Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA; Otolaryngology Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA; Pediatric Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.
World Neurosurg. 2021 Mar;147:e405-e410. doi: 10.1016/j.wneu.2020.12.077. Epub 2021 Jan 5.
The pediatric skull base may present anatomic challenges to the skull base surgeon, including limited sphenoid pneumatization and a narrow nasal corridor. The rare nature of pediatric skull base pathology makes it difficult to gain experience with these anatomic challenges. The objective of this study was to create a 3-dimensionally (3D) printed model of the pediatric skull base and assess its potential as a training tool.
Twenty-eight participants at various stages of training and practice were included in our study. They completed a pre- and postdissection questionnaire assessing challenges with endoscopic endonasal skeletonization of the carotid arteries and sella face using the 3D printed model.
The majority of participants had completed a skull base surgery fellowship (60.7%), were <5 years into practice (60.7%), and had <10 cases of pediatric skull base experience (82.1%). Anticipated challenges included limitation of maneuverability of instruments (71.4%), narrow nasal corridor and nonpneumatized bone (57.1%). On a scale of 0-10, 10 being very difficult, the average participant expected level of difficulty with visualization was 6.89 and expected level of difficulty with instrumentation was 7.3. On postdissection assessment, there was a nonstatistically significant change to 6.93 and 7.5, respectively. Participants endorsed on a scale of 0-10, 10 being very realistic, an overall model realism of 7.0 and haptic realism of 7.1.
A 3D printed model of the pediatric skull base may provide a realistic model to help participants gain experience with anatomic limitations characteristic of the pediatric anterior skull base.
小儿颅底可能给颅底外科医生带来解剖学挑战，包括蝶窦气化不全和鼻腔通道狭窄。小儿颅底病变的罕见性质使得很难获得这些解剖学挑战的经验。本研究的目的是创建小儿颅底的 3 维（3D）打印模型，并评估其作为培训工具的潜力。
我们的研究纳入了 28 名处于不同培训和实践阶段的参与者。他们在使用 3D 打印模型进行内镜经鼻颈动脉和鞍脸骨骼化之前和之后完成了一份调查问卷，评估了对这些解剖学挑战的挑战。
大多数参与者已经完成了颅底外科奖学金（60.7%），从业时间<5 年（60.7%），并且有<10 例小儿颅底经验（82.1%）。预期的挑战包括仪器操作的局限性（71.4%），鼻腔通道狭窄和非气化骨（57.1%）。在 0-10 的评分中，10 表示非常困难，平均参与者预计可视化的难度为 6.89，仪器操作的难度为 7.3。在解剖后评估中，分别为 6.93 和 7.5，没有统计学意义的变化。参与者在 0-10 的评分中，10 表示非常真实，对模型的整体逼真度评分为 7.0，触觉逼真度评分为 7.1。
小儿颅底的 3D 打印模型可以提供一个真实的模型，帮助参与者获得小儿前颅底特征性解剖学限制的经验。
