The Manufacturing of 3D Printed models for the Neurotraumatological Education of Military Surgeons.

Abstract

When deployed abroad, military surgeons frequently have to deal with casualties involving head trauma. The emergency treatments, as well as craniotomies, are often performed by non-neurosurgeons qualified with basic neurotraumatological skills. Previous neurotrauma courses for education of non-neurosurgeons in Germany teach surgical emergency skills but do not include the training of skills needed to successfully utilize imaging in surgical planning, which is of importance for the safety and success of the treatment. To overcome these limitations, 3D printed models of neurotrauma cases were fabricated for application in the training of non-neurosurgeons. Five models of actual neurotrauma cases from our neurosurgical department were segmented from CT scans and 3D printed using multi-part fused deposition modeling. Model quality was assessed with respect to the representation of pre-defined anatomical landmarks. The models were then fixed to a wooden mount with a central light source and covered by a latex mask for skin simulation. Surgical planning by means of craniometric measurements on the basis of available CT scans of the corresponding patients was then applied to the model. The 3D printed models precisely represented the cranium, the lesion, and anatomical landmarks, which are taken into consideration during surgical planning. Surface covering with washable latex masks ensured sufficient masking of the now non-noticeable lesion within the semi-translucent skull. Surgical planning was performed using washable marker drawings. When lighted, the otherwise non-visible lesion within the semi-translucent 3D printed craniums became visible and facilitated immediate success control for the course participants. The presented method provided a way to fabricate precise 3D models of neurotrauma cases, which are suitable to teach the application of medical imaging in surgical planning. For further benefit analysis, the application of the presented education tool needs to be investigated within a neurotrauma course.