Integration of 3D-printed middle ear models and middle ear prostheses in otosurgical training.
3D printing
Middle ear
Ossicles
Ossiculoplasty
PORP
Temporal bone
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
24 Apr 2024
24 Apr 2024
Historique:
received:
13
12
2023
accepted:
17
04
2024
medline:
25
4
2024
pubmed:
25
4
2024
entrez:
24
4
2024
Statut:
epublish
Résumé
In otosurgical training, cadaveric temporal bones are primarily used to provide a realistic tactile experience. However, using cadaveric temporal bones is challenging due to their limited availability, high cost, and potential for infection. Utilizing current three-dimensional (3D) technologies could overcome the limitations associated with cadaveric bones. This study focused on how a 3D-printed middle ear model can be used in otosurgical training. A cadaveric temporal bone was imaged using microcomputed tomography (micro-CT) to generate a 3D model of the middle ear. The final model was printed from transparent photopolymers using a laser-based 3D printer (vat photopolymerization), yielding a 3D-printed phantom of the external ear canal and middle ear. The feasibility of this phantom for otosurgical training was evaluated through an ossiculoplasty simulation involving ten otosurgeons and ten otolaryngology-head and neck surgery (ORL-HNS) residents. The participants were tasked with drilling, scooping, and placing a 3D-printed partial ossicular replacement prosthesis (PORP). Following the simulation, a questionnaire was used to collect the participants' opinions and feedback. A transparent photopolymer was deemed suitable for both the middle ear phantom and PORP. The printing procedure was precise, and the anatomical landmarks were recognizable. Based on the evaluations, the phantom had realistic maneuverability, although the haptic feedback during drilling and scooping received some criticism from ORL-HNS residents. Both otosurgeons and ORL-HNS residents were optimistic about the application of these 3D-printed models as training tools. The 3D-printed middle ear phantom and PORP used in this study can be used for low-threshold training in the future. The integration of 3D-printed models in conventional otosurgical training holds significant promise.
Sections du résumé
BACKGROUND
BACKGROUND
In otosurgical training, cadaveric temporal bones are primarily used to provide a realistic tactile experience. However, using cadaveric temporal bones is challenging due to their limited availability, high cost, and potential for infection. Utilizing current three-dimensional (3D) technologies could overcome the limitations associated with cadaveric bones. This study focused on how a 3D-printed middle ear model can be used in otosurgical training.
METHODS
METHODS
A cadaveric temporal bone was imaged using microcomputed tomography (micro-CT) to generate a 3D model of the middle ear. The final model was printed from transparent photopolymers using a laser-based 3D printer (vat photopolymerization), yielding a 3D-printed phantom of the external ear canal and middle ear. The feasibility of this phantom for otosurgical training was evaluated through an ossiculoplasty simulation involving ten otosurgeons and ten otolaryngology-head and neck surgery (ORL-HNS) residents. The participants were tasked with drilling, scooping, and placing a 3D-printed partial ossicular replacement prosthesis (PORP). Following the simulation, a questionnaire was used to collect the participants' opinions and feedback.
RESULTS
RESULTS
A transparent photopolymer was deemed suitable for both the middle ear phantom and PORP. The printing procedure was precise, and the anatomical landmarks were recognizable. Based on the evaluations, the phantom had realistic maneuverability, although the haptic feedback during drilling and scooping received some criticism from ORL-HNS residents. Both otosurgeons and ORL-HNS residents were optimistic about the application of these 3D-printed models as training tools.
CONCLUSIONS
CONCLUSIONS
The 3D-printed middle ear phantom and PORP used in this study can be used for low-threshold training in the future. The integration of 3D-printed models in conventional otosurgical training holds significant promise.
Identifiants
pubmed: 38658934
doi: 10.1186/s12909-024-05436-9
pii: 10.1186/s12909-024-05436-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
451Informations de copyright
© 2024. The Author(s).
Références
Chien WW, Da Cruz MJ, Francis HW. Validation of a 3D-printed human temporal bone model for otology surgical skill training. World J Otorhinolaryngol - Head Neck Surg. 2021;7(2):88–93. https://doi.org/10.1016/j.wjorl.2020.12.004 .
doi: 10.1016/j.wjorl.2020.12.004
Skrzat J, Zdilla MJ, Brzegowy P, Hołda M. 3 D printed replica of the human temporal bone intended for teaching gross anatomy. Folia Med Cracov. 2019;59(3):23–30. https://doi.org/10.24425/fmc.2019.131133 .
Mukherjee P, Cheng K, Wallace G, et al. 20 Year Review of Three-dimensional Tools in Otology: Challenges of Translation and Innovation. Otol Neurotol. 2020;41(5):589–95. https://doi.org/10.1097/MAO.0000000000002619 .
doi: 10.1097/MAO.0000000000002619
Aussedat C, Venail F, Marx M, Boullaud L, Bakhos D. Training in temporal bone drilling. Eur Ann Otorhinolaryngol Head Neck Dis. 2022;139(3):140–5. https://doi.org/10.1016/j.anorl.2021.02.007 .
doi: 10.1016/j.anorl.2021.02.007
Trier P, Noe KØ, Sørensen MS. The Visible Ear Surgery Simulator. R S: Published online; 2008.
