scholarly journals Effect of 3D-Printed Models on Cadaveric Dissection in Temporal Bone Training

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110650
Author(s):  
Andreas Frithioff ◽  
Martin Frendø ◽  
Kenneth Weiss ◽  
Søren Foghsgaard ◽  
David Bue Pedersen ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Assessment Tool ◽  
Three Dimensional ◽  
University Hospital ◽  
Cadaver Dissection ◽  
Cadaveric Dissection ◽  
Vr Training ◽  
3D Printed ◽  
Temporal Bones ◽  
Simulation Center

Objective Mastoidectomy is a cornerstone in the surgical management of middle and inner ear diseases. Unfortunately, training is challenged by insufficient access to human cadavers. Three-dimensional (3D) printing of temporal bones could alleviate this problem, but evidence on their educational effectiveness is lacking. It is largely unknown whether training on 3D-printed temporal bones improves mastoidectomy performance, including on cadavers, and how this training compares with virtual reality (VR) simulation. To address this knowledge gap, this study investigated whether training on 3D-printed temporal bones improves cadaveric dissection performance, and it compared this training with the already-established VR simulation. Study Design Prospective cohort study of an educational intervention. Setting Tertiary university hospital, cadaver dissection laboratory, and simulation center in Copenhagen, Denmark. Methods Eighteen otorhinolaryngology residents (intervention) attending the national temporal bone dissection course received 3 hours of mastoidectomy training on 3D-printed temporal bones. Posttraining cadaver mastoidectomy performances were rated by 3 experts using a validated assessment tool and compared with those of 66 previous course participants (control) who had received time-equivalent VR training prior to dissection. Results The intervention cohort outperformed the controls during cadaver dissection by 29% ( P < .001); their performances were largely similar across training modalities but remained at a modest level (~50% of the maximum score). Conclusion Mastoidectomy skills improved from training on 3D-printed temporal bone and seemingly more so than on time-equivalent VR simulation. Importantly, these skills transferred to cadaveric dissection. Training on 3D-printed temporal bones can effectively supplement cadaver training when learning mastoidectomy.

Objective structured assessment of technical skill in temporal bone dissection: validation of a novel tool

2021 ◽  
pp. 1-11
Author(s):  
M Stavrakas ◽  
G Menexes ◽  
S Triaridis ◽  
P Bamidis ◽  
J Constantinidis ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Rating Scale ◽  
Assessment Tool ◽  
Three Dimensional ◽  
Technical Skills ◽  
Technical Skill ◽  
Global Rating Scale ◽  
Global Rating ◽  
Validity And Reliability ◽  
Cortical Mastoidectomy

Abstract Objective This study developed an assessment tool that was based on the objective structured assessment for technical skills principles, to be used for evaluation of surgical skills in cortical mastoidectomy. The objective structured assessment of technical skill is a well-established tool for evaluation of surgical ability. This study also aimed to identify the best material and printing method to make a three-dimensional printed temporal bone model. Methods Twenty-four otolaryngologists in training were asked to perform a cortical mastoidectomy on a three-dimensional printed temporal bone (selective laser sintering resin). They were scored according to the objective structured assessment of technical skill in temporal bone dissection tool developed in this study and an already validated global rating scale. Results Two external assessors scored the candidates, and it was concluded that the objective structured assessment of technical skill in temporal bone dissection tool demonstrated some main aspects of validity and reliability that can be used in training and performance evaluation of technical skills in mastoid surgery. Conclusion Apart from validating the new tool for temporal bone dissection training, the study showed that evolving three-dimensional printing technologies is of high value in simulation training with several advantages over traditional teaching methods.

scholarly journals 3D-Customized Guiding Template for Posterior Fixation in Complex Atlantoaxial Instability—Preliminary Experiences of National Cheng Kung University Hospital

2020 ◽  
Vol 81 (01) ◽  
pp. e20-e27
Author(s):  
Yi-Yun Chen ◽  
Liang-Chun Chao ◽  
Jing-Jing Fang ◽  
E-Jian Lee
Keyword(s):  
Three Dimensional ◽  
University Hospital ◽  
Atlantoaxial Instability ◽  
Posterior Fixation ◽  
Screw Insertion ◽  
Anatomical Abnormality ◽  
Spine Model ◽  
Atlantoaxial Fixation ◽  
3D Printed ◽  
Complex Cases

Objective Atlantoaxial fixation is technically demanding and challenging, especially in cases with anatomical abnormality. The purpose of this study is to report the effectiveness of the three-dimensional (3D)-customized guiding template for placement of C1 and C2 screws in cases with abnormalities. Method Two patients with anatomical abnormality and one without were included. The preoperative computed tomography (CT) image was analyzed using our software. The entry point, trajectory, and depth of the screws were designed based on these images. Templates with screw guiding cylinders and cervical spine model were created. In operation, guiding templates were applied directly to the laminae. Drilling, tapping, and screwing were performed through the cylinders. To evaluate the accuracy, deviation of the screw axis from the preplanned trajectory was measured on postoperative CT. A classification system was taking to evaluate the pedicle screw insertion. Results In complex cases, one of C2 screws has grade 2 deviation, and two has grade 1. There was no deviation in screws of C1. All patients achieved symptoms free after 6 months follow-up. Conclusion Although 3D-printed template for atlantoaxial fixation still has limitation in complex cases, it has been proved usefulness and makes the most difficult and dangerous spinal posterior fixation easy to achieve.

