How safe are 3D-printed skull models for neurosurgical simulation? Measurement of airborne particles and VOCs while burr hole drilling

Purpose Three-dimensional (3D)printed skulls for neurosurgical training are increasingly being used due to the widespread access to 3D printing technology, their low cost and accuracy, as well as limitations and ethical concerns associated with using human cadavers. However, little is known about the risks of airborne particles or volatile organic compounds (VOCs) released while drilling into 3D-printed plastic models. The aim of this study is to assess the level of exposure to airborne contaminants while burr hole drilling. Design/methodology/approach 3D-printed skull samples were produced using three different materials (polyethylene terephthalate glycol [PETG], white resin and BoneSTN) across three different 3D print processes (fused filament fabrication, stereolithography [SLA] and material jetting). A neurosurgeon performed extended burr hole drilling for 10 min on each sample. Spot measurements of particulate matter (PM2.5 and PM10) were recorded, and air samples were analysed for approximately 90 VOCs. Findings The particulate matter for PETG was found to be below the threshold value for respirable particles. However, the particulate matter for white resin and BoneSTN was found to be above the threshold value at PM10, which could be harmful for long periods of exposure without personal protective equipment (PPE). The VOC measurements for all materials were found to be below safety thresholds, and therefore not harmful. Originality/value To the best of the authors’ knowledge, this is the first study to evaluate the safety of 3D-printed materials for burr hole surgical drilling. It recommends PETG as a safe material requiring minimal respiratory control measures, whereas resin-based materials will require safety controls to deal with airborne particles.