Using 3D Printing Technology to Teach Cartilage Framework Carving for Ear Reconstruction

摘要

Objective: The aim of this study was to determine the validity of using a carvable 3D printed rib model in combination with a 3D printed auricular framework to facilitate the teaching, training and planning of auricular reconstruction. Design: 3D printed costal cartilages from ribs 6 to 9 were produced using a FormLabs Form3 Printer and used to make negative moulds. 2:1 silicone-cornstarch mixture was added to each mould to make 12 simulated 6-9th costal cartilages suitable for carving. 3D printed auricular frameworks were produced in polylactic acid using an Ultimaker 3 3D printer to demonstrate the component parts and constructed framework of an auricular reconstruction. Participants: 12 plastic surgery trainees attended a workshop in which they each attempted auricular reconstruction using the carvable models and 3D printed plastic models as a guide. All candidates completed a pre- and post-training questionnaire to assess confidence and comprehension of auricular reconstruction, and the suitability of the models for facilitating this teaching. Results: Only 42% of trainees (n=5) had observed an ear reconstruction in theatre prior to the training course. Statistically significant improvements in the appreciation of the different components that make an auricular framework (p0.0001) and confidence in carving and handling costal cartilage (p0.0001) were noted following completion of the training. Highly significant improvements in comprehension of the approach to ear reconstruction (p=0.006) and locating the subunits of a reconstructed ear from costal cartilage (p=0.003) were also noted. 100% of participants felt the 3D printed teaching aids directly enhanced their learning. Conclusions: Ear reconstruction is a complex, time consuming multi-stage operation demanding significant amounts of experience, planning and an appreciation of the 3D chondrocutaneous structure. In this study we have demonstrated the value of 3D printing in producing a suitable simulated costal cartilage model and as an adjunct to comprehending and planning a framework for auricular reconstruction.