Department of Otolaryngology and Head and Neck Surgery, McGill University, Montreal, QC, Canada.
Center for Medical Education, McGill University, Montreal, QC, Canada.
Int Forum Allergy Rhinol. 2017 Apr;7(4):399-404. doi: 10.1002/alr.21887. Epub 2016 Nov 29.
Providing alternative training modalities may improve trainees' ability to perform septoplasty. Three-dimensional printing has been shown to be a powerful tool in surgical training. The objectives of this study were to explain the development of our 3-dimensional (3D) printed septoplasty training model, to assess its face and content validity, and to present evidence supporting its ability to distinguish between levels of surgical proficiency.
Imaging data of a patient with a nasal septal deviation was selected for printing. Printing materials reproducing the mechanical properties of human tissues were selected based on literature review and prototype testing. Eight expert rhinologists, 6 senior residents, and 6 junior residents performed endoscopic septoplasties on the model and completed a postsimulation survey. Performance metrics in quality (final product analysis), efficiency (time), and safety (eg, perforation length, nares damage) were recorded and analyzed in a study-blind manner.
The model was judged to be anatomically correct and the steps performed realistic, with scores of 4.05 ± 0.82 and 4.2 ± 1, respectively, on a 5-point Likert scale. Ninety-two percent of residents desired the simulator to be integrated into their teaching curriculum. There was a significant difference (p < 0.05) between the expert, intermediate, and novice groups in time taken and nares cuts, whereas other performance metrics showed no significant difference.
To our knowledge, there are no other simulator training models for septoplasty. Our model incorporates 2 different materials mixed into the 3 relevant consistencies necessary to simulate septoplasty. Our findings provide evidence supporting the validity of the model.
提供替代培训模式可能会提高受训者行鼻中隔成形术的能力。三维打印已被证明是手术培训的有力工具。本研究的目的是解释我们的三维（3D）打印鼻中隔成形术培训模型的开发过程，评估其表面和内容效度，并提供支持其区分手术熟练程度的能力的证据。
选择一位鼻中隔偏曲患者的影像学数据进行打印。根据文献回顾和原型测试选择复制人体组织机械性能的打印材料。8 名鼻科专家、6 名高年住院医师和 6 名低年住院医师在模型上进行内镜鼻中隔成形术，并完成模拟后调查。以盲法方式记录和分析质量（最终产品分析）、效率（时间）和安全性（例如穿孔长度、鼻孔损伤）方面的性能指标。
模型被判断为解剖正确，操作步骤逼真，5 分制得分为 4.05±0.82 和 4.2±1。92%的住院医师希望将模拟器纳入他们的教学课程。在时间和鼻孔切开方面，专家、中级和初级组之间存在显著差异（p<0.05），而其他性能指标则没有显著差异。
据我们所知，目前尚无其他鼻中隔成形术模拟器培训模型。我们的模型结合了两种不同的材料，混合到模拟鼻中隔成形术所需的 3 种相关稠度中。我们的研究结果为模型的有效性提供了证据。
