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

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.

Authors+Show Affiliations

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.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.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.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.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.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.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.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.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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27729115

Citation

Barber, Samuel R., et al. "3D-printed Pediatric Endoscopic Ear Surgery Simulator for Surgical Training." International Journal of Pediatric Otorhinolaryngology, vol. 90, 2016, pp. 113-118.
Barber SR, Kozin ED, Dedmon M, et al. 3D-printed pediatric endoscopic ear surgery simulator for surgical training. Int J Pediatr Otorhinolaryngol. 2016;90:113-118.
Barber, S. R., Kozin, E. D., Dedmon, M., Lin, B. M., Lee, K., Sinha, S., ... Lee, D. J. (2016). 3D-printed pediatric endoscopic ear surgery simulator for surgical training. International Journal of Pediatric Otorhinolaryngology, 90, pp. 113-118. doi:10.1016/j.ijporl.2016.08.027.
Barber SR, et al. 3D-printed Pediatric Endoscopic Ear Surgery Simulator for Surgical Training. Int J Pediatr Otorhinolaryngol. 2016;90:113-118. PubMed PMID: 27729115.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 3D-printed pediatric endoscopic ear surgery simulator for surgical training. AU - Barber,Samuel R, AU - Kozin,Elliott D, AU - Dedmon,Matthew, AU - Lin,Brian M, AU - Lee,Kyuwon, AU - Sinha,Sumi, AU - Black,Nicole, AU - Remenschneider,Aaron K, AU - Lee,Daniel J, Y1 - 2016/08/31/ PY - 2016/06/18/received PY - 2016/08/29/revised PY - 2016/08/29/accepted PY - 2016/10/13/entrez PY - 2016/10/13/pubmed PY - 2017/3/25/medline KW - 3D printing KW - Endoscopic ear surgery KW - Simulator KW - Surgical simulation KW - Transcanal endoscopic ear surgery SP - 113 EP - 118 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 90 N2 - 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. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/27729115/3D_printed_pediatric_endoscopic_ear_surgery_simulator_for_surgical_training_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(16)30284-1 DB - PRIME DP - Unbound Medicine ER -