Validation of 3D-Printed Adenoidectomy Simulator Using Smartphone and Suction Cautery Stylus

Introduction: Adenoidectomy is a common procedure introduced to otolaryngology residents early in training, requiring skills that can be challenging to learn given the difficulty of operating through a mirror and within a limited physical space. This study’s purpose was to develop and validate a simple, 3D printed adenoidectomy simulator to teach the skill of holding a mirror and using suction cautery to reduce adenoid tissue, sparing the tauri, posterior septum, and Passavant’s ridge.

Methods: A single-center prospective study was conducted at a large academic institution. Otolaryngology residents (n=20) completed pre- and post-simulation self-assessments of surgical expertise, confidence with the procedure, and their impression of the simulator. Final images from each of 3 trials were analyzed using ImageJ software. Primary outcomes were performance scores, time to completion, and resident ratings. Individual, inter- and intragroup comparisons were performed.

Results: Timed trials were completed by 10 junior and 10 senior residents. Time to completion on first attempt differed significantly between junior residents, mean 67 sec, vs senior residents, mean 40.9 sec, p=0.043. Image analysis of n=13 residents’ triplicate adenoidectomy attempts showed average percentage of correctly cauterized adenoids by group was not statistically significant. Analysis of n=15 completed surveys showed a significant initial difference between juniors’ confidence in executing the procedure vs seniors’ on a 1 (0%) to 5 (100%) confidence scale, p=0.009. Junior residents had a significant increase in confidence with the adenoidectomy procedure after using the simulator, mean 2.7, compared to senior residents’ post-simulation mean confidence of 3.8, p=0.033.

Conclusions: A 3D printed adenoidectomy simulator can be used to teach junior residents the difficult skill of operating through a mirror in small spaces. Further work is ongoing to develop other smartphone games to further enhance speed accuracy of mirror and suction cautery stylus use and assess if simulator use translates to improved surgical skills in a clinical environment.