (education); Ear Canal (anatomy & histology); Ear, Middle (anatomy & histology, surgery); Endoscopy (education); Humans; Models, Anatomic; Otologic Surgical Procedures (education); Pediatrics (education); Printing, Three-Dimensional; Simulation Training (methods)

Publication Date

11-1-2016

Publication Title

International journal of pediatric otorhinolaryngology

E-ISSN

1872-8464

Volume

90

First Page

113

Last Page

118

PubMed ID

27729115

Digital Object Identifier (DOI)

10.1016/j.ijporl.2016.08.027

Recommended Citation

Barber, Samuel R.; Kozin, Elliott D.; Dedmon, Matthew; Lin, Brian M.; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K.; and Lee, Daniel J., "3D-printed pediatric endoscopic ear surgery simulator for surgical training" (2016). ENT and Skull Base Surgery. 50.
https://scholar.barrowneuro.org/ent-and-skull-base-surgery/50