Computed tomography-based training model for otoplasty

Abstract

Otoplasty for the correction of protruding ears is characterized by various techniques and a common and popular cosmetic procedure. For the surgeon, whether beginner or advanced, it is essential to understand the principles and master techniques for standard auricular deformities before applying further sophisticated methods, because a lot of complications and failures are caused by wrong indication and incorrect surgical techniques. The different surgical steps are best learned from teaching models. Therefore, we developed two different silicone models of protruding ears with moderate auricular deformities: one with conchal hyperplasia for the training of conchal resection, and one without antihelix for creating an antihelical fold by suturing technique, based on computed tomography scans of patients. The silicone ear models were evaluated during four standardized surgery courses for residents in otorhinolaryngology by 91 participants using specially designed questionnaires. Nearly all participants rated the training on the auricular models as very helpful (n = 51) or good (n = 31); the scores for the different techniques and properties of the models ranged from 2.0 to 2.6 in a range from 1 (very good) to 4 (inadequate). The good results demonstrate the possibility for learning different surgical otoplasty techniques with this newly designed teaching tool.

Validation study of an ex vivo porcine auricular model for simulation training in otoplasty

“…There are currently limited platforms available for otoplasty training. 9,10 Whilst cadaveric dissection plays an important role for many operations, its role in otoplasty is limited, with preserved ear cartilage becoming considerably softer with fixation, making the surgical steps more difficult to carry out. 16 Furthermore, most UK centres have limited access to cadaveric models because of the high costs and need for specific facilities, making this model less practical for implementation into training programmes.…”

“…However, the materials used lack a realistic tissue feel, impacting their usefulness to simulation training in otoplasty, and as yet they have not been validated for this purpose. 9 Animal models have been used for simulation training in otolaryngology surgery as an alternative to cadaveric tissue. Animal models offer a realistic, inexpensive and practical platform that is readily available and easily implemented into local training schemes.…”

“…However, the materials used lack a realistic tissue feel, impacting their usefulness to simulation training in otoplasty, and as yet they have not been validated for this purpose. 9…”

“…There are currently limited platforms available for otoplasty simulation, including three-dimensional printed and animal models which are yet to be validated. 9,10 This study aimed to perform a validation assessment of a novel porcine ex vivo model for otoplasty training.…”

Diseño y validación de un novedoso modelo de simulación para otoplastia a bajo costo

“…Con respecto a modelos sintéticos, la literatura disponible muestra una debilidad común: todos presentan una sola capa que no emula la piel y el cartílago por separado, además de que no cuentan con una adecuada validación. [17][18][19][20][21][22][23] Por otro lado, el uso de cadáveres humanos está limitado por el costo y la fortuna de encontrar alguno que presente las deformidades características. 24,25 Considerando que nuestro grupo ya cuenta con experiencia previa en el desarrollo y validación de programas de entrenamiento 26 y teniendo en cuenta lo dicho previamente, el objetivo de este estudio fue desarrollar un nuevo modelo de simulación para otoplastia que fuese de bajo costo y a su vez, evaluar su validez de apariencia, contenido y constructo.…”