Comparison of Materials Used for 3D-Printing Temporal Bone Models to Simulate Surgical Dissection

Abstract

Objective: To identify 3D-printed temporal bone (TB) models that most accurately recreate cortical mastoidectomy for use as a training tool by comparison of different materials and fabrication methods. Background: There are several different printers and materials available to create 3D-printed TB models for surgical planning and trainee education. Current reports using Acrylonitrile Butadiene Styrene (ABS) plastic generated via fused deposition modeling (FDM) have validated the capacity for 3D-printed models to serve as accurate surgical simulators. Here, a head-to-head comparison of models produced using different materials and fabrication processes was performed to identify superior models for application in skull base surgical training. Methods: High-resolution CT scans of normal TBs were used to create stereolithography files with image conversion for application in 3D-printing. The 3D-printed models were constructed using five different materials and four printers, including ABS printed on a MakerBot 2x printer, photopolymerizable polymer (Photo) using the Objet 350 Connex3 Printer, polycarbonate (PC) using the FDM-Fortus 400 mc printer, and two types of photocrosslinkable acrylic resin, white and blue (FLW and FLB, respectively), using the Formlabs Form 2 stereolithography printer. Printed TBs were drilled to assess the haptic experience and recreation of TB anatomy with comparison to the current paradigm of ABS. Results: Surgical drilling demonstrated that FLW models created by FDM as well as PC and Photo models generated using photopolymerization more closely recreated cortical mastoidectomy compared to ABS models. ABS generated odor and did not represent the anatomy accurately. Blue resin performed poorly in simulation, likely due to its dark color and translucent appearance. Conclusions: PC, Photo, and FLW models best replicated surgical drilling and anatomy as compared to ABS and FLB models. These prototypes are reliable simulators for surgical training.

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

“…The materials have different mechanical properties, costs, and accessibility as some materials require more advanced print facilities. Five studies evaluated material suitability for replication of the human temporal bone 5,6,10,26,31 by testing flexibility and drilling behavior 6,31 and through subjective comparison with cadaveric or real-life temporal bones. 5,10,26 Three of these studies found resin well suited, 5,26,31 but a specific conclusion on which material is superior cannot be made (see Suppl.…”

“…Five studies evaluated material suitability for replication of the human temporal bone 5,6,10,26,31 by testing flexibility and drilling behavior 6,31 and through subjective comparison with cadaveric or real-life temporal bones. 5,10,26 Three of these studies found resin well suited, 5,26,31 but a specific conclusion on which material is superior cannot be made (see Suppl. Tables S1 and S2 in the online version of the article).…”

3D Printed Biomimetic Rabbit Airway Simulation Model for Nasotracheal Intubation Training

“…White and Tango Plus has been used to represent bone in other 3D-printed medical applications such as the thorax and have been used to substitute hard and soft tissues in models (35,48,49). This adds to the tactile experience of the trainees.…”

Three-dimensional printing in otolaryngology education: a systematic review

“…Furthermore, it is noted that although temporal bone dissection has historically been used in otologic surgery training, biological risks, ethical issues, and difficulty in obtaining relevant parts have limited its general use in surgical education. All these considerations justify the use of 3D prototypes and simulators in this field [45].…”