Temporal bone Pneumatization in Otosclerosis

2008 ◽  
Vol 139 (6) ◽  
pp. 850-853 ◽  
Author(s):  
Daniel T. Ganc ◽  
Robert W. Jyung
Keyword(s):  
Temporal Bone ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Neck Surgery ◽  
Adult Patients ◽  
Control Group ◽  
Test Analysis ◽  
Temporal Bone Pneumatization ◽  
History Of ◽  
Temporal Bones

Objectives To determine whether there is a difference in the pneumatization of temporal bones with otosclerosis versus normal temporal bones. Methods A retrospective study of 46 ears from 24 adult patients with otosclerosis and 64 ears from 47 adult patients in a control group. The study group included temporal bone CT scans available from patients with otosclerosis. The control group consisted of patients who had temporal bone CTs for reasons likely unrelated to a history of middle ear disease. Data were obtained with a virtual reality system that allows three-dimensional manipulation and analysis. Results The temporal bone pneumatization for the otosclerosis group was 4.82 ± 2.27 cm3 vs 6.06 ± 2.71 cm3 for the control group. Two-sample t test analysis revealed no statistical significance ( P = 0.059) between pneumatization in the control vs otosclerosis groups. Conclusion There is no difference in temporal bone pneumatization between patients with otosclerosis and a control population. Therefore, temporal bone pneumatization by itself is not an adequate explanation for the apparent protective effect of otosclerosis against otitis media. © 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.

scholarly journals Impact of temporal bone dissection on the understanding anatomy of the ear among medical students

2018 ◽  
Vol 4 (6) ◽  
pp. 1489
Author(s):  
K. C. Prasad ◽  
Prathyusha K. ◽  
Shreeharsha Maruvala ◽  
Harshita T. R. ◽  
Indu Varsha Gopi ◽  
...  
Keyword(s):  
Medical Students ◽  
Temporal Bone ◽  
Three Dimensional ◽  
Operative Procedures ◽  
Research Centre ◽  
Medical College ◽  
Group I ◽  
Group Ii ◽  
Temporal Bones ◽  
The Impact

<p class="abstract">The aim was to study the impact of temporal bone dissection demonstrations on understanding anatomy of the ear among medical students. During a period of six months from October 2017 to March 2018, 10 cadaveric temporal bones dissections were demonstrated using ZEISS microscope and in the presence of medical students headed by a Consultant Otolaryngologist in the department of ENT, Sri Devaraj URS Medical College and Research Centre, Kolar. Anatomy of the middle ear and inner ear and various operative procedures were demonstrated. The students were divided into 2 groups. Group I comprised students who attended the temporal bone dissection and Group II included those who didn’t attend dissection. After the session both the groups were assessed by the consultant. Scores were given to the group individuals based on the ability to answer the questions. 10 Temporal bone dissections were demonstrated in 6 months period to medical students who were divided into 2 groups based on their attendance of the demonstration. The students of both groups were assessed. Scores were given by Likert scale-5point scale question. The results of our study proved that those students who attended the temporal bone dissection (Group-I) had better understanding of the anatomy and operative procedures of the ear as compared to students in group II. Demonstration of temporal bone dissection to the medical students had a good impact on their understanding of the three dimensional anatomy of the ear.</p>

scholarly journals Endoscopic Anatomy of Hypotympanum Surgical Implications

2018 ◽  
Vol 01 (02) ◽  
pp. 058-067
Author(s):  
Rajesh Boddepalli ◽  
Sreerama Boddepalli
Keyword(s):  
Temporal Bone ◽  
Local Anesthesia ◽  
Type A ◽  
Jugular Foramen ◽  
Type B ◽  
Cadaveric Dissection ◽  
Endoscopic Anatomy ◽  
Type C ◽  
Four Levels ◽  
Temporal Bones

Abstract Objective To assess the endomeatal endoscopic morphological anatomy of hypotympanum under local anesthesia and further cadaveric dissection of temporal bone to know complete anatomical details of hypotympanum. Materials and Methods Two hundred six cases of live operations were studied, these included 160 cases of simple dry perforations for myringoplasty and 46 cases of stapedectomy operations. All operations were performed under local anesthesia using a 0-degree, 4-mm endoscope. The hypotympanum was visualized. Twenty wet temporal bones were dissected endoscopically and complete hypotympanic details were studied. Results Out of 206 cases, 94 cases (45%) were found to be type A; 51 cases (25%) were type B and 60 cases (30%) were type C hypotympanum. Wet cadaveric bones were dissected to visualize the transmeatal endoscopic jugular foramen in four levels (levels 1, 2, 3, and 4).

