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可操作的、低成本的、高分辨率的、患者特异性的 3D 打印颞骨用于手术模拟和评估。

Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation.

机构信息

Department of Otolaryngology, University of Pittsburgh Medical Center, PA, USA.

Department of Radiology, University of Pittsburgh Medical Center, PA, USA.

出版信息

Ann Otol Rhinol Laryngol. 2021 Sep;130(9):1044-1051. doi: 10.1177/0003489421993733. Epub 2021 Feb 8.

Abstract

OBJECTIVES

Three-dimensional printed models created on a consumer level printer can be used to practice mastoidectomy and to discern mastoidectomy experience level. Current models in the literature for mastoidectomy are limited by expense or operability. The aims of this study were (1) to investigate the utility of an inexpensive model for mastoidectomy and (2) to assess whether the model can be used as an evaluation tool to discern the experience level of the surgeon performing mastoidectomy.

METHODS

Three-dimensional printed temporal bone models from the CT scan of a 7-year old patient were created using a consumer-level stereolithography 3D printer for a raw material cost of $10 each. Mastoidectomy with facial recess approach was performed by 4 PGY-2 residents, 4 PGY-5 residents, and 4 attending surgeons on the models who then filled out an evaluation. The drilled models were collected and then graded in a blinded fashion by 6 attending otolaryngologists.

RESULTS

Both residents and faculty felt the model was useful for training (mean score 4.7 out of 5; range: 4-5) and case preparation (mean score: 4.3; range: 3-5). Grading of the drilled models revealed significant differences between junior resident, senior resident, and attending surgeon scores ( = .012) with moderate to excellent interrater agreement (ICC = 0.882).

CONCLUSION

The described operable model that is patient-specific was rated favorably for pediatric mastoidectomy case preparation and training by residents and faculty. The model may be used to differentiate between experience levels and has promise for use in formative and summative evaluations.

摘要

目的

使用消费级打印机创建的三维打印模型可用于练习乳突切除术,并辨别乳突切除术的经验水平。目前文献中用于乳突切除术的模型受到费用或可操作性的限制。本研究的目的是:(1)研究一种廉价模型在乳突切除术中的应用;(2)评估该模型是否可用作辨别行乳突切除术的外科医生经验水平的评估工具。

方法

使用消费级立体光刻 3D 打印机,根据一名 7 岁患者的 CT 扫描创建了三维打印颞骨模型,每个模型的原材料成本为 10 美元。4 名 PGY-2 住院医师、4 名 PGY-5 住院医师和 4 名主治外科医生在模型上进行了经面神经隐窝入路的乳突切除术,然后填写了评估表。钻过的模型被收集起来,然后由 6 名主治耳鼻喉科医生进行盲法评分。

结果

住院医师和教员都认为该模型对培训(平均得分为 5 分制中的 4.7 分;范围:4-5 分)和病例准备(平均得分为 4.3 分;范围:3-5 分)有用。对钻过的模型进行评分显示,初级住院医师、高级住院医师和主治外科医生的评分之间存在显著差异(P = .012),且具有较好的组内一致性(ICC = 0.882)。

结论

这种可操作的、针对患者的模型在儿科乳突切除术病例准备和培训方面得到了住院医师和教员的好评。该模型可用于区分经验水平,有望用于形成性和总结性评估。

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