Rapid Production Nasal Osteotomy Simulators With Multi-Modality Manufacturing: 3D-Printing, Casting, and Molding

Introduction: Rhinoplasty and specifically performing nasal osteotomies have been reported to be a key indicator procedure in which residents have been demonstrated to have lower confidence in their surgical proficiency. Nasal osteotomy models constructed with 3D printing have been proposed, however, these models have inherent limitations. The goal of this project is to expand and improve upon previously described nasal osteotomy models with the goals of decreasing cost and production time while ensuring model fidelity.

Methods: A combined methodology of 3D printing, silicone molding, and resin casting was used to design nasal osteotomy models in order to address material issues such as print delamination. Models were then used in a resident simulation lab on performing nasal osteotomies in December of 2023. Participant confidence in performing nasal osteotomies was assessed using surveys at multiple time points (baseline, post-lecture, and post-simulation lab). Model utility and impact on participant confidence were assessed.

Results: Using a combined manufacturing methodology, we achieved a production time reduction of 97.7% and a cost reduction of 82% for this polyurethane resin nasal osteotomy model relative to the previously described SimuBone model. Participants were noted to have a significant improvement in confidence of their understanding and ability to perform nasal osteotomies relative to baseline assessments. Significant improvement was noted between the post-lecture and post-simulation assessments.

Conclusions: Rhinoplasty and nasal osteotomies are challenging procedures in which residents have reported decreased confidence relative to other key indicator cases. In this study, with use of multiple manufacturing modalities including 3D printing, we improved upon the design of a previously described nasal osteotomy simulator with significant reductions in cost and production time, increased model fidelity with the addition of a silicone soft tissue midface model component, and demonstrated statistically significant improvement in participant confidence following the simulation lab.