Cholesteatoma in three dimensions: a teaching tool and an aid to improved pre-operative consent

2009 ◽  
Vol 124 (2) ◽  
pp. 126-131 ◽  
Author(s):  
D P Morris ◽  
R G Van Wijhe
Keyword(s):  
Temporal Bone ◽  
Three Dimensional ◽  
Three Dimensions ◽  
Teaching Tool ◽  
Surgical Experience ◽  
Teaching Programme ◽  
Computed Tomography Images ◽  
Three Dimensional Models ◽  
Temporal Bones ◽  
User Friendly

AbstractBackground:Otological surgeons face two recurring challenges. Firstly, we must foster an appreciation of the complex, three-dimensional anatomy of the temporal bone in order to enable our trainees to operate safely and independently. Secondly, we must explain to our patients the necessity for surgery which carries the potential for serious complication.Methods:Amira® software was applied to pre-operative computed tomography images of temporal bones with cholesteatoma, to create three-dimensional computer images. Normal structures and cholesteatoma were displayed in a user-friendly, interactive format, allowing both trainee and patient to visualise disease and important structures within the temporal bone.Results:Three cases, and their three-dimensional computer models are presented. Zoom, rotation and transparency functions complemented the three-dimensional effect.Conclusion:These three-dimensional models provided a useful adjunct to cadaveric temporal bone dissection and surgical experience for our residents' teaching programme. Also, patients with cholesteatoma reported a better understanding of their pre-operative condition when the models were used during the consenting process.

Investigation of Temporal Bone Anatomy by Plastic Moulding and Cryomicrotomy

1986 ◽  
Vol 27 (4) ◽  
pp. 389-394 ◽  
Author(s):  
H. Wilbrand ◽  
W. Rauschning
Keyword(s):  
Temporal Bone ◽  
Polyester Resin ◽  
Plastic Material ◽  
Three Dimensional ◽  
Accurate Information ◽  
Radiographic Images ◽  
Cochlear Aqueduct ◽  
Temporal Bone Anatomy ◽  
Temporal Bones ◽  
Bone Structures

To increase our understanding of the complex topographic relations between temporal bone structures and to facilitate the interpretation of their radiographic images, two techniques were developed. 1) Plastic moulding of temporal bone specimens using polyester resin and silicone rubber substances providing detailed information and a three-dimensional survey of the structures. Carefully macerated temporal bone specimens are filled with plastic material under vacuum and the bone is then dissolved. The preparations, freed from irrelevant structures and embellished, allow metric evaluation of the different structures and their topographic relations. 2) Automatic serial cryomicrotomy of fresh, deep-frozen temporal bones, using a commercial sledge-cryomicrotome. Photography of the cut surfaces of the specimen, usually at distances of 0.25 to 0.50 mm, allows natural-colour reproduction of minute detail, e.g. the melanin cell area in the cochlea, the smallest vessels on the ossicular surfaces, and the origin of the cochlear aqueduct at the basal turn of the cochlea. By correlating the photographs with images from the corresponding tomographic planes accurate information is obtained for interpretation of the radiographic images. A combination of the two techniques facilitates a detailed study and is a valuable aid in the teaching of temporal bone anatomy.

Evaluation of the mastoid air cell system by high resolution computed tomography: three-dimensional multiplanar volume rendering technique

2003 ◽  
Vol 117 (8) ◽  
pp. 595-598 ◽  
Author(s):  
Ahmet Koç ◽  
Gazanfer Ekinci ◽  
A. Mert Bilgili ◽  
Ihsan N. Akpinar ◽  
Hamdi Yakut ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Volume Rendering ◽  
Three Dimensional ◽  
Cell System ◽  
Mastoid Cavity ◽  
High Resolution Computed Tomography ◽  
Mastoid Pneumatization ◽  
Temporal Bones

