Hostname: page-component-6b989bf9dc-wj8jn Total loading time: 0 Render date: 2024-04-11T08:39:09.628Z Has data issue: false hasContentIssue false

Three-dimensional printing as a tool in otolaryngology training: a systematic review

Published online by Cambridge University Press:  23 December 2019

G Chen
3dMedLab, Austin Health, University of Melbourne, Australia
M Jiang
3dMedLab, Austin Health, University of Melbourne, Australia
J Coles-Black*
3dMedLab, Austin Health, University of Melbourne, Australia Department of Vascular Surgery, Austin Health, Heidelberg, Australia
K Mansour
Department of Surgery, Royal Melbourne Hospital, Australia
J Chuen
3dMedLab, Austin Health, University of Melbourne, Australia Department of Vascular Surgery, Austin Health, Heidelberg, Australia
D Amott
Ear, Nose and Throat Surgery Unit, Northern Hospital, Australia
Author for correspondence: Dr Jasamine Coles-Black, Department of Vascular Surgery, Austin Health, 145 Studley Road, Heidelberg3084, Victoria, Australia E-mail:



Three-dimensional printing is a revolutionary technology that is disrupting the status quo in surgery. It has been rapidly adopted by otolaryngology as a tool in surgical simulation for high-risk, low-frequency procedures. This systematic review comprehensively evaluates the contemporary usage of three-dimensional printed otolaryngology simulators.


A systematic review of the literature was performed with narrative synthesis.


Twenty-two articles were identified for inclusion, describing models that span a range of surgical tasks (temporal bone dissection, airway procedures, functional endoscopic sinus surgery and endoscopic ear surgery). Thirty-six per cent of articles assessed construct validity (objective measures); the other 64 per cent only assessed face and content validity (subjective measures). Most studies demonstrated positive feedback and high confidence in the models’ value as additions to the curriculum.


Whilst further studies supported with objective metrics are merited, the role of three-dimensional printed otolaryngology simulators is poised to expand in surgical training given the enthusiastic reception from trainees and experts alike.

Review Articles
Copyright © JLO (1984) Limited, 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Dr J Coles-Black takes responsibility for the integrity of the content of the paper


