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A three-dimensional printed myringotomy, tympanostomy and ventilation tube placement simulator

Published online by Cambridge University Press:  06 May 2021

L Ferreira e Silva ,
M Chisté Ferreira ,
I I Couceiro Seto ,
A Martins Umbelino ,
V C Aguiar Gomes ,
L de Borborema Garcia  and
L J Almeida Amaro
L Ferreira e Silva*
Affiliation:
Otolaryngology Unit, University Hospital Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Belém, Brazil Núcleo de Medicina Tropical, Federal University of Pará, Belém, Brazil
M Chisté Ferreira
Affiliation:
Medical School, Universidade do Estado do Pará, State University of Pará, Belém, Brazil
I I Couceiro Seto
Affiliation:
Otolaryngology Unit, University Hospital Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Belém, Brazil
A Martins Umbelino
Affiliation:
Otolaryngology Unit, University Hospital Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Belém, Brazil
V C Aguiar Gomes
Affiliation:
Otolaryngology Unit, University Hospital Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Belém, Brazil
L de Borborema Garcia
Affiliation:
Otolaryngology Department, Universidade Federal de São Paulo, Brazil
L J Almeida Amaro
Affiliation:
Otolaryngology Unit, University Hospital Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Belém, Brazil
*
Author for correspondence: Mr Luigi Ferreira e Silva, Otolaryngology Unit, Hospital Universitário Bettina Ferro de Souza, Hospital Complex of Federal University of Pará, Rua Augusto Corrêa, 01, Campus Guamá, Belém 66075-110, Brazil E-mail: luigisilva1@gmail.com
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Abstract

Objective

Tympanostomy is one of the most commonly performed surgical procedures in otolaryngology, and its complexity is challenging for trainee surgeons. Investing in medical education is a cornerstone of good patient safety practices. For trainees, use of simulators before operating on actual patients helps mitigate risks. This study aimed to develop a three-dimensional printed model simulator for myringotomy, tympanostomy and ventilation tube placement.

Methods

An articulated model with a detachable portion, base and plastic bag to simulate the external auditory canal, middle ear and tympanic membrane, respectively, was modelled and printed.

Results

The final simulator was made from acrylonitrile butadiene styrene polymer and measured 4 × 4 × 12 cm. It was designed to mimic the angulation of patient anatomy in the myringotomy position and simulate the texture and colour of the tissues of interest. The cost was low, and testing with an operating microscope and endoscope yielded satisfactory results. The advent of three-dimensional printing technology has made surgical simulation more accessible and less expensive, providing several advantages for medical education.

Conclusion

The proposed model fulfilled expectations as a safe, inexpensive, reproducible, user-friendly and accessible surgical education tool that can be improved and reassessed for further research.

Keywords

Medical EducationSimulation TrainingEducational TechnologyMiddle Ear VentilationInternship And Residency

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 5 , May 2021 , pp. 420 - 425
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr L Ferreira e Silva takes responsibility for the integrity of the content of the paper

