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Modifications to a 3D-printed temporal bone model for augmented stapes fixation surgery teaching

Abstract

Functional outcomes and complications in otosclerosis surgery are governed by the surgeon’s experience. Thus, teaching the procedure to residents to guide them through the learning process as quickly as possible is challenging. Artificial 3D-printed temporal bones are replacing cadaver specimens in many institutions to learn mastoidectomy, but these are not suitable for middle ear surgery training. The goal of this work was to adapt such an artificial temporal bone to aid the teaching of otosclerosis surgery and to evaluate this tool. We have modified a commercially available 3D-printed temporal bone by replacing the incus and stapes of the model with in-house 3D-printed ossicles. The incus could be attached to a 6-axis force sensor. The stapes footplate was fenestrated and attached to a 1-axis force sensor. Six junior surgeons (residents) and seven senior surgeons (fellows or consultants) were enrolled to perform piston prosthesis placement and crimping as performed during otosclerosis surgery. The time required to perform the tasks and the forces applied to the incus and stapes were collected and analyzed. No statistically significant differences were observed between the junior and senior groups for time taken to perform the tasks and the forces applied to the incus during crimping and placement of the prosthesis. However, significantly lower forces were applied to the stapes by the senior surgeons in comparison with the junior surgeons during prosthesis placement (junior vs senior group, 328 ± 202.9 vs 80 ± 99.6 mN, p = 0.008) and during prosthesis crimping (junior vs senior group, 565 ± 233 vs 66 ± 48.6 mN, p = 0.02). We have described a new teaching tool for otosclerosis surgery based on the modification of a 3D-printed temporal bone to implement force sensors on the incus and stapes. This tool could be used as a training tool to help the residents to self-evaluate their progress with recording of objective measurements.

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Author information

Correspondence to Yann Nguyen.

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Human and animal rights statement

This article does not contain any studies with human participants or animals performed by any of the authors. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors indicate no potential conflict of interest. The authors would like to thank Armand Czaplinski for his assistance with the drawing of the 3D models, the modified incus, and stapes used in this study.

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Supplementary material 1 (AVI 255489 kb)

Supplementary material 2 (AVI 255489 kb)

Supplementary material 3 (MP4 79771 kb)

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Nguyen, Y., Mamelle, E., De Seta, D. et al. Modifications to a 3D-printed temporal bone model for augmented stapes fixation surgery teaching. Eur Arch Otorhinolaryngol 274, 2733–2739 (2017). https://doi.org/10.1007/s00405-017-4572-1

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Keywords

  • Training
  • Educational
  • Stapedotomy
  • Middle ear
  • Piston
  • Prosthesis
  • Forces
  • Ossicular chain
  • Otosclerosis