Purpose or Case Report: Successful bronchoscope handling requires the skill to orient bronchoscope position and direction in response to the intraluminal view provided by the bronchoscope camera. Additional challenges for pediatric physicians are smaller airways and the physiologically higher breathing frequency and airway collapsibility in babies and toddlers. We aimed to create a set of anatomically accurate 3D printed pediatric static and dynamic airway models that can be further used to teach and train residents/fellows in bronchoscopy and foreign body removal.
Methods & Materials: Three versions of 3D printed models were designed: a static tree model, a dynamic tree model, and translucent airway box model. CT patient data of three different ages (1, 5, 18) was selected for segmenting in Materialise Mimics. For the tree methods, the airway was then wrapped with a 2mm offset and hollowed out to create a lumen-like model and then was printed in the soft Tango+ material on Connex 500 or J750 printers. The branches were open for the static model and closed for the dynamic. The box was created by subtracting the airway from a box around its extents. This was then printed in VisoClear on a Project 6000HD printer. A y-connector and air sucking pump was attached to the dynamic model to simulate breathing and airway collapsibility.
Three pediatric pulmonology attendings evaluated the models for physiologic accuracy and usefulness for teaching and training.
Results: All models were evaluated to have an excellent intraluminal accuracy (branching and angles of bronchi, appearance of the lumen) and usefulness for teaching and training. The translucent box was favored for presenting and the static model to learn basic handling of the bronchoscope in bronchoscopy and foreign body removal. The dynamic model provided the most realistic cartilage consistency and endoscopic simulation of the physiologic breathing patient.
Next steps planned are automatization of breathing simulation with different age-adjusted breathing frequencies and prospective enrollment of residents/fellows to formally assess technical skill development.
Conclusions: By fabricating three different 3D printed airway models, which enable visualization of bronchoscope handling and simulation of realistic intraluminal as well as physiological conditions in different age groups, we created a promising tool for teaching, training and testing pediatric residents/fellows in bronchoscopy and foreign body removal.