3D‐Printed Models for Temporal Bone Surgical Training: A Systematic Review

Abstract

Objective 3D-printed models hold great potential for temporal bone surgical training as a supplement to cadaveric dissection. Nevertheless, critical knowledge on manufacturing remains scattered, and little is known about whether use of these models improves surgical performance. This systematic review aims to explore (1) methods used for manufacturing and (2) how educational evidence supports using 3D-printed temporal bone models. Data Sources PubMed, Embase, the Cochrane Library, and Web of Science. Review Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, relevant studies were identified and data on manufacturing and validation and/or training extracted by 2 reviewers. Quality assessment was performed using the Medical Education Research Study Quality Instrument tool; educational outcomes were determined according to Kirkpatrick’s model. Results The search yielded 595 studies; 36 studies were found eligible and included for analysis. The described 3D-printed models were based on computed tomography scans from patients or cadavers. Processing included manual segmentation of key structures such as the facial nerve; postprocessing, for example, consisted of removal of print material inside the model. Overall, educational quality was low, and most studies evaluated their models using only expert and/or trainee opinion (ie, Kirkpatrick level 1). Most studies reported positive attitudes toward the models and their potential for training. Conclusion Manufacturing and use of 3D-printed temporal bones for surgical training are widely reported in the literature. However, evidence to support their use and knowledge about both manufacturing and the effects on subsequent surgical performance are currently lacking. Therefore, stronger educational evidence and manufacturing knowhow are needed for widespread implementation of 3D-printed temporal bones in surgical curricula.

Effect of 3D‐Printed Models on Cadaveric Dissection in Temporal Bone Training

“…Most previous studies on 3D-printed models for temporal bone surgical training have based conclusions about effectiveness solely on participants’ opinions on the training. 13 This provides insufficient evidence and is considered outdated in surgical educational research. 15 A single study found that participants training with 3D-printed models performed better during subsequent cadaveric dissection as compared with no training.…”

“…Three-dimensional printing provides new possibilities for training technical skills, and temporal bone surgery is no exception. 10,13 The expected potential of 3D-printed models for temporal bone training is supported by the establishment of a 3D-Printed Temporal Bone Working Group by the American Academy of Otolaryngology-Head and Neck Surgery, which has the purpose of gathering knowledge on the subject. 28 There are several considerations when creating a suitable temporal bone model with 3D printing, as the various print technologies have different strengths and limitations.…”

“…16 Learning skills during simulation that do not benefit or transfer to patients would render such training irrelevant. VR training of mastoidectomy transfers to improved cadaver dissection, but knowledge on transfer from 3D-printed models is scarce, 13 despite their perceived potential for training, and only a single study has evaluated the use of 3D-printed models as preparation for cadaveric dissection. 17 Consequently, further knowledge on transfer is needed to elucidate whether 3D-printed temporal bone models can actually aid trainees’ skills acquisition and to plan the best possible training curricula in an era of limited cadaver dissection.…”

“…12 A large number of studies have reported on the development and manufacturing of 3D-printed models for temporal bone training, but there is limited educational evidence on their use. Specifically, most evaluations rely on participants' subjective opinions of the models 13 : a measure that is poorly correlated with actual surgical skills. 14,15 Consequently, it remains largely unknown whether 3D-printed temporal bone models can be used to improve surgical performance.…”

The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals—Cross-Sectional Multispecialty Review

“…Particular interest in 3D printing has been observed in otosurgery [ 74 , 75 , 76 , 77 ]. Three-dimensional models of the temporal bones allow designing an operation for each patient individually.…”