Virtual Functional Endoscopic Sinus Surgery Simulation with 3D-Printed Models for Mixed-Reality Nasal Endoscopy

American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published online August 2018. DOI: 10.1177/0194599818797586

Samuel R. Barber, MD, Saurabh Jain, MSc, Young-Jun Son, PhD, and Eugene H. Chang, MD


The surgeon’s knowledge of a patient’s individual anatomy is critical in skull base surgery. Trainees and experienced surgeons can benefit from surgical simulation; however, current models are expensive and impractical for widespread use. In this study, we report a next-generation mixed-reality surgical simulator. We segmented critical anatomic structures for 3-dimensional (3D) models to develop a modular teaching tool. We then developed a navigation tracking system utilizing a 3D-printed endoscope as a trackable virtual-reality (VR) controller and validated the accuracy on VR and 3Dprinted skull models within 1 cm. We combined VR and augmented-reality visual cues with our 3D physical model to simulate sinus endoscopy and highlight segmented structures in real time. This report provides evidence that a mixed-reality simulator combining VR and 3D-printed models is feasible and may prove useful as