Evaluation of a Novel Technique for a 3D-Printed Temporal Bone Analog for Mastoidectomy Training

Introduction: Cadaveric temporal bones (CTBs) for otologic instruction have become increasingly expensive and scarce. Simulators offer a potentially cost-effective alternative to cadaveric specimens but must possess material characteristics similar to those of cadaveric specimens to be of value. This study evaluated otolaryngologists' interactions with additively manufactured (AM) analogs of cadaveric cortical and trabecular temporal bone and assessed how these interactions correlated with otologic experience. Materials and methods: Solid and porous photopolymer samples with unique geometry profiles were created from multiple materials using a Stratasys J750 inkjet 3D printer (Stratasys Ltd., Rehovot, Israel). Surveys using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES) were administered to otolaryngology trainees, otologists, and pediatric otolaryngologists to evaluate AM temporal bone (AMTB) analogs and a CTB. Kendall’s tau was used to compare Likert-scale responses to training year and level of otologic experience. Cronbach’s α for interrater reliability was calculated based on training. To account for multiple comparisons from correlations, p-values were adjusted using the Benjamini-Hochberg false discovery rate. Results: Nineteen responses from thirteen otolaryngology trainees, two otologists, and four pediatric otolaryngologists with extensive otologic experience were included. All participants consistently rated both AMTB analogs positively for fidelity to cadaveric bone. Increasing surgical experience, as measured by both training year and completed mastoidectomies, was associated with higher survey scores for the AM analogs; however, after adjusting for multiple comparisons, there was no statistically significant association between training year or mastoidectomy experience and survey responses. Discussion: Otologic training simulators must possess structural and material properties that closely match those of the human temporal bone. All respondents validated both solid and porous AM bony analogs, with a non-significant trend toward higher satisfaction with increasing surgical experience. Conclusions: This study provides the basis for constructing CT-based AMTB models that provide high-fidelity haptic feedback for otologic training.