Zopf, DA, Hollister, SJ, Nelson, ME, Ohye, RG, Green, GE. Bioresorbable airway splint created with a three-dimensional printer. N Engl J Med 2013;368:2043–510.1056/NEJMc1206319CrossRefGoogle ScholarPubMed
Dorrity, JA, Odland, R. 3D printing and preoperative planning in acute midface trauma. Otolaryngol Head Neck Surg 2017;157(1 suppl):P181–2Google Scholar
Martelli, NPP, Serrano, CP, van den Brink, HPP, Pineau, JP, Prognon, PPP, Borget, IPP et al. Advantages and disadvantages of 3-dimensional printing in surgery: a systematic review. Surgery 2016;159:1485–50010.1016/j.surg.2015.12.017CrossRefGoogle Scholar
Shaharan, S, Neary, P. Evaluation of surgical training in the era of simulation. World J Gastrointest Endosc 2014;6:436–4710.4253/wjge.v6.i9.436CrossRefGoogle ScholarPubMed
Forgione, A, Guraya, SY. The cutting-edge training modalities and educational platforms for accredited surgical training: a systematic review. J Res Med Sci 2017;22:51Google ScholarPubMed
Coles-Black, J, Chao, I, Chuen, J. Three-dimensional printing in medicine. Med J Aust 2017;207:102–310.5694/mja16.01073CrossRefGoogle ScholarPubMed
Da Cruz, MJ, Francis, HW. Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development. J Laryngol Otol 2015;129(suppl 3):S23–910.1017/S0022215115001346CrossRefGoogle ScholarPubMed
Hochman, JB, Rhodes, C, Wong, D, Kraut, J, Pisa, J, Unger, B. Comparison of cadaveric and isomorphic three-dimensional printed models in temporal bone education. Laryngoscope 2015;125:2353–710.1002/lary.24919CrossRefGoogle ScholarPubMed
Mowry, SE, Jammal, H, Myer, C, Solares, CA, Weinberger, P. A novel temporal bone simulation model using 3D printing techniques. Otol Neurotol 2015;36:1562–510.1097/MAO.0000000000000848CrossRefGoogle ScholarPubMed
Rose, AS, Kimbell, JS, Webster, CE, Harrysson, OL, Formeister, EJ, Buchman, CA. Multi-material 3D models for temporal bone surgical simulation. Ann Otol Rhinol Laryngol 2015;124:528–3610.1177/0003489415570937CrossRefGoogle ScholarPubMed
Nguyen, Y, Mamelle, E, De Seta, D, Sterkers, O, Bernardeschi, D, Torres, R. Modifications to a 3D-printed temporal bone model for augmented stapes fixation surgery teaching. Eur Arch Otorhinolaryngol 2017;274:2733–910.1007/s00405-017-4572-1CrossRefGoogle ScholarPubMed
Barber, SR, Kozin, ED, Dedmon, M, Lin, BM, Lee, K, Sinha, S et al. 3D-printed pediatric endoscopic ear surgery simulator for surgical training. Int J Pediatr Otorhinolaryngol 2016;90:113–1810.1016/j.ijporl.2016.08.027CrossRefGoogle ScholarPubMed
Monfared, A, Mitteramskogler, G, Gruber, S, Salisbury, JK Jr, Stampfl, J, Blevins, NH. High-fidelity, inexpensive surgical middle ear simulator. Otol Neurotol 2012;33:1573–710.1097/MAO.0b013e31826dbca5CrossRefGoogle ScholarPubMed
Ding, CY, Yi, XH, Jiang, CZ, Xu, H, Yan, XR, Zhang, YL et al. Development and validation of a multi-color model using 3-dimensional printing technology for endoscopic endonasal surgical training. Am J Transl Res 2019;11:1040–8Google ScholarPubMed
Hsieh, TY, Cervenka, B, Dedhia, R, Strong, EB, Steele, T. Assessment of a patient-specific, 3-dimensionally printed endoscopic sinus and skull base surgical model. JAMA Otolaryngol Head Neck Surg 2018;144:574–910.1001/jamaoto.2018.0473CrossRefGoogle ScholarPubMed
Yoshiyasu, Y, Chang, DR, Bunegin, L, Lin, RP, Aden, JK, Prihoda, TJ et al. Construct validity of a low-cost medium-fidelity endoscopic sinus surgery simulation model. Laryngoscope 2019;129:1505–910.1002/lary.27748CrossRefGoogle ScholarPubMed
Alrasheed, AS, Nguyen, LHP, Mongeau, L, Funnell, WRJ, Tewfik, MA. Development and validation of a 3D-printed model of the ostiomeatal complex and frontal sinus for endoscopic sinus surgery training. Int Forum Allergy Rhinol 2017;7:837–4110.1002/alr.21960CrossRefGoogle ScholarPubMed
Chang, DR, Lin, RP, Bowe, S, Bunegin, L, Weitzel, EK, McMains, KC et al. Fabrication and validation of a low-cost, medium-fidelity silicone injection molded endoscopic sinus surgery simulation model. Laryngoscope 2017;127:781–6Google ScholarPubMed
