Conventional simulators for intubation today are expensive and lack the anatomical accuracy needed. As a solution, South Korean researchers developed a new simulation model with 3D printing and silicone molding, releasing their findings in the recently published ‘Patient-specific and hyper-realistic phantom for an intubation simulator with a replaceable difficult airway of a toddler using 3D printing.’
Whether you have any experience in medicine at all or not, most likely you are somewhat aware of the intubation procedure and the fact that most patients have a strong desire to avoid the process. Far too many individuals are experiencing intubation today, due to complications from COVID-19. Training for medical students is also sometimes challenging, due to lack of accuracy in educational devices, as well as limited opportunities to actually intubate difficult cases; however, difficult tracheal intubation can cause serious respiratory issues or even death and improvements need to be made regarding education of medical professionals.
In developing the tracheal intubation simulator for this study and evaluating its true potential for training, the researchers focused on attending to details like jaw and cervical spine mobility, and tongue pressure in patients with Crouzon syndrome—a disorder causing premature fusion of the skull.
Employing three different 3D printers—a Form 2, an XFAB, and an Object J750—they created airway and tongue parts for the “phantom,” a simulator meant to appear similar to an individual with Crouzon syndrome.
“One of the most important factors of this phantom is the accuracy of mouth opening. The opening distance of the inter-incisor was set to 21, 32, and 47 mm. Two researchers measured these distances five times to analyze the accuracy of the opening distance of the mouth,” explained the researchers. “All the measurements were within the 95% limits of agreement.”
In creating the samples, the researchers used CT data from images of an 18-month-old female toddler’s head. They specifically centered in on the following key parts:
- Skin
- Mandible
- Cranio-maxilla
- Skull
- Airway
- C-spine
- Tongue
The airways and tongue were fabricated as one part, again, meant to be similar to a Crouzan syndrome patient. The tongue also had three joints, connected to a mandible, with both parts able to move together.
With 3D printed bone and soft tissue molded to imitate the human body, the researchers found the phantom to be successful—confirming the feasibility for use by those in training, and for use in practicing to intubate children as young as toddlers who are “developmentally compromised” or exhibit craniofacial anomalies.
“Future work will focus on the generation of a variety of craniofacial anomaly models with the addition of an interchangeable model design that would bring this project one step closer to imitating reality, thereby enhancing the quality of training with models,” concluded the researchers. “We believe that the current 3D printing technology can narrow the gap between simulation-based medical education and authentic patient experience. For more realistic simulation, the patient-specific phantom was fabricated to mimic human tissue, with a realistic mouth opening and an accurate shape of the difficult airway, which has a great potential for the medical education and training field.”
This new study follows current trends in the fabrication of simulators, solving cost issues, as well as offering a host of other benefits; for example, Singapore-based Creatz3D has designed and 3D printed life-sized medical mannequins that allow for medical training in swab collections for patients. International researchers have created a 3D printed phantom for greater ease in simulating procedures like administering epidurals, and experts at the 3D printing lab at Mayo Clinic’s Department of Neurosurgery—the B.R.A.I.N. (Biotechnology Research and Innovation Neuroscience) Laboratory have 3D printed a simulator to train medical students in spinal anatomy and pedicle screw placement.
[Source / Images: ‘Patient-specific and hyper-realistic phantom for an intubation simulator with a replaceable difficult airway of a toddler using 3D printing’]