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Piazza A, Corvino S, Colosso GQ, Campeggi A, Agosti E, Serioli S, Frati A, Santoro A. 3-Dimensional Printed Model of the Temporal Bone for Neurosurgical Training. Oper Neurosurg (Hagerstown) 2024:01787389-990000000-01234. [PMID: 38967429 DOI: 10.1227/ons.0000000000001213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The development of neurosurgical skills stands out as a paramount objective for neurosurgery residents during their formative years. Mastery of intricate and complex procedures is a time-intensive process marked by a gradually ascending learning curve. Consequently, the study and simulation on surgical models assume significant importance. One of the most intricate neuroanatomical regions includes the petrous and mastoid portions of the temporal bone. These regions host critical, highly functional, and vital neurovascular structures, including the facial nerve, cochlea, semicircular canals, internal carotid artery, and middle ear. This fully open-source 3-dimensional (3D) model of the temporal bone, created for educational purposes, should be easily and economically reproducible using a 3D printer, offering all residents the opportunity to understand the spatial location, three-dimensional anatomical structures, and fundamental intricacies of mastoidectomy. METHODS A 3D model of the temporal bone was fabricated using a computed tomography (CT) scan derived from an actual human body. The CT scan of the model was meticulously juxtaposed with the reference sample CT scan. Neurosurgical residents were recruited as participants for this study. Each participant was tasked with executing a mastoidectomy on 2 separate occasions, with a 2-week interval between attempts. Throughout these sessions, various parameters, including the time taken for task completion, the volume of bone removal, and any potential complications, were systematically registered. RESULTS The mean volume of bone removed increased by 34.5%, and the mean task time and the mean number of complications decreased by 10.3% and 25%, respectively, during the training. CONCLUSION Engaging in training with cost-effective anatomical models constitutes a valuable tool for refining technical skills during residency. We posit that this type of model training should be incorporated as part of the trainee's curriculum during the residency program because of the myriad advantages evidenced by the findings of this study.
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Affiliation(s)
- Amedeo Piazza
- Department of Neurosurgery, University of Rome, Rome, Italy
- Department of Neurosurgery, Papa Giovanni XXIII University Hospital, Bari, Italy
| | - Sergio Corvino
- Division of Neurosurgery, Department of Neuroscience, Reproductive and Odontostomatological Sciences, "Università Federico II", Naples, Italy
| | | | - Alice Campeggi
- Surgical and Medical Sciences and Translational Medicine, University of Rome "Sapienza", Rome, Italy
| | - Edoardo Agosti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Simona Serioli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Rienas W, Hubbell R, Toivonen J, Geritano M, Hall A, Prabhu S, Robson C, Weinstock P, Poe DS. 3D printed temporal bones for preoperative simulation and planning. Am J Otolaryngol 2024; 45:104340. [PMID: 38723379 DOI: 10.1016/j.amjoto.2024.104340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Demonstrate the utility of 3D printed temporal bone models in individual patient preoperative planning and simulation. METHODS 3D models of the temporal bone were made from 5 pediatric and adult patients at a tertiary academic hospital with challenging surgical anatomy planned for cochlear implantation or exteriorization of cholesteatoma with complex labyrinthine fistula. The 3D models were created from CT scan used for preoperative planning, simulation and intraoperative reference. The utility of models was assessed for ease of segmentation and production and impact on surgery in regard to reducing intraoperative time and costs, improving safety and efficacy. RESULTS Three patients received cochlear implants, two exteriorization of advanced cholesteatoma with fistulas (1 internal auditory canal/cochlea, 1 all three semicircular canals). Surgical planning and intraoperative referencing to the simulations by the attending surgeon and trainees significantly altered original surgical plans. In a case of X-linked hereditary deafness, optimal angles and rotation maneuvers for cochlear implant insertion reduced operating time by 93 min compared to the previous contralateral side surgery. Two cochlear implant cases planned for subtotal petrosectomy approach due to aberrant anatomy were successfully approached through routine mastoidectomy. The cholesteatoma cases were successfully exteriorized without necessitating partial labyrinthectomy or labyrinthine injury. There were no complications. CONCLUSION 3D printed models for simulation training, surgical planning and use intraoperatively in temporal bone surgery demonstrated significant benefits in designing approaches, development of patient-specific techniques, avoidance of potential or actual complications encountered in previous or current surgery, and reduced surgical time and costs.
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Affiliation(s)
- William Rienas
- George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States of America; Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America
| | - Richard Hubbell
- Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, 2160S. First Ave, Maywood, IL 60153, United States of America.
| | - Joonas Toivonen
- Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, FI-20014 Turun Yliopisto, Finland.
| | - Mariah Geritano
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Andrew Hall
- University Hospital for Wales, Heath Park Way, Cardiff CF14 4XW, United Kingdom
| | - Sanjay Prabhu
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Caroline Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Peter Weinstock
- Immersive Design Systems, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America; Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Dennis S Poe
- Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America.
