Development of a 3D-Printed Hybrid Simulation Model for Transnasal Flexible Endoscopy Using Cadaveric Laryngeal Specimens

Abstract

Introduction:

Transnasal endoscopic (TNE) procedures are gaining clinical importance in both diagnostic and therapeutic laryngology. Despite this growing relevance, there is currently no dedicated simulation model available for training these techniques, which require high anatomical accuracy and realistic scope maneuverability.

Methods:

We designed a 3D-printed anatomical framework based on a publicly available CT dataset, modified to allow realistic transnasal access and secure integration of excised cadaveric larynges. The model supports repeated use with interchangeable specimens and includes features for precise anatomical positioning. The setup was evaluated in 8 cadaveric larynges for anatomical realism and endoscope maneuverability by 2 experienced laryngologists.

Results:

Key laryngeal landmarks, such as the vocal folds, arytenoid cartilages, and aryepiglottic folds, were clearly identifiable in all specimens during flexible endoscopy, closely resembling the view in awake patients. Scope navigation through the nasal cavity and hypopharynx was described as smooth and realistic. The total production cost of $388.25 makes the model a cost-efficient alternative to commercial simulators. Its design allows for repeated use and adaptation to different specimen types.

Discussion:

We present the first simulation model specifically designed for training transnasal endoscopic laryngeal procedures. The hybrid model combines anatomical accuracy, realistic handling, and affordability, making it a valuable tool for surgical education and technique development. Its potential applications extend beyond laryngology, including anesthesiology and pulmonology, where transnasal access is also required.