低成本3D打印颞骨模型用于手术模拟：一项初步研究

文献信息

中文摘要

背景： 手术模拟需要逼真的模型以进行充分的手术准备。为解决尸体标本稀缺、储存复杂和成本高昂的问题，已开发出三维（3D）打印模型等替代方法，但3D打印模型可能价格昂贵，且需要专业设备和专业知识。我们开发并测试了使用易获取、可负担材料制成的3D打印颞骨模型，并评估其作为培训替代品的应用。
方法： 使用1名成人患者和1名儿童患者的计算机断层扫描，我们使用以下材料3D打印了4个成人和4个儿童颞骨模型：丙烯腈-丁二烯-苯乙烯共聚物、聚乳酸、高抗冲聚苯乙烯和Formlabs白色树脂（Formlabs公司）。8名既往有颞骨钻孔经验的耳鼻咽喉科住院医师参与了研究。住院医师被随机分配至成人或儿童骨，并对所用3D打印材料设盲。在钻磨3D模型后，参与者立即完成了一份8项Likert量表问卷，评估3D打印颞骨相对于尸体颞骨的价值、易用性、安全性和相似性。
结果： 住院医师认为这些模型在培训价值方面与尸体骨相似，但认为模型的骨性解剖结构欠佳，尤其是乳突气房和钻孔产生的粉尘。统计分析未发现不同材料或住院医师级别之间存在显著差异（P>0.05）。材料总成本为33.88美元（美元），儿童模型为2.58至3.03美元，成人模型为4.42至8.19美元。
结论： 通过改进我们模型的骨性解剖结构，并进一步优化低成本材料以提高触觉真实感，3D打印颞骨可能提供与尸体骨相当的培训替代方案，且每个模型的成本更低，并且无需昂贵的储存。未来研究应在更大的受试者内队列中评估3D打印颞骨模型，并评估成本效益，以确定其相对于尸体标本的价值。

英文摘要

BACKGROUND: Surgical simulation requires realistic models for proper surgical preparation. To address the scarcity, storage complexity, and cost of cadaver specimens, alternative approaches such as three-dimensional (3D)-printed models have been developed, but 3D-printed models can be expensive and require specialized equipment and expertise. We developed and tested 3D-printed temporal bone models made with accessible, affordable materials and evaluated their use as training replacements.
METHODS: Using computed tomography scans of 1 adult patient and 1 pediatric patient, we 3D-printed 4 adult and 4 pediatric temporal bone models with the following materials: acrylonitrile butadiene styrene, polylactic acid, high-impact polystyrene, and Formlabs white resin (Formlabs Inc). Eight otolaryngology residents with prior experience with temporal bone drilling participated in the study. Residents were randomized to either an adult or pediatric bone and blinded to the 3D-print material used. Immediately after drilling the 3D models, the participants completed an 8-item Likert scale questionnaire that evaluated the value, ease of use, safety, and similarity of the 3D-printed temporal bones compared to cadaver temporal bones.
RESULTS: Residents rated the models as similar to cadaver bones in terms of training value but rated the bony anatomy of the models as suboptimal, specifically the mastoid air cells and dust from drilling. Statistical analysis found no significant differences across materials or residency levels (P>0.05). The total cost of the materials was $33.88 (US dollars), with pediatric models ranging from $2.58 to $3.03 and adult models ranging from $4.42 to $8.19.
CONCLUSION: With improvements to the bony anatomy of our models and further optimization of the low-cost materials to improve haptic realism, 3D-printed temporal bones may provide comparable training alternatives to cadaver bones that are less costly per model and require no costly storage. Future studies should evaluate 3D-printed temporal bone models in larger within-subject cohorts and assess cost-effectiveness to determine their value relative to cadaver specimens.