Validation of a three-dimensional printed pediatric middle ear model for endoscopic surgery training

Joshua Anthony Stramiello, Stephanie J. Wong, Raquel Good, Alice Tor, Justin Ryan, Daniela Carvalho

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: The purpose of this study is to assess the anatomical appropriateness of a three-dimensional (3D) printed pediatric middle ear model with a replaceable middle ear unit as an endoscopic ear surgery (EES) simulator. Methods: Single-blinded, prospective, proof-of-concept study conducted in a simulation operative suite. A simulator was developed through segmentation of source images and multi-material 3D printing. Subjects were asked to point to seven anatomical sites before and after a short anatomy presentation of a human middle ear photograph. They also filled out a survey about the feasibility of the model. Outcome variables included survey scores, pre-anatomy lesson (PreAL) and post-anatomy lesson (PostAL) quiz scores. Results: There were 24 participants (19 residents, 1 fellow, and 4 attendings), none with self-reported proficiency in EES. The PreAL mean score was 4.42 and PostAL quiz mean score was 5.32 (average improvement of 43% [CI = 17%–70%]; p =.003). The higher the level of training, the higher the PreAL scores (0.55 points per year of training; p =.004). The subspecialty (otology, other, in-training) was also associated with the PreAL scores (p =.004). Total survey score means were 22.8 (out of 30). Conclusion: The results of our study suggest that our model has adequate anatomical high fidelity to mimic a real, pediatric temporal bone for EES. As 3D printing technologies continue to advance, the quality of ear models has the potential to provide improved surgical training for pediatric EES. Level of Evidence: 4.

Original languageEnglish
Pages (from-to)2133-2138
Number of pages6
JournalLaryngoscope investigative otolaryngology
Issue number6
StatePublished - Dec 2022
Externally publishedYes


  • 3D printed
  • endoscopic ear surgery
  • middle ear
  • pediatric
  • surgical model


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