Piloting 3D technologies as a surgical simulation suite for patient-specific cochlear implantation surgeries in pediatrics

Background: Cochlear implants (CIs) help restore hearing in patients with severe to profound hearing loss. High-fidelity simulation tools may enhance surgical preparedness, patient safety, and training opportunities. This study validates the use of patient-specific 3D models in a virtual reality (VR) simulation environment (CardinalSim) and 3D printed as preoperative rehearsal tools for pediatric CI surgery. Methods: A cross-over study was conducted with five pediatric CI cases referred to a pediatric cochlear implant centre. Participants included attending surgeons and trainees. CT-derived models were imported to VR simulations and used to make 3D printed replicas of each patient’s temporal bone. Participants completed simulations using VR, followed by the corresponding printed model, with surveys collected after each. Trainee performance was assessed using standardized competency rating scales, and simulation metrics were recorded. After surgery, participants completed a a clinical impact questionnaire. Preoperative metrics were compared to intraoperative performance. Primary outcomes were the face and content validity of both modalities. Results: VR and 3D printed models demonstrated strong face and content validity. VR facilitated anatomical orientation and time efficiency, while 3D models offered superior tactile realism. Simulation times increased progressively from VR to printed models to surgery, reflecting growing task complexity. Participants reported improved confidence and surgical preparedness following simulation. Conclusion: Patient-specific VR and 3D printed simulations offer complementary benefits for preoperative planning and surgical training in pediatric CI cases. These tools represent promising, scalable solutions for enhancing safety and performance in complex pediatric otologic surgery. Trial Registration: Clinical trial number - not applicable.