<scp>3D</scp> ‐Printed High‐Fidelity Pediatric Mannequin for Rigid and Flexible Bronchoscopy Training on Difficult Airways

ABSTRACT Effective pediatric airway management, particularly in patients with congenital anomalies, is a significant clinical challenge, complicated by the scarcity of realistic pathological training models. This study describes the design, development, and validation of a high‐fidelity pediatric difficult airway simulator for training in rigid and flexible bronchoscopy. Developed by the T3Ddy Laboratory with the University of Florence and Meyer Children's Hospital—IRCCS, the mannequin was based on CT data from a 19‐month‐old patient with complex airway anomalies, using reverse engineering and additive manufacturing. The simulator adopts a modular design with interchangeable anatomical components, enabling replication of diverse clinical scenarios, including rare congenital tracheal conditions. Key features include a flexible cervical spine for dynamic head positioning, simulated lubrication and hemorrhage systems, and anatomically precise upper airway structures. The airway underwent iterative redesign to balance anatomical fidelity and manufacturability. Production combined fused deposition modeling with silicone casting in custom molds incorporating functional details. Validation occurred during a pediatric bronchoscopy training course, where structured questionnaires assessed realism, usability, and educational value. Participants reported high satisfaction, particularly with rigid bronchoscopy, while suggesting improvements in haptic feedback and fluid simulation. This work demonstrates that advanced design and manufacturing can create customizable, reusable simulators that strengthen pediatric airway management training and fill critical gaps in pathological model availability.