The mastoid air cell system is an important contributor to the pathophysiology of middle-ear inflammatory disease. The mastoid cavity is not only an air reservoir, but also an active space for gas exchange. Various methods of temporal bone imaging have been designed to investigate mastoid pneumatization. In this study, we examined 100 normal temporal bones for the evaluation of mastoid pneumatization. Mastoid air cell systems were measured by reconstructed axial and coronal high resolution computed tomography (HRCT) images. The reconstructions were made by a three-dimensional multiplanar volume rendering (3D MPVR) technique. The mean volume of the mastoid air cell pneumatization was 7.9 cm3 (4.0-14.0 cm3, SD = 2.3 cm3). The ears were allocated to the groups with respect to measured mastoid air cell pneumatization. Twenty-eight per cent of the ears have small pneumatization with an aircell system not exceeding 6 cm3. Fifty-two per cent had an air cell system between six and 10 cm3, and 20 per cent had an air cell system exceeding 10 cm3. With its excellent imaging quality and the ability to eliminate bone and soft tissue, HRCT is the best method for evaluating the mastoid air cell system. The 3D MPVR technique must be used tomeasure the temporal bone/mastoid pneumatization for the best results.

3D-Printed Models for Temporal Bone Surgical Training: A Systematic Review

2021 ◽  
pp. 019459982199338
Author(s):  
Andreas Frithioff ◽  
Martin Frendø ◽  
David Bue Pedersen ◽  
Mads Sølvsten Sørensen ◽  
Steven Arild Wuyts Andersen
Keyword(s):  
Systematic Review ◽  
Temporal Bone ◽  
Surgical Training ◽  
Cochrane Library ◽  
Surgical Performance ◽  
Positive Attitudes ◽  
Print Material ◽  
3D Printed ◽  
Meta Analyses ◽  
Temporal Bones

Objective 3D-printed models hold great potential for temporal bone surgical training as a supplement to cadaveric dissection. Nevertheless, critical knowledge on manufacturing remains scattered, and little is known about whether use of these models improves surgical performance. This systematic review aims to explore (1) methods used for manufacturing and (2) how educational evidence supports using 3D-printed temporal bone models. Data Sources PubMed, Embase, the Cochrane Library, and Web of Science. Review Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, relevant studies were identified and data on manufacturing and validation and/or training extracted by 2 reviewers. Quality assessment was performed using the Medical Education Research Study Quality Instrument tool; educational outcomes were determined according to Kirkpatrick’s model. Results The search yielded 595 studies; 36 studies were found eligible and included for analysis. The described 3D-printed models were based on computed tomography scans from patients or cadavers. Processing included manual segmentation of key structures such as the facial nerve; postprocessing, for example, consisted of removal of print material inside the model. Overall, educational quality was low, and most studies evaluated their models using only expert and/or trainee opinion (ie, Kirkpatrick level 1). Most studies reported positive attitudes toward the models and their potential for training. Conclusion Manufacturing and use of 3D-printed temporal bones for surgical training are widely reported in the literature. However, evidence to support their use and knowledge about both manufacturing and the effects on subsequent surgical performance are currently lacking. Therefore, stronger educational evidence and manufacturing knowhow are needed for widespread implementation of 3D-printed temporal bones in surgical curricula.

scholarly journals EP.TU.702Role of cadaveric dissections in current medical education

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sangara Narayanasamy ◽  
Pradeep Thomas
Keyword(s):  
Learning Styles ◽  
Medical Curriculum ◽  
Three Dimensional ◽  
Computer Software ◽  
Team Work ◽  
Advanced Technology ◽  
Visual Methods ◽  
Cadaver Dissection ◽  
Cadaveric Dissection ◽  
Digital World

Abstract Introduction Today’s digital world has surplus educational resources for the students. Medical curriculum has changed the traditional way of teaching to audio-visual methods. Learning anatomy has changed from cadaveric dissection to specimen models, life models and three-dimensional models, which has raised questions as to whether cadaver dissection should be continued. Multimodel Approach Computer software with 3-D models is a useful tool for the beginners (Silen et al., 2008). Didactic lectures provide easy steps to be followed during dissection. Body paintings explain the surface anatomy in an appropriate way. Online videos are user friendly and personalized, so that one could review them repeatedly. Finally, live demonstration in theatre explains the structures and relations, with the flaws of only limited students benefited Pros Cadaver dissection creates interest to explore and learn detailed anatomy, to gain everlasting knowledge blending the theoretical knowledge with the practical and to involve in research. In addition, students develop the art of team work building their interpersonal skills. Cons Unpleasant smell of the formalin preserved cadaver, limited opportunities for everyone to learn, inadequate fund, inexperienced staff and psychological distress (Evans and Fitzgibbon, 1992). Conclusion Cadaveric dissection is a better method of learning (Winkelmann, 2007). Students understanding subjects precisely, make them better clinicians. Other teaching methods could be used as supplements. Recommendations Organize different teaching techniques helping diversity of students to learn anatomy based on their learning styles. Use of advanced technology like real time pictures, videos and imaging modalities to learn anatomy (Swamy and Searle, 2012).

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