3D Printing in Otolaryngology Surgery: Descriptive Review of Literature to Define the State of the Art

Novel Image-Guided Simulator for Transcervical Intralaryngeal Injection Training

OBJECTIVE(S)

To assess the impact of a novel 3D-printed simulation model with Brainlab Image Guidance on enhancing otolaryngology residents' skills and confidence in performing transcervical intralaryngeal injection (TII) compared with conventional training methods.

METHODS

Utilizing a 3D-printed larynx model derived from computed tomography (CT) scans, this study involved 16 otolaryngology residents divided into two groups for TII training: one with Brainlab Image Guidance (LMIG) and the other without (LM). Pre- and post-training evaluations measured participants' confidence while the Brainlab system measured the accuracy of their needle placements.

RESULTS

After training, participants exhibited a significant increase in confidence with an average rise from 1.56 to 2.75 on a 5-point scale. The LMIG group outperformed the LM group in accuracy achieving statistically significant reductions in target distances after training (3.5 mm right, 3.6 mm left). The LMIG also demonstrated a significantly greater increase in procedural confidence over the LM group after training.

CONCLUSION

The TII laryngeal model with Brainlab Image Guidance significantly improves procedural confidence and accuracy among otolaryngology residents, signifying potential advantage over a more conventional training approach. The model's realistic tactile and live instrument positioning feedback augments the process of surgical skill refinement in a controlled, risk-free, simulation environment.

LEVEL OF EVIDENCE

NA Laryngoscope, 135:763-768, 2025.

3D printed ventilation tubes and their effect on biological models

BACKGROUND

Acute otitis media (AOM) causes inflammation and hearing loss. Ventilation tubes are key in treatment. 3D printing improves prostheses in otorhinolaryngology, offering precision and greater adaptability.

MATERIALS AND METHODS

An experimental study was conducted with Wistar rats from July to December 2020. 3D tympanostomy tube models were designed, with technical specifications and tests performed on inexpensive 3D printers. The tympanostomy tube was inserted endoscopically.

RESULTS

Procedures were performed on five rats with implants in both ears. Pre-intervention pathologies, such as atical retraction and glue ear, were found. The PLA-printed tympanostomy tube showed improvement after adjustments. Histopathological results revealed significant middle and inner ear damage.

CONCLUSION

In our study, the design and 3D printing of implants fulfilled the desired functions when modified, with a height of 5 mm. Complications included PLA degradation and ear damage. There were no adverse events during observation, highlighting the need for further research on 3D-printed implants.

Development and mechanical-functional validation of 3D-printed laparoscopic forceps

INTRODUCTION

3-dimensional printing has enabled the development of unique and affordable additive manufacturing, including the prototyping and production of surgical forceps. Objective: demonstrate the development, 3D printing and mechanical-functional validation of a laparoscopic grasping forceps.

METHODS

the clamp was designed using a computer program and printed in 3 dimensions with polylactic acid (PLA) filament and added 5 screws for better leverage. Size and weight measurements were carried out, as well as mechanicalfunctional grip and rotation tests in the laboratory with a validated simulator.

RESULTS

Called "Easylap", the clamp weighed 48 grams, measured 43cm and was printed in 8 pieces, taking an average of 12 hours to produce. It allowed the simulation of the functional characteristics of laparoscopic pressure forceps, in addition to the rotation and rack locking mechanism. However, its strength is reduced due to the material used.

CONCLUSION

It is possible to develop plastic laparoscopic grasping forceps through 3-dimensional printing.

Surgical Medical Education via 3D Bioprinting: Modular System for Endovascular Training

There is currently a shift in surgical training from traditional methods to simulation-based approaches, recognizing the necessity of more effective and controlled learning environments. This study introduces a completely new 3D-printed modular system for endovascular surgery training (M-SET), developed to allow various difficulty levels. Its design was based on computed tomography angiographies from real patient data with femoro-popliteal lesions. The study aimed to explore the integration of simulation training via a 3D model into the surgical training curriculum and its effect on their performance. Our preliminary study included 12 volunteer trainees randomized 1:1 into the standard simulation (SS) group (3 stepwise difficulty training sessions) and the random simulation (RS) group (random difficulty of the M-SET). A senior surgeon evaluated and timed the final training session. Feedback reports were assessed through the Student Satisfaction and Self-Confidence in Learning Scale. The SS group completed the training sessions in about half time (23.13 ± 9.2 min vs. 44.6 ± 12.8 min). Trainees expressed high satisfaction with the training program supported by the M-SET. Our 3D-printed modular training model meets the current need for new endovascular training approaches, offering a customizable, accessible, and effective simulation-based educational program with the aim of reducing the time required to reach a high level of practical skills.

The Creation of an Average 3D Model of the Human Cartilaginous Nasal Septum and Its Biomimetic Applications

The cartilaginous nasal septum is integral to the overall structure of the nose. Developing our an-atomic understanding of the septum will improve the planning and techniques of septal surgeries. While the basic dimensions of the septum have previously been described, the average shape in the sagittal plane has yet to be established. Furthermore, determining the average shape allows for the creation of a mean three-dimensional (3D) septum model. To better understand the average septal shape, we dissected septums from 40 fresh human cadavers. Thickness was measured across pre-defined points on each specimen. Image processing in Photoshop was used to superimpose lateral photographs of the septums to determine the average shape. The average shape was then combined with thickness data to develop a 3D model. This model may be utilized in finite elemental analyses, creating theoretical results about septal properties that are more translatable to real-world clinical practice. Our 3D septum also has numerous applications for 3D printing. Realistic models can be created for educational or surgical planning purposes. In the future, our model could also serve as the basis for 3D-printed scaffolds to aid in tissue regeneration to reconstruct septal defects. The model can be viewed at the NIH 3D model repository (3DPX ID: 020598, Title: 3D Nasal Septum).

Cost-effective 3D scanning and printing technologies for outer ear reconstruction: current status

Current 3D scanning and printing technologies offer not only state-of-the-art developments in the field of medical imaging and bio-engineering, but also cost and time effective solutions for surgical reconstruction procedures. Besides tissue engineering, where living cells are used, bio-compatible polymers or synthetic resin can be applied. The combination of 3D handheld scanning devices or volumetric imaging, (open-source) image processing packages, and 3D printers form a complete workflow chain that is capable of effective rapid prototyping of outer ear replicas. This paper reviews current possibilities and latest use cases for 3D-scanning, data processing and printing of outer ear replicas with a focus on low-cost solutions for rehabilitation engineering.