Development and preliminary validation of a multidisciplinary 3D‑printed skull base model for endoscopic endonasal surgical training

OBJECTIVE: The aim of the article is to present the development and application of a 3D-printed skull base model, which includes the internal carotid arteries, tumour and the optic nerve, to train neurosurgeons and ear, nose and throat (ENT) in performing the endonasal endoscopic approach (EEA). This procedure is challenging due to the proximity of critical structures such as nerves, blood vessels and brain. METHODOLOGY: The 3D model was generated using magnetic resonance imaging (MRI) and computed tomography (CT) scans, which provided detailed anatomical data. These scans were processed with 3D reconstruction software to accurately replicate the key areas, including the tumour and surrounding structures. Neurosurgery and ENT consultants and residents, practised the EEA using these printed models. After completing the procedures, participants filled out a questionnaire to evaluate the realism and reliability of the model by applying a statistical analysis appropriate to the study. RESULTS: The participants reported that the 3D-printed models provided a highly realistic simulation of the anatomical structures involved in the EEA. The model was deemed effective in replicating the key areas of interest, allowing them to safely practise the procedure in a controlled environment. Our results show that in two days approximately and for less than 10€, the surgeon may have the opportunity to train the surgery after establishing the printing parameters. A strong positive correlation was found among these variables (p < 0.01), suggesting that those who found the model useful also perceived a greater clinical applicability and believed that the 3D-printed model could help improve their surgical skills. CONCLUSIONS: The study demonstrates that 3D-printed models based on MRI and CT scans offer a reliable and realistic method for surgical training. These models provide an essential tool for practising complex procedures, such as the EEA, improving the safety and effectiveness of surgical training and potentially enhancing patient outcomes.