Kavanagh Katherine R, Cote Valerie, Tsui Yvonne, Kudernatsch Simon, Peterson Donald R, Valdez Tulio A
Department of Otolaryngology Head and Neck Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.
Division of Otolaryngology Head and Neck Surgery, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
Laryngoscope. 2017 Apr;127(4):E132-E137. doi: 10.1002/lary.26326. Epub 2016 Oct 12.
Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible.
Pediatric laryngeal models were developed using two manufacturing methods: direct three-dimensional (3D) printing of anatomical models and casted anatomical models using 3D-printed molds. Polylactic acid, acrylonitrile butadiene styrene, and high-impact polystyrene (HIPS) were used for the directly printed models, whereas a silicone elastomer (SE) was used for the casted models.
The models were evaluated for anatomic quality, ease of manipulation, hardness, and cost of production. A tissue likeness scale was created to validate the simulation model. Fleiss' Kappa rating was performed to evaluate interrater agreement, and analysis of variance was performed to evaluate differences among the materials.
The SE provided the most anatomically accurate models, with the tactile properties allowing for surgical manipulation of the larynx. Direct 3D printing was more cost-effective than the SE casting method but did not possess the material properties and tissue likeness necessary for surgical simulation.
The SE models of the pediatric larynx created from a casting method demonstrated high quality anatomy, tactile properties comparable to human tissue, and easy manipulation with standard surgical instruments. Their use in a reliable, low-cost, accessible, modular simulation system provides a valuable training resource for otolaryngology residents.
N/A. Laryngoscope, 127:E132-E137, 2017.
通过模拟来获取和测试技术技能是外科和非外科专业医学教育及住院医师培训的重要组成部分。高质量的模拟教育依赖于模型的可用性、可及性和可靠性。本研究的目的是描述一种用于耳鼻喉科住院医师培训的实用小儿喉部模型。理想情况下，该模型应成本低廉，具有类似人体组织的触觉特性，且能可靠地复制。
使用两种制造方法开发小儿喉部模型：解剖模型的直接三维（3D）打印和使用3D打印模具铸造解剖模型。直接打印的模型使用聚乳酸、丙烯腈丁二烯苯乙烯和高抗冲聚苯乙烯（HIPS），而铸造模型使用硅橡胶弹性体（SE）。
对模型的解剖质量、操作简便性、硬度和生产成本进行评估。创建了一个组织相似性量表来验证模拟模型。进行Fleiss' Kappa评分以评估评分者间的一致性，并进行方差分析以评估材料之间的差异。
SE提供了解剖结构最准确的模型，其触觉特性便于对喉部进行手术操作。直接3D打印比SE铸造方法更具成本效益，但不具备手术模拟所需的材料特性和组织相似性。
通过铸造方法制作的小儿喉部SE模型显示出高质量的解剖结构、与人体组织相当的触觉特性，并且能用标准手术器械轻松操作。将其用于可靠、低成本、可及且模块化的模拟系统，为耳鼻喉科住院医师提供了宝贵的培训资源。
无。《喉镜》2017年第127卷：E132 - E137页
