Comparison of Cadaveric and Isomorphic Three-Dimensional Printed Models in Temporal Bone Education

Objectives/Hypothesis: Current three-dimensional (3D) printed simulations are complicated by insufficient void spaces and inconsistent density. We describe a novel simulation with focus on internal anatomic fidelity and evaluate against template/identical cadaveric education. Study Design: Research ethics board-approved prospective cohort study. Methods: Generation of a 3D printed temporal bone was performed using a proprietary algorithm that deconstructs the digital model into slices prior to printing. This supplemental process facilitates removal of residual material from air-containing spaces and permits requisite infiltrative access to the all regions of the model. Ten otolaryngology trainees dissected a cadaveric temporal bone (CTB) followed by a matched/isomorphic 3D printed bone model (PBM), based on derivative micro-computed tomography data. Participants rated 1) physical characteristics, 2) specific anatomic constructs, 3) usefulness in skill development, and 4) perceived educational value. The survey instrument employed a seven-point Likert scale. Results: Trainees fell physical characteristics of the PBM were quite similar to CTB, with highly ranked cortical (5.5 +/- 1.5) and trabecular (5.2 +/- 1.3) bone drill quality. The overall model was considered comparable to CTB (5.9 +/- 0.74), with respectable air cell reproduction (6.1 +/- 1.1). Internal constructs were rated as satisfactory (range, 4.9-6.2). The simulation was considered a beneficial training tool for all types of mastoidectomy (range, 5.9-6.6), posterior tympanotomy (6.5 +/- 0.71), and skull base approaches (range, 6-6.5). Participants believed the model to be an effective training instrument (6.7 +/- 0.68), which should be incorporated into the temporal bone lab (7.0 +/- 0.0). The PBM was thought to improve confidence (6.7 +/- 0.68) and operative performance (6.7 +/- 0.48). Conclusions: Study participants found the PBM to be an effective platform that compared favorably to CTB. The model was considered a valuable adjunctive training tool with both realistic mechanical and visual character.