title: Comparison of cadaveric and isomorphic three-dimensional printed models in temporal bone education.
abstract: OBJECTIVE
  Current three-dimensional (3D) printed simulations are complicated by insufficient void spaces and inconsistent density. We describe a novel simulation with focus on internal anatomic fidelity and evaluate against template/identical cadaveric education.
  
  
  METHODS
  Research ethics board-approved prospective cohort study.
  
  
  METHODS
  Generation of a 3D printed temporal bone was performed using a proprietary algorithm that deconstructs the digital model into slices prior to printing. This supplemental process facilitates removal of residual material from air-containing spaces and permits requisite infiltrative access to the all regions of the model. Ten otolaryngology trainees dissected a cadaveric temporal bone (CTB) followed by a matched/isomorphic 3D printed bone model (PBM), based on derivative micro-computed tomography data. Participants rated 1) physical characteristics, 2) specific anatomic constructs, 3) usefulness in skill development, and 4) perceived educational value. The survey instrument employed a seven-point Likert scale.
  
  
  RESULTS
  Trainees felt physical characteristics of the PBM were quite similar to CTB, with highly ranked cortical (5.5 ± 1.5) and trabecular (5.2 ± 1.3) bone drill quality. The overall model was considered comparable to CTB (5.9 ± 0.74), with respectable air cell reproduction (6.1 ± 1.1). Internal constructs were rated as satisfactory (range, 4.9-6.2). The simulation was considered a beneficial training tool for all types of mastoidectomy (range, 5.9-6.6), posterior tympanotomy (6.5 ± 0.71), and skull base approaches (range, 6-6.5). Participants believed the model to be an effective training instrument (6.7 ± 0.68), which should be incorporated into the temporal bone lab (7.0 ± 0.0). The PBM was thought to improve confidence (6.7 ± 0.68) and operative performance (6.7 ± 0.48).
  
  
  CONCLUSIONS
  Study participants found the PBM to be an effective platform that compared favorably to CTB. The model was considered a valuable adjunctive training tool with both realistic mechanical and visual character.
  
  
  METHODS
  NA
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jordan B
authors.initials: JB
authors.lastname: Hochman
authors.affiliation: Department of Continuing Medical Education, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rhodes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Dana
authors.initials: D
authors.lastname: Wong
authors.affiliation: Department of Continuing Medical Education, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jay
authors.initials: J
authors.lastname: Kraut
authors.affiliation: Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Justyn
authors.initials: J
authors.lastname: Pisa
authors.affiliation: Department of Continuing Medical Education, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Bertram
authors.initials: B
authors.lastname: Unger
mesh_terms: D002102:Cadaver; D013502:General Surgery / Q000193:education*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008953:Models, Anatomic; D019291:Skull Base / Q000601:surgery; D013701:Temporal Bone / Q000033:anatomy & histology*
keywords: auditory physiology; bone; education; evidence-based medicine; middle ear; surgery; temporal; training