Advancing 3D Printed Burr Hole and Craniotomy Models for Neurosurgical Simulation through Multi-Material Methods.

OBJECTIVE: 3D printing technology presents a promising avenue for the development of affordable neurosurgical simulation models, addressing many challenges related to the use of cadavers, animal models, and direct patient engagement. The aim of this study is to introduce and evaluate a new high-fidelity neurosurgical simulation model targeted for both burr hole and craniotomy procedures. METHODS: Twelve different 3D printed skull models were manufactured using five different materials (PEEK, White Resin, Rigid10K, BoneSTN, SkullSTN) from three different 3D print processes (Fused Filament Fabrication, Stereolithography, Material Jetting). Six consultant neurosurgeons conducted burr holes and craniotomies on each sample while blinded to these manufacturing details. Participants completed a survey based on the qualities of the models, including; mechanical performance, visual appearance, interior feeling, exterior feeling, sound, overall quality, and recommendations for training purposes based on their prior experience completing these procedures on human skulls. RESULTS: This study found that the multi-material stereolithography printed models consisting of White Resin for the outer table and Rigid 10K for the diploe and inner table were successful in replicating a human skull for burr hole and craniotomy simulation. This was followed by the porous General BoneSTN preset material on a Stratasys J750 Digital Anatomy Printer. CONCLUSIONS: The findings indicate that widely accessible and economical desktop stereolithography 3D printers can provide an effective solution in neurosurgical training, thus promoting their integration in hospitals.

Evaluation of 3D Printed Burr Hole Simulation Models Using 8 Different Materials.

OBJECTIVE: 3D printing is increasingly used to fabricate three-dimensional neurosurgical simulation models, making training more accessible and economical. 3D printing includes various technologies with different capabilities for reproducing human anatomy. This study evaluated different materials across a broad range of 3D printing technologies to identify the combination that most precisely represents the parietal region of the skull for burr hole simulation. METHODS: Eight different materials (polyethylene terephthalate glycol, Tough PLA, FibreTuff, White Resin, BoneSTN, SkullSTN, polymide [PA12], glass-filled polyamide [PA12-GF]) across 4 different 3D printing processes (fused filament fabrication, stereolithography, material jetting, selective laser sintering) were produced as skull samples that fit into a larger head model derived from computed tomography imaging. Five neurosurgeons conducted burr holes on each sample while blinded to the details of manufacturing method and cost. Qualities of mechanical drilling, visual appearance, skull exterior, and skull interior (i.e., diploë) and overall opinion were documented, and a final ranking activity was performed along with a semistructured interview. RESULTS: The study found that 3D printed polyethylene terephthalate glycol (using fused filament fabrication) and White Resin (using stereolithography) were the best models to replicate the skull, surpassing advanced multimaterial samples from a Stratasys J750 Digital Anatomy Printer. The interior (e.g., infill) and exterior structures strongly influenced the overall ranking of samples. All neurosurgeons agreed that practical simulation with 3D printed models can play a vital role in neurosurgical training. CONCLUSIONS: The study findings reveal that widely accessible desktop 3D printers and materials can play a valuable role in neurosurgical training.