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Iannella G, Pace A, Mucchino A, Greco A, De Virgilio A, Lechien JR, Maniaci A, Cocuzza S, Perrone T, Messineo D, Magliulo G. A new 3D-printed temporal bone: 'the SAPIENS'-specific anatomical printed-3D-model in education and new surgical simulations. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08645-6. [PMID: 38683361 DOI: 10.1007/s00405-024-08645-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Otology and neuro-otology surgeries pose significant challenges due to the intricate and variable anatomy of the temporal bone (TB), requiring extensive training. In the last years 3D-printed temporal bone models for otological dissection are becoming increasingly popular. In this study, we presented a new 3D-printed temporal bone model named 'SAPIENS', tailored for educational and surgical simulation purposes. METHODS The 'SAPIENS' model was a collaborative effort involving a multidisciplinary team, including radiologists, software engineers, ENT specialists, and 3D-printing experts. The development process spanned from June 2022 to October 2023 at the Department of Sense Organs, Sapienza University of Rome. Acquisition of human temporal bone images; temporal bone rendering; 3D-printing; post-printing phase; 3D-printed temporal bone model dissection and validation. RESULTS The 'SAPIENS' 3D-printed temporal bone model demonstrated a high level of anatomical accuracy, resembling the human temporal bone in both middle and inner ear anatomy. The questionnaire-based assessment by five experienced ENT surgeons yielded an average total score of 49.4 ± 1.8 out of 61, indicating a model highly similar to the human TB for both anatomy and dissection. Specific areas of excellence included external contour, sigmoid sinus contour, cortical mastoidectomy simulation, and its utility as a surgical practice simulator. CONCLUSION We have designed and developed a 3D model of the temporal bone that closely resembles the human temporal bone. This model enables the surgical dissection of the middle ear and mastoid with an excellent degree of similarity to the dissection performed on cadaveric temporal bones.
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Affiliation(s)
- Giannicola Iannella
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Annalisa Pace
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy.
| | - Alessandro Mucchino
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Antonio Greco
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Armando De Virgilio
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Jerome R Lechien
- Faculty of Medicine and Pharmacy, University of Mons (UMons), Mons, Belgium
| | | | - Salvatore Cocuzza
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Italy
| | - Tiziano Perrone
- Department of Otolaryngology, Civil Hospital of Alghero, Alghero, Italy
| | - Daniela Messineo
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Giuseppe Magliulo
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
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Brumpt E, Bertin E, Gabrion X, Coussens C, Tatu L, Louvrier A. Are 3D-printed anatomical models of the ear effective for teaching anatomy? A comparative pilot study versus cadaveric models. Surg Radiol Anat 2024; 46:103-115. [PMID: 38231228 DOI: 10.1007/s00276-023-03276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Despite the combination of chalkboard lectures and cadaveric models, the ear remains a complex anatomical structure that is difficult for medical students to grasp. The aim of this study was to evaluate the contribution of a 3D-printed ear model for educating undergraduate medical students by comparing it with a conventional cadaveric model. METHODS Models of the ear comprising the outer ear, tympanic membrane, ossicles and inner ear were modeled and then 3D-printed at 6:1 and 10:1 scales based on cadaveric dissection and CT, cone-beam CT and micro/nano CT scans. Cadaveric models included two partially dissected dry temporal bones and ossicles. Twenty-four 3rd year medical students were given separate access to cadaveric models (n = 12) or 3D-printed models (n = 12). A pre-test and two post-tests were carried out to assess knowledge (n = 24). A satisfaction questionnaire focusing solely on the 3D-printed model, comprising 17 items assessed on a 5-point Likert scale, was completed by all study participants. A 5-point Likert scale questionnaire comprising four items (realism, color, quality and satisfaction with the 3D-printed ear model) was given to three expert anatomy Professors. RESULTS The test scores on the first post-test were higher for the students who had used the 3D-printed models (p < 0.05). Overall satisfaction among the students and the experts was very high, averaging 4.7 on a 5-point Likert-type satisfaction scale. CONCLUSION This study highlights the overall pedagogical value of a 3D-printed model for learning ear anatomy.
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Affiliation(s)
- Eléonore Brumpt
- Département d'Anatomie, University Franche-Comté, UFRSanté, 19 Rue Ambroise-Paré CS 71806, 25000, Besançon, France.
- Radiologie, CHU Besançon, 25000, Besançon, France.
- Laboratoire Nano MédecineImagerieThérapeutique, University Franche-Comté, EA 4662, 25000, Besançon, France.
| | - Eugénie Bertin
- Département d'Anatomie, University Franche-Comté, UFRSanté, 19 Rue Ambroise-Paré CS 71806, 25000, Besançon, France
- Chirurgie Maxillo-FacialeStomatologie et Odontologie Hospitalière, CHU Besançon, 25000, Besançon, France
| | - Xavier Gabrion
- Département de Mécanique Appliquée, University Franche-Comté, FEMTO-ST, CNRS/UFC/ENSMM/UTBM, 25000, Besançon, France
| | - Camille Coussens
- Plateforme I3DM (Impression 3D Médicale), CHU Besançon, 25000, Besançon, France
| | - Laurent Tatu
- Département d'Anatomie, University Franche-Comté, UFRSanté, 19 Rue Ambroise-Paré CS 71806, 25000, Besançon, France
- Neurologie, CHU Besançon, 25000, Besançon, France
- Laboratoire de Neurosciences Intégratives et Cliniques, University Franche-Comté, EA 481, 25000, Besançon, France
| | - Aurélien Louvrier
- Laboratoire Nano MédecineImagerieThérapeutique, University Franche-Comté, EA 4662, 25000, Besançon, France
- Chirurgie Maxillo-FacialeStomatologie et Odontologie Hospitalière, CHU Besançon, 25000, Besançon, France
- Plateforme I3DM (Impression 3D Médicale), CHU Besançon, 25000, Besançon, France
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