Evaluation of Printed 3-Dimensional Temporal Bone Models in Surgical Procedures

Abstract

Background: The current surgical training model is based primarily on cadaveric dissection; however, opportunities are limited due to small numbers of specimens. Alternatives to cadaveric dissection such as virtual reality simulations and rapid prototyped models attempt to replicate the cadaveric gold standard in order to enhance the learning process. Cadaveric comparison to virtual haptic modeling, as undertaken in Australia, demonstrated significant differences in drilling techniques based on hand motion analysis. This raises concerns that some forms of simulation may result in the development of inappropriate and maladaptive skills. Objective: To determine if there is a significant difference in drilling technique during surgical training procedures on rapid prototyped 3D temporal bone models and cadaveric specimens. Methods: Eight (8) otolaryngology residents completed a mastoidectomy on cadaveric temporal bone and printed models. Motion sensors within an electromagnetic field were used to capture drilling technique. Results: Significant differences in the drilling technique was demonstrated. An increased number of curved strokes, and longer, faster strokes were taken when drilling the printed models. It was also noted that junior residents had significantly different drilling technique when compared to the senior residents. Conclusion: Technique growth from junior to senior level residents was shown to occur. Therefore, caution must be taken when residents drill printed models because results demonstrate altered drilling technique.