Skill Transfer From 3D-Printed Temporal Bone Training to Cadaveric Mastoidectomy: A Randomized Controlled Trial

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.