A three-dimensionally printed otological model for cholesteatoma mastoidectomy training.

PURPOSE: To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3-D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy. METHODS: We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with 3-D Slicer to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations. RESULTS: Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD. CONCLUSIONS: Using 3-D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3-D model of temporal bones for mastoidectomy training for cholesteatoma.

Three-dimensional printing in otolaryngology education: a systematic review.

PURPOSE: The progressive expansion of the technology that facilitates the development of three-dimensional (3D) printing within the field of otorhinolaryngology has opened up a new study front in medicine. The objective of this study is to systematically review scientific publications describing the development of 3D models having applications in otorhinolaryngology, with emphasis on subareas with a large number of publications, as well as the countries in which the publications are concentrated. METHODS: In this literature review, specific criteria were used to search for publications on 3D models. The review considered articles published in English on the development of 3D models to teach otorhinolaryngology. The studies with presurgical purposes or without validation of the task by surgeons were excluded from this review. RESULTS: This review considered 39 articles published in 10 countries between 2012 and 2021. The works published prior to 2012 were not considered as per the inclusion criteria for the research. Among the 39 simulators selected for review, otology models comprised a total of 15 publications (38%); they were followed by rhinology, with 12 (31%); laryngology, with 8 (21%); and head and neck surgery, with 4 publications (10%). CONCLUSION: The use of 3D technology and printing is well established in the context of surgical education and simulation models. The importance of developing new technological tools to enhance 3D printing and the current limitations in obtaining appropriate animal and cadaver models signify the necessity of investing more in 3D models.

Spatial distribution of dengue disease in municipality of Mossoró, Rio Grande do Norte, using the Geographic Information System.

The dengue viral infection is one of the most relevant vector-borne diseases in the world. The disease can manifest in a variety of forms, from asymptomatic to a condition of dengue hemorrhagic fever (DHF). The last reported cases in Brazil correspond to 80% of the cases reported in the Americas, which emphasizes the magnitude of the problem. This study was conducted using Geographic Information System (GIS) techniques, in order to evaluate the spatial distribution of the disease in the urban area of Mossoró, Rio Grande do Norte. In the period between 2001 and 2007, 867 new cases were listed. About 85.7% of the addresses were georeferenced, with a larger number of cases, 14.8%, in the neighborhoods of Santo Antônio and Santa Delmira (north region), and 11.7% in the neighborhoods of Conjunto Vingt-Rosado and Alto de São Manoel (east region). There were 18 confirmed cases of dengue hemorrhagic fever associated with regions with the highest incidence of classic cases of the disease. The use of Geographic Information System (GIS) proved a great benefit for better visualization of the endemic, especially in elucidating the actual distribution of dengue cases in the county and providing an effective tool for planning the monitoring of the disease at a local level.