Three-dimensional printing of a low-cost, high-fidelity laryngeal dissection station.

Abstract

Microlaryngeal phonosurgery requires a significant amount of operative precision to obtain desired voice outcomes.1,2 Residents have traditionally developed these skills via intraoperative experience; however, with growing duty-hour restrictions and relatively limited case volume, it has become more difficult to achieve mastery of these super-specialized procedures through operative experience alone. In fact, the majority of otolaryngology–head and neck surgery residents believe their training in phonomicrosurgery would be enhanced by laboratory-based simulation sessions.3 Accordingly, several authors have described laryngeal dissection stations aimed at facilitating such simulations.2,4,5 All these have a role in increasing competence among trainees and in allowing for the instruction of phonosurgical technique. Within the realm of surgical simulation, there is tension between high-fidelity and low-fidelity models. High-fidelity models more closely mimic clinical phonosurgery in equipment and task, but they often have a large cost associated with their manufacture and are not always readily available, especially if several stations are needed (personal conversation with Dr. Dailey and Dr. Jiang regarding availability of their teaching station for purchase by the senior author, LMA).5,6 To solve these issues, lower cost models have been described utilizing commonly available materials; however, as described, this lower cost model requires use of a clinical laryngoscope, something not feasible in institutions that do not allow instrumentation to be shared between patient-care and teaching lab environments.7 Also, this low-cost model offers lower fidelity in the modeling of microlaryngeal surgery: rubber bands, bacitracin, and plastic wrap are used to simulate layers of the true vocal fold given that the system is not designed to hold an animal larynx. A laryngeal dissection station that was simultaneously high fidelity and low cost would solve this tension and improve the teaching of phonosurgery in a simulation setting. Ideally, this station would closely mimic the conditions of operative microlaryngoscopy in terms of dimensions, positioning, and stability of the laryngoscope; would allow for the use of animal larynges that make possible high-fidelity modeling of phonosurgery; would not require the use of a clinical laryngoscope from the operating room; and would be readily available for those in any programs who wished to use it.6,8 Here, we describe a laryngeal dissection station constructed with a 3-dimensional (3D) printed laryngoscope that fulfills these criteria.