从3D打印颞骨训练到尸体乳突切除术的技能迁移：一项随机对照试验
Skill Transfer From 3D-Printed Temporal Bone Training to Cadaveric Mastoidectomy: A Randomized Controlled Trial.
文献信息
| PMID | 42813381 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Santiago L Vallejos Riart |
| 作者单位 | Department of Otorhinolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 确定使用3D打印颞骨模型进行结构化尸体解剖前模拟训练是否能改善新手耳鼻咽喉科住院医师在尸体解剖中的乳突切除术表现。
研究设计： 前瞻性随机对照试验。
地点： 一家三级学术医疗中心的颞骨实验室。
参与者： 30名既往无乳突切除术经验的耳鼻咽喉科住院医师。
干预： 参与者被随机分为2组。干预组在尸体解剖前使用3D打印颞骨模型（Auris-Otobone）完成一次2小时的结构化模拟训练，而对照组接受标准理论教学。随后所有住院医师在标准化实验室条件下、无指导教师协助的情况下完成一例简单尸体乳突切除术。
主要结局指标： 技术表现由5名设盲的耳科专家使用25项改良Welling量表进行评估。评分者间信度采用组内相关系数（ICC）评估。组间差异采用线性混合效应模型分析。
结果： 除性别分布外，两组基线特征具有可比性。干预组的改良Welling量表总体得分显著高于对照组（16.44±2.62 vs. 12.28±2.63），平均差异为4.16分（95% CI：2.68-5.64；P<0.001）。方差分析显示，大部分得分变异可归因于住院医师之间的差异，而非评估者之间的差异，校正后的ICC提示评分者间一致性为中等（约0.56）。
结论： 使用3D打印颞骨模型进行结构化尸体解剖前模拟训练与新手耳鼻咽喉科住院医师乳突切除术表现的改善相关。这些发现提示，3D打印颞骨模型可能是耳科模拟课程中有用的辅助工具，尤其有助于在尸体解剖前早期获得技术技能。
英文摘要
OBJECTIVE: To determine whether structured precadaveric simulation training using a 3D-printed temporal bone model improves mastoidectomy performance during cadaveric dissection among novice otolaryngology residents.
STUDY DESIGN: Prospective randomized controlled trial.
SETTING: Temporal bone laboratory of a tertiary academic medical center.
PARTICIPANTS: Thirty otolaryngology residents without prior mastoidectomy experience.
INTERVENTION: Participants were randomized into 2 groups. The intervention group completed a 2-hour structured simulation session using a 3D-printed temporal bone model (Auris-Otobone) before cadaveric dissection, whereas the control group received standard theoretical instruction. All residents subsequently performed a simple cadaveric mastoidectomy under standardized laboratory conditions without instructor assistance.
MAIN OUTCOME MEASURES: Technical performance was assessed using the 25-item Modified Welling Scale by 5 blinded expert otologists. Inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC). Group differences were analyzed using a linear mixed-effects model.
RESULTS: Baseline characteristics were comparable between groups except for sex distribution. The intervention group achieved significantly higher global Modified Welling Scale scores than the control group (16.44±2.62 vs. 12.28±2.63), corresponding to a mean difference of 4.16 points (95% CI: 2.68-5.64; P<0.001). Variance analysis showed that most score variability was attributable to differences between residents rather than evaluators, and the adjusted ICC indicated moderate inter-rater agreement (∼0.56).
CONCLUSIONS: Structured precadaveric simulation training using a 3D-printed temporal bone model was associated with improved mastoidectomy performance among novice otolaryngology residents. These findings suggest that 3D-printed temporal bone models may represent a useful adjunct within otologic simulation curricula, particularly for early technical skill acquisition before cadaveric dissection.