Step-Specific Simulation: The Utility of 3D Printing for the Fabrication of a Low-Cost, Learning Needs-Based Rhinoplasty Simulator

Abstract

Background Rhinoplasty is a complex procedure that requires meticulous planning and precise execution. Plastic surgeons involved in teaching residents must balance a trainee’s hands-on experience while ensuring appropriate execution of difficult maneuvers. Surgical simulation, a field of growing importance with the shift towards competency-based education, may aid in trainee skill development. Through the concept of deliberate practice, the authors looked to explore the utility and economics of 3-dimensional (3D) printing technology to develop a step-specific rhinoplasty simulator. Objectives The main objective of this study was to address rhinoplasty skills previously identified as “learning areas of weakness” and develop a low-cost, step-specific simulator to help rhinoplasty teaching. Methods A patient’s facial bones, upper and lower lateral cartilages, and septum were segmented from a computed tomography scan and rendered in 3D format. This was 3D printed utilizing Ultimaker Polylactic filament with a polyvinyl acetate dissolvable support for bone, a mixture of Rigur 450 and Tango plus polyjet material for cartilage, and Smooth-On Dragon Skin for skin. Results A modular simulator was developed with 3 separate, interchangeable components with a perfect fit design. The simulator allowed for deliberate practice of the 5 rhinoplasty learning areas of weakness, with a maximal recurring cost of $75 CAD. Conclusions Through the employment of 3D printing, a low-cost, maneuver-specific rhinoplasty simulator reinforcing deliberate practice was developed. This concept of simulation-based deliberate practice may be of increasing interest when considering the implementation of competency-based curricular standards in plastic surgery education.

A systematic review of facial plastic surgery simulation training models

“…Six animal simulators, [34][35][36][37][38][39] three synthetic three-dimensional (3D)-printed simulators, 32,33,40 and one mixed synthetic and animal simulator 31 were identified for endoscopic septoplasty and septorhinoplasty (Table 3). All synthetic 3D-printed simulators [31][32][33]40 were based on computed tomography scans of human facial skeletons. Of the animal models studied, five were ovine 34,[36][37][38][39] and one study utilised chicken sternal cartilage for cartilage grafting.…”

Anatomical subject validation of an instrumented hammer using machine learning for the classification of osteotomy fracture in rhinoplasty

“…Today, educational tools for surgical simulation using 3D printed models allow young surgeons to acquire the necessary experience more quickly and safely [23], [24]. Such learning technique is increasingly in demand but remains expensive and is never similar to the real anatomy of the operating room.…”

Evaluation of the Usability of a Low-Cost 3D Printer in a Tissue Engineering Approach for External Ear Reconstruction

“…Within recent years, the field of surgical 3D printing has expanded its aim from creating implants and scaffolds to manufacturing 3D tools that could improve the technique and experience of surgeons by simulating the anatomy and pathology of the patient. 3D-printed surgical simulations are used during preoperative planning, for intraoperative guidance and surgical education [52][53][54]. For external ear reconstruction, different surgical simulation attempts from costal cartilage simulators to reference ears have been published using a variety of materials [10,[55][56][57][58].…”