An Open‐Source Three‐Dimensionally Printed Laryngeal Model for Injection Laryngoplasty Training

Abstract

Objectives/Hypothesis A limited number of three‐dimensionally (3D)‐printed laryngeal simulators have been described in the literature, only one of which is specifically designed for percutaneous injection laryngoplasty (PIL) training and is currently of limited availability. This study describes the development and evaluation of a high‐fidelity, open‐source, low‐cost 3D‐printed simulator for PIL training, improving on existing models. Study Design Simulator design and survey evaluation. Methods Computed tomography scans of the upper airways were processed with 3D Slicer to generate a computer model of the endolarynx. Blender and Fusion 360 were used to refine the mucosal model and develop casts for silicone injection molding. The casted endolaryngeal structures were inserted into a modified version of a publicly available laryngeal cartilage model. The final models were evaluated by 10 expert laryngologists using a customized version of the Michigan Standard Simulation Experience Scale. Internal consistency and interrater reliability of the survey were evaluated using Cronbach's α and intraclass correlation, respectively. Results Expert laryngologists highly rated the model for measures of fidelity, educational value, and overall quality (mean = 4.8, standard deviation = 0.5; 1 = strongly disagree, 5 = strongly agree). All reviewers rated the model as ready for use as is or with slight modifications. The filament needed for one cartilage model costs $0.96, whereas the silicone needed for one soft‐tissue model costs $1.89. Conclusions Using 3D‐printing technology, we successfully created the first open‐source, low‐cost, and anatomically accurate laryngeal model for injection laryngoplasty training. Our simulator is made freely available for download on Wikifactory with step‐by‐step tutorials for 3D printing, silicone molding, assembly, and use. Level of Evidence NA Laryngoscope, 131:E890–E895, 2021

Development and validation of a 3D laryngeal model in surgical skills training

“…There are few synthetic models in 3D printing that are currently available. Lee et al 31 built a model for percutaneous injection laryngoplasty training that does not include endoscopic training. Kavanagh et al 32 developed a pediatric laryngeal model with excellent anatomical quality that replicates only pediatric pathologies.…”

Three-dimensional printing in otolaryngology education: a systematic review

“…Therefore, to improve training and develop new teaching modalities, it is necessary to develop and optimize simulation techniques, particularly those involving 3D technology. Despite its limitations (i.e., simplification of the human anatomy and scarcity of validation studies), simulation has several advantages over traditional surgical practices with respect to improving training, since it facilitates practice in low-risk environments, the repetition of procedures to ensure success, immediate feedback, and objective performance evaluation [2].…”

“…Because of the contemporary trends that emphasize skillbased medical training and the progressive restriction of residents' surgical hours, simulators are becoming increasingly important in training since they have several inherent advantages in terms of satisfying the need to provide time-efficient training, including the ability to simulate unusual procedures and enable trainees to practice/train/simulate surgical procedures in low-risk environments [2].…”

Reinforcement Learning Based Vocal Fold Localization in Preoperative Neck CT for Injection Laryngoplasty

“…To the best of our knowledge, no computational approach currently exists for vocal fold localization or injection route identification. Some manual approaches can be found where vocal fold and needle routes are studied using neck CT across different patients [4] or a 3D printed larynx [5,6]. In general anatomical landmark localization problem, deep learning based heatmap regression methods are widely used where spatial heatmaps around the landmarks are usually regressed [7].…”