Varoquier M, Hoffmann CP, Perrenot C, Tran N, Parietti-Winkler C. Construct, Face, and Content Validation on Voxel-Man® Simulator for Otologic Surgical Training. Int J Otolaryngol. 2017;2017:1–8. https://doi.org/10.1155/2017/2707690 .
doi: 10.1155/2017/2707690
Frithioff A, Frendø M, Weiss K, et al. Effect of 3D‐Printed Models on Cadaveric Dissection in Temporal Bone Training. OTO Open. 2021;5(4). doi: https://doi.org/10.1177/2473974X211065012
Gadaleta DJ, Huang D, Rankin N, et al. 3D printed temporal bone as a tool for otologic surgery simulation. Am J Otolaryngol. 2020;41(3): 102273. https://doi.org/10.1016/j.amjoto.2019.08.004 .
doi: 10.1016/j.amjoto.2019.08.004
Stramiello JA, Wong SJ, Good R, Tor A, Ryan J, Carvalho D. Validation of a three-dimensional printed pediatric middle ear model for endoscopic surgery training. Laryngoscope Investig Otolaryngol. 2022;7(6):2133–8. https://doi.org/10.1002/lio2.945 .
doi: 10.1002/lio2.945
Jenks CM, Patel V, Bennett B, Dunham B, Devine CM. Development of a 3‐Dimensional Middle Ear Model to Teach Anatomy and Endoscopic Ear Surgical Skills. OTO Open. 2021;5(4). doi: https://doi.org/10.1177/2473974X211046598
Hochman JB, Kraut J, Kazmerik K, Unger BJ. Generation of a 3D Printed Temporal Bone Model with Internal Fidelity and Validation of the Mechanical Construct. Otolaryngol Neck Surg. 2014;150(3):448–54. https://doi.org/10.1177/0194599813518008 .
doi: 10.1177/0194599813518008
Mick PT, Arnoldner C, Mainprize JG, Symons SP, Chen JM. Face Validity Study of an Artificial Temporal Bone for Simulation Surgery. Otol Neurotol. 2013;34(7):1305–10. https://doi.org/10.1097/MAO.0b013e3182937af6 .
doi: 10.1097/MAO.0b013e3182937af6
Sieber DM, Andersen SAW, Sørensen MS, Mikkelsen PT. OpenEar Image Data Enables Case Variation in High Fidelity Virtual Reality Ear Surgery. Otol Neurotol. 2021;42(8):1245–52. https://doi.org/10.1097/MAO.0000000000003175 .
doi: 10.1097/MAO.0000000000003175
Probst R, Stump R, Mokosch M, Röösli C. Evaluation of an Infant Temporal-Bone Model as Training Tool. Otol Neurotol. 2018;39(6):e448–52. https://doi.org/10.1097/MAO.0000000000001839 .
doi: 10.1097/MAO.0000000000001839
Rose AS, Kimbell JS, Webster CE, Harrysson OLA, Formeister EJ, Buchman CA. Multi-material 3D Models for Temporal Bone Surgical Simulation. Ann Otol Rhinol Laryngol. 2015;124(7):528–36. https://doi.org/10.1177/0003489415570937 .
doi: 10.1177/0003489415570937
Yuan ZM, Zhang XD, Wu SW, et al. A simple and convenient 3D printed temporal bone model for drilling simulating surgery. Acta Otolaryngol (Stockh). 2022;142(1):19–22. https://doi.org/10.1080/00016489.2021.2015079 .
doi: 10.1080/00016489.2021.2015079
Bakhos D, Velut S, Robier A, Al Zahrani M, Lescanne E. Three-Dimensional Modeling of the Temporal Bone for Surgical Training. Otol Neurotol. 2010;31(2):328–34. https://doi.org/10.1097/MAO.0b013e3181c0e655 .
doi: 10.1097/MAO.0b013e3181c0e655
Mukherjee P, Cheng K, Chung J, Grieve SM, Solomon M, Wallace G. Precision Medicine in Ossiculoplasty. Otol Neurotol. 2021;42(2):e177–85. https://doi.org/10.1097/MAO.0000000000002928 .
doi: 10.1097/MAO.0000000000002928
Heikkinen AK, Lähde S, Rissanen V, et al. Feasibility of 3D-printed middle ear prostheses in partial ossicular chain reconstruction. Int J Bioprinting. Published online April 4, 2023. doi: https://doi.org/10.18063/ijb.727
Chenebaux M, Lescanne E, Robier A, Kim S, Bakhos D. Evaluation of a temporal bone prototype by experts in otology. J Laryngol Otol. 2014;128(7):586–90. https://doi.org/10.1017/S0022215114001297 .
doi: 10.1017/S0022215114001297
Langridge B, Momin S, Coumbe B, Woin E, Griffin M, Butler P. Systematic Review of the Use of 3-Dimensional Printing in Surgical Teaching and Assessment. J Surg Educ. 2018;75(1):209–21. https://doi.org/10.1016/j.jsurg.2017.06.033 .
doi: 10.1016/j.jsurg.2017.06.033