Multi‐institutional Comparison of Temporal Bone Models: A Collaboration of the AAO‐HNSF 3D‐Printed Temporal Bone Working Group

Mowry, Sarah E.; Jabbour, Noel; Rose, Austin S.; Wiet, Gregory J.; Svrakic, Maja; Zopf, David; VanKoevering, Kyle K.; Powell, Allison R.; Freiser, Monika E.; Hochman, Jordan B.; Smith, Richard V.

doi:10.1177/0194599820960474

Cited by 19 publications

(28 citation statements)

References 14 publications

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“…The survey results from this study supports that the acrylic resin drills well. Mowry et al 15 of the Academy of Otolarynoglogy-Head & Neck Surgery 3D Printing Working Group compared temporal bone models for surgical practice submitted by different institutions. A drilling event in which multiple models were drilled and scored by several otolaryngologists was conducted.…”

Section: Discussionmentioning

confidence: 99%

Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation

Freiser

Ghodadra

McCall

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: Three-dimensional printed models created on a consumer level printer can be used to practice mastoidectomy and to discern mastoidectomy experience level. Current models in the literature for mastoidectomy are limited by expense or operability. The aims of this study were (1) to investigate the utility of an inexpensive model for mastoidectomy and (2) to assess whether the model can be used as an evaluation tool to discern the experience level of the surgeon performing mastoidectomy. Methods: Three-dimensional printed temporal bone models from the CT scan of a 7-year old patient were created using a consumer-level stereolithography 3D printer for a raw material cost of $10 each. Mastoidectomy with facial recess approach was performed by 4 PGY-2 residents, 4 PGY-5 residents, and 4 attending surgeons on the models who then filled out an evaluation. The drilled models were collected and then graded in a blinded fashion by 6 attending otolaryngologists. Results: Both residents and faculty felt the model was useful for training (mean score 4.7 out of 5; range: 4-5) and case preparation (mean score: 4.3; range: 3-5). Grading of the drilled models revealed significant differences between junior resident, senior resident, and attending surgeon scores ( P = .012) with moderate to excellent interrater agreement (ICC = 0.882). Conclusion: The described operable model that is patient-specific was rated favorably for pediatric mastoidectomy case preparation and training by residents and faculty. The model may be used to differentiate between experience levels and has promise for use in formative and summative evaluations.

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Section: Discussionmentioning

confidence: 99%

Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation

Freiser

Ghodadra

McCall

et al. 2021

Ann Otol Rhinol Laryngol

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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).…”

Section: Resultsmentioning

confidence: 99%

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

Frithioff

Frendø

Pedersen

et al. 2021

Otolaryngol.--head neck surg.

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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.

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“…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. Choice of print technology affects the price of the model but also the material available for printing, the technical expertise necessary for in-house printing, and postprocessing.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Objective Mastoidectomy is a cornerstone in the surgical management of middle and inner ear diseases. Unfortunately, training is challenged by insufficient access to human cadavers. Three-dimensional (3D) printing of temporal bones could alleviate this problem, but evidence on their educational effectiveness is lacking. It is largely unknown whether training on 3D-printed temporal bones improves mastoidectomy performance, including on cadavers, and how this training compares with virtual reality (VR) simulation. To address this knowledge gap, this study investigated whether training on 3D-printed temporal bones improves cadaveric dissection performance, and it compared this training with the already-established VR simulation. Study Design Prospective cohort study of an educational intervention. Setting Tertiary university hospital, cadaver dissection laboratory, and simulation center in Copenhagen, Denmark. Methods Eighteen otorhinolaryngology residents (intervention) attending the national temporal bone dissection course received 3 hours of mastoidectomy training on 3D-printed temporal bones. Posttraining cadaver mastoidectomy performances were rated by 3 experts using a validated assessment tool and compared with those of 66 previous course participants (control) who had received time-equivalent VR training prior to dissection. Results The intervention cohort outperformed the controls during cadaver dissection by 29% ( P < .001); their performances were largely similar across training modalities but remained at a modest level (~50% of the maximum score). Conclusion Mastoidectomy skills improved from training on 3D-printed temporal bone and seemingly more so than on time-equivalent VR simulation. Importantly, these skills transferred to cadaveric dissection. Training on 3D-printed temporal bones can effectively supplement cadaver training when learning mastoidectomy.

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Multi‐institutional Comparison of Temporal Bone Models: A Collaboration of the AAO‐HNSF 3D‐Printed Temporal Bone Working Group

Cited by 19 publications

References 14 publications

Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation

Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation

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

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

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