3D Printing for Difficult Airway Management Training: Design of Patient-Specific Airway Models for Rare Anatomical Variations and Comparative Evaluation of Their Cost-Effectiveness and Realism in Simulation-Based Education

Abstract: Background: In order to manage uncommon and intricate anatomical variations, simulation-based airway training is essential. The lack of patient-specific features in traditional high-fidelity simulators reduces their realism and educational potential. For procedural training, patient-specific 3D-printed airway models present a potentially realistic and affordable option. Methods: De-identified MRI and high-resolution CT datasets were used to create three-dimensional airway models that included anatomical variations like tumors, congenital malformations, and post-traumatic deformities. Mimics and Blender were used for segmentation and 3D reconstruction, and PLA and TPU models were printed with silicone coating to replicate tissue compliance. Using a 5-point Likert scale, postgraduate anesthesia technologists and consultant anesthesiologists assessed the models for procedural ease, tactile realism, and anatomical accuracy. Confidence surveys conducted before and after the simulation assessed the impact of education. Commercial high-fidelity simulators were used to compare the models. Wilcoxon signed-rank tests, paired t-tests, and effect size computations were all used in the statistical analysis. Results: Comparing patient-specific 3D models to commercial simulators, the former showed better tactile realism (4.5 ± 0.5 vs 4.3 ± 0.6; p = 0.037), procedural ease (4.7 ± 0.3 vs 4.5 ± 0.4; p = 0.046), and anatomical fidelity (4.6 ± 0.4 vs 4.4 ± 0.5; p = 0.041). Cost-benefit analysis favored 3D-printed models (0.092 ± 0.01 vs 0.058 ± 0.02; p = 0.004), and post-simulation confidence improved significantly. Conclusion: When compared to traditional high-fidelity simulators, patient-specific 3D-printed airway models for uncommon anatomical variations exhibit superior realism, comparable or enhanced educational impact, and significantly better cost-effectiveness. Particularly in environments with limited resources, integrating these models into simulation-based airway curricula can enhance trainee readiness for uncommon and complicated airway scenarios. Keywords: 3D printing, airway simulation, anatomical fidelity, tactile realism, cost-effectiveness, educational impact.