title: Pediatric laryngeal simulator using 3D printed models: A novel technique.
abstract: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible.
  
  
  
  Pediatric laryngeal models were developed using two manufacturing methods: direct three-dimensional (3D) printing of anatomical models and casted anatomical models using 3D-printed molds. Polylactic acid, acrylonitrile butadiene styrene, and high-impact polystyrene (HIPS) were used for the directly printed models, whereas a silicone elastomer (SE) was used for the casted models.
  
  
  
  The models were evaluated for anatomic quality, ease of manipulation, hardness, and cost of production. A tissue likeness scale was created to validate the simulation model. Fleiss' Kappa rating was performed to evaluate interrater agreement, and analysis of variance was performed to evaluate differences among the materials.
  
  
  
  The SE provided the most anatomically accurate models, with the tactile properties allowing for surgical manipulation of the larynx. Direct 3D printing was more cost-effective than the SE casting method but did not possess the material properties and tissue likeness necessary for surgical simulation.
  
  
  
  The SE models of the pediatric larynx created from a casting method demonstrated high quality anatomy, tactile properties comparable to human tissue, and easy manipulation with standard surgical instruments. Their use in a reliable, low-cost, accessible, modular simulation system provides a valuable training resource for otolaryngology residents.
  
  
  
  N/A. Laryngoscope, 127:E132-E137, 2017.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Kavanagh
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.
authors.forename: Valerie
authors.initials: V
authors.lastname: Cote
authors.affiliation: Division of Otolaryngology Head and Neck Surgery, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Tsui
authors.affiliation: College of Science Technology Engineering and Mathematics, Texas A&M University, Texarkana, Texas, U.S.A.
authors.forename: Simon
authors.initials: S
authors.lastname: Kudernatsch
authors.affiliation: College of Science Technology Engineering and Mathematics, Texas A&M University, Texarkana, Texas, U.S.A.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Peterson
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.
authors.forename: Tulio A
authors.initials: TA
authors.lastname: Valdez
mesh_terms: D002983:Clinical Competence; D003362:Cost-Benefit Analysis; D004503:Education, Medical, Graduate / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D007830:Larynx / Q000033:anatomy & histology* / Q000601:surgery; D008953:Models, Anatomic; D010036:Otolaryngology / Q000193:education; D010372:Pediatrics; D066330:Printing, Three-Dimensional / Q000191:economics*; D000066908:Simulation Training / Q000379:methods*
keywords: Simulation; laryngoscopy; pediatric otolaryngology; resident education