References

Aggarwal, R, Mytton, OT, Derbrew, M, Hananel, D, Heydenburg, M, Issenberg, B et al. Training and simulation for patient safety. Qual Saf Health Care 2010;19(suppl 2):i34–43CrossRefGoogle ScholarPubMed
Flores, CD, Bez, MR, Bruno, RM. The use of simulation in medical education [in Portuguese]. RBIE 2014;22:98–108CrossRefGoogle Scholar
Luna, RA, Spight, D. Simulation in medical education: a necessary change [in Portuguese]. Revista HUPE 2014;13:57–61Google Scholar
Nogueira Júnior, JF, Cruz, DN. Real models and virtual simulator in otolaryngology: review of literature. Braz J Otorhinolaryngol 2010;76:129–35CrossRefGoogle Scholar
de Sousa, AMA, Okada, DM, Suzuki, FA. The use of simulators in the learning for otologic surgery [in Portuguese]. Arq Int Otorrinolaringol 2011;15:509–14Google Scholar
Pazin Filho, A, Scarpelini, S. Simulation: definition [in Portuguese]. Medicina (Ribeirão Preto) 2007;40:162–6CrossRefGoogle Scholar
Musbahi, O, Aydin, A, Omran, YA, Skilbeck, CJ, Ahmed, K. Current status of simulation in otolaryngology: a systematic review. J Surg Educ 2017;74:203–15CrossRefGoogle ScholarPubMed
Gadaleta, DJ, Huang, D, Rankin, N, Hsue, V, Sakkal, M, Bovenzi, C et al. 3D printed temporal bone as a tool for otologic surgery simulation. Am J Otolaryngol 2020;41:102273CrossRefGoogle 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;90:113–18CrossRefGoogle ScholarPubMed
Testa, JR, Dimatos, SC, Greggio, B, Duarte, JA. Evaluation of the results and complications of the ventilation tubes’ setting surgery in patients with serous otitis media [in Portuguese]. Int Arch Otorhinolaryngol 2010;14:90–4Google Scholar
American Academy of Otolaryngology – Head and Neck Surgery. AAAO-HNSF clinical practice guideline: tympanostomy tubes in children. 2013. In: https://www.entnet.org/sites/default/files/July2013_TubesFactSheet.pdf [9 March 2020]Google Scholar
Cullen, KA, Hall, MJ, Golosinskiy, A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report 2009;1–25Google Scholar
da Costa, SS, Francesco, RCD, Lessa, MM, Abdo, TRT, Felix, F, Moraes e Silva, NMAV et al. URTI Guideline: upper respiratory tract infections [in Portuguese]. Wolters Kluwer Health. Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. 2007. In: https://www.aborlccf.org.br/imageBank/guidelines_completo_07.pdf [1 March 2020]Google Scholar
Kay, DJ, Nelson, M, Rosenfeld, RM. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg 2001;124:374–80CrossRefGoogle ScholarPubMed
Agha, RA, Fowler, AJ. The role and validity of surgical simulation. Int Surg 2015;100:350–7CrossRefGoogle ScholarPubMed
Tan, SS, Sarker, SK. Simulation in surgery: a review. Scott Med J 2011;56:104–9CrossRefGoogle Scholar
Sparks, D, Kavanagh, KR, Vargas, JA, Valdez, TA. 3D printed myringotomy and tube simulation as an introduction to otolaryngology for medical students. Int J Pediatr Otorhinolaryngol 2020;128:109730CrossRefGoogle ScholarPubMed
Chan, AL, Carrillo, RJD, Ong, KC. Simulation platform for myringotomy with ventilation tube insertion in adult ears. Philipp J Otolaryngol Head Neck Surg 2018;33:14–20CrossRefGoogle Scholar
Ganguli, A, Pagan-Diaz, GJ, Grant, L, Cvetkovic, C, Bramlet, M, Vozenilek, J et al. 3D printing for preoperative planning and surgical training: a review. Biomed Microdevices 2018;20:65CrossRefGoogle ScholarPubMed
Vaitaitis, VJ, Dunham, ME, Kwon, YC, Mayer, WC, Evans, AK, Baker, AJ et al. A surgical simulator for tympanostomy tube insertion incorporating capacitive sensing technology to track instrument placement. Otolaryngol Head Neck Surg 2020;162:343–5CrossRefGoogle ScholarPubMed
Anschuetz, L, Stricker, D, Yacoub, A, Wimmer, W, Caversaccio, M, Huwendiek, S. Acquisition of basic ear surgery skills: a randomized comparison between endoscopic and microscopic techniques. BMC Med Educ 2019;19:357CrossRefGoogle ScholarPubMed
Martellucci, S, Pagliuca, G, de Vincentiis, M, De Virgilio, A, Fusconi, M, Gallipoli, C et al. Myringotomy and ventilation tube insertion with endoscopic or microscopic technique in adults: a pilot study. Otolaryngol Head Neck Surg 2015;152:927–30CrossRefGoogle ScholarPubMed
Cohen, MS, Landegger, LD, Kozin, ED, Lee, DJ. Pediatric endoscopic ear surgery in clinical practice: lessons learned and early outcomes. Laryngoscope 2016;126:732–8CrossRefGoogle ScholarPubMed
Ragab, A, Mohammed, AA, Abdel-Fattah, AA, Afifi, AM. Prevalence of complications associated with tympanostomy tube insertion. Menoufia Med J 2015;28:918–22CrossRefGoogle Scholar