Narayanan, V, Narayanan, P, Rajagopalan, R, Karuppiah, R, Rahman, ZA, Wormald, PJ et al. Endoscopic skull base training using 3D printed models with pre-existing pathology. Eur Arch Otorhinolaryngol 2015;272:753–710.1007/s00405-014-3300-3CrossRefGoogle ScholarPubMed
Cote, V, Schwartz, M, Arbouin Vargas, JF, Canfarotta, M, Kavanagh, KR, Hamdan, U et al. 3-Dimensional printed haptic simulation model to teach incomplete cleft palate surgery in an international setting. Int J Pediatr Otorhinolaryngol 2018;113:292–710.1016/j.ijporl.2018.08.016CrossRefGoogle Scholar
AlReefi, MA, Nguyen, LH, Mongeau, LG, Haq, BU, Boyanapalli, S, Hafeez, N et al. Development and validation of a septoplasty training model using 3-dimensional printing technology. Int Forum Allergy Rhinol 2017;7:39940410.1002/alr.21887CrossRefGoogle ScholarPubMed
Al-Ramahi, J, Luo, H, Fang, R, Chou, A, Jiang, J, Kille, T. Development of an innovative 3D printed rigid bronchoscopy training model. Ann Otol Rhinol Laryngol 2016;125:965–910.1177/0003489416667742CrossRefGoogle ScholarPubMed
Gauger, VT, Rooney, D, Kovatch, KJ, Richey, L, Powell, A, Berhe, H et al. A multidisciplinary international collaborative implementing low cost, high fidelity 3D printed airway models to enhance Ethiopian anesthesia resident emergency cricothyroidotomy skills. Int J Pediatr Otorhinolaryngol 2018;114:124–810.1016/j.ijporl.2018.08.040CrossRefGoogle ScholarPubMed
Barber, SR, Kozin, ED, Naunheim, MR, Sethi, R, Remenschneider, AK, Deschler, DG. 3D-printed tracheoesophageal puncture and prosthesis placement simulator. Am J Otolaryngol 2018;39:374010.1016/j.amjoto.2017.08.001CrossRefGoogle ScholarPubMed
Kavanagh, KR, Cote, V, Tsui, Y, Kudernatsch, S, Peterson, DR, Valdez, TA. Pediatric laryngeal simulator using 3D printed models: a novel technique. Laryngoscope 2017;127:E132–710.1002/lary.26326CrossRefGoogle ScholarPubMed
Ainsworth, TA, Kobler, JB, Loan, GJ, Burns, JA. Simulation model for transcervical laryngeal injection providing real-time feedback. Ann Otol Rhinol Laryngol 2014;123:881–610.1177/0003489414539922CrossRefGoogle ScholarPubMed
Chari, DA, Chan, DK. Novel inexpensive method to improve surgical training in congenital aural atresiaplasty using 3D simulation software. Otolaryngol Head Neck Surg 2018;159(1 suppl):P307–8Google Scholar
Ha, JF, Morrison, RJ, Green, GE, Zopf, DA. Computer-aided design and 3-dimensional printing for costal cartilage simulation of airway graft carving. Otolaryngol Head Neck Surg 2017;156:1044–710.1177/0194599817697048CrossRefGoogle ScholarPubMed
Suzuki, M, Ogawa, Y, Kawano, A, Hagiwara, A, Yamaguchi, H, Ono, H. Rapid prototyping of temporal bone for surgical training and medical education. Acta Otolaryngol 2004;124:400–210.1080/00016480410016478CrossRefGoogle ScholarPubMed
Kasbekar, A, Narasimhan, G, Lesser, T. The development of a new 3D printed temporal bone model and its comparison to other training models. J Laryngol Otol 2016;130(suppl 3):S18710.1017/S0022215116005879CrossRefGoogle Scholar
Kozin, ED, Barber, SR, Wong, K, Kiringoda, R, Kempfle, J, Remenschneider, A et al. 3D printed temporal bone coupled with surgical navigation. Otolaryngol Head Neck Surg 2017;157(1 suppl):P233Google Scholar
Chan, HH, Siewerdsen, JH, Vescan, A, Daly, MJ, Prisman, E, Irish, JC. 3D rapid prototyping for otolaryngology-head and neck surgery: applications in image-guidance, surgical simulation and patient-specific modeling. PLoS One 2015;10:e013637010.1371/journal.pone.0136370CrossRefGoogle ScholarPubMed
Gallagher, AG, Ritter, EM, Satava, RM. Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 2003;17:1525–910.1007/s00464-003-0035-4CrossRefGoogle ScholarPubMed
Kostusiak, M, Hart, M, Barone, DG, Hofmann, R, Kirollos, R, Santarius, T et al. Methodological shortcomings in the literature evaluating the role and applications of 3D training for surgical trainees. Med Teach 2017;39:1168–7310.1080/0142159X.2017.1362102CrossRefGoogle ScholarPubMed