Development and evaluation of a low-cost 3D-printed simulator for ossicular prosthesis placement

Experienced otologists achieve better functional outcomes and fewer complications post-surgery. Otology requires high surgical precision, with risks including total and permanent hearing loss in the operated ear. Although otologic surgical simulators exist, most are sophisticated and expensive. The main objective of this study was to develop and assess a reproducible, affordable, and effective middle ear surgical simulator, defined by its ability to improve residents' anatomical understanding, confidence, and basic technical skills in prosthesis placement. A simulator model was 3D-printed to allow junior ENT residents to practice ossicular prosthesis placement outside the operating room. Residents and senior surgeons evaluated the model using a Likert scale through satisfaction questionnaires. An anatomical model of the middle ear at a 1:6 scale, previously validated by experts, was accessible to residents beforehand. A simulator can be printed at very low-cost, under €20. Resident satisfaction with the anatomical model was high, rated 4.1/5. Regarding the surgical model, experts gave a good rating of 3.6/5, while residents rated their satisfaction at 4/5. This study enabled the creation of a satisfactory, reproducible, and low-cost surgical simulator, although its limitations-including single-material printing and the absence of soft tissues-restrict its use mainly to early training.