Open access 3D printed open airway reconstruction and rib cartilage carving simulation model

Objective

To create a cost-effective, high-fidelity, and easily reproducible model for open airway reconstruction simulation.

Methods

3D printing and molding techniques were used to create silicone-based laryngotracheal and rib cartilage models. Models were utilized in an open airway reconstruction and cartilage graft carving simulation lab at a tertiary academic center in January 2024. Participants were surveyed regarding their confidence in performing key portions of the surgery (carving of anterior and posterior grafts, parachuting suture technique, tracheal resection and anastomosis). Surveys were collected at three time points (baseline, post-lecture, and post-simulation lab). Impact on participant confidence was analyzed using paired t-test.

Results

The airway and cartilage models were able to be fashioned quickly with a very low cost. The cost per model for the airway and rib cartilage models were $0.53 and $0.13, respectively. Thirteen participants completed the lab and surveys. When the simulation and post-lecture surveys were compared to the baseline survey, a statistically significant improvement in confidence was noted. Comparison of post-simulation and post-lecture surveys demonstrated statistically significant improvement (p < 0.001) with a large effect size (Cohen's d ≥ 1.58) for all survey items. Models were found to be of high fidelity based on the assessment questions.

Conclusion

With this simulation study, we demonstrated increased confidence for residents in understanding of key steps involved in open airway reconstruction and cartilage carving using cheap and high-fidelity models. All files will be made open source to increase accessibility and reproducibility.