Randomized Controlled Trial Using Patient-Specific 3D-Printed Model for Mastoidectomy Preparation

Monday, September 30, 2024

10:18 AM – 10:24 AM EDT

Location: MBCC, Art Deco 228AB

Disclosure(s):

Vusala Snyder, MD MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Chareeni E. Kurukulasuriya, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amber D. Shaffer, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Noel Jabbour, MD, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: This study assessed whether mastoidectomy case preparation with patient-specific 3D printed temporal bone models leads to improved resident education and outcomes while determining the feasibility of 3D printing at an academic medical center.

Methods: A single center randomized controlled trial was conducted from 2019-2022 within the otolaryngology residency program at a large urban tertiary care system. Residents were randomized to either pre-drilling a patient-specific 3D temporal bone model or to the control arm of standard of care patient image review alone for each case. Across 21 residents, 176 potential mastoidectomy cases were randomized, and for 37 cases all study components were completed. Residents reported prior experience, self-assessed performance, and impressions of the model. Then, 4 attending physicians completed blinded evaluations of resident surgical performance. Primary outcomes were resident confidence and assessment of mastoidectomy performance.

Results: On n = 37 post-surgery resident surveys, the mean PGY level was 3.3. Self-assessed performance in mastoidectomies was 3.3, corresponding to “performed majority of surgery acceptably” on a scale from 1 (poor) to 5 (outstanding). Patient-specific models were pre-drilled for 15/37 (40.5%) cases. In per protocol analysis residents rated performance 1.6 points higher on cases with a model compared to those without (p = 0.04). Of respondents who pre-drilled, 11/15 (73%) wanted a model as preparation for their next mastoidectomy case. Faculty assessment of surgical performance completed for n = 57 cases did not significantly differ between arms, nor did anesthesia and surgery durations. Further analysis is ongoing to assess whether resident experience and case complexity impact outcomes in each arm.

Conclusions: This study demonstrates the impact of drilling patient-specific 3D models for mastoidectomy case preparation on trainee confidence and acquisition of critical surgical knowledge. Larger studies are needed to assess the impact on patient care, specifically complication rates and OR efficiency.

Presenting Author(s)

Vusala Snyder, MD, MS

Resident Physician
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Chareeni E. Kurukulasuriya, MD

Resident Physician
NYU Langone Health/NYU Grossman School of Medicine
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AS

Amber D. Shaffer, PhD

Research Assistant Professor
UPMC Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
MF

Monika E. Freiser, MD

Assistant Profressor
West Virginia University
Morgantown , WV, United States

Disclosure information not submitted.
Jennifer L. McCoy, MA

Senior Research Associate, Pediatric Otolaryngology
UPMC Children’s Hospital of Pittsburgh
Pittsburgh, Pennsylvania, United States

Disclosure information not submitted.

Senior Author(s)

Noel Jabbour, MD, MS

Associate Professor of Otolaryngology
University of Pittsburgh School of Medicine
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.