Three-dimensional Printed Trainer in Endoscopic Middle Ear Surgery

OBJECTIVE: The primary objective of this study was to test an in-house developed and 3D-printed endoscopic middle ear surgery trainer (EEST) that replicates patient-specific external auditory canal (OEAC) anatomy. The trainer is designed to train ENT residents and surgeons in navigating OEAC anatomic variability and to improve hand-eye coordination.

METHODS: The EEST was designed using segmentations from temporal bone imaging from a human cadaveric head. Five 3D-printed models were created using photopolymer resin, incorporating gradual augmentations to the scutum and the bulge of the anterior bony wall. A single surgeon performed surgical procedures on these models and documented his experience. In addition, 3 surgeons and 2 experienced residents tested one model and completed a content and face validity questionnaire.

RESULTS: In this pilot study, an experienced ENT surgeon successfully completed surgical tasks in all 5 EEST models. Scutum resection was required in 4 simulations. The EEST demonstrated an overall mean Likert scale rating of 3.9 (SD=0.4) on face validity and a content validity rating of 4.5 (SD=0.3) when tested by three surgeons and 2 residents.

CONCLUSION: This study offers a valuable start for further development of an affordable, 3D-printed, patient-specific, surgical trainer for endoscopic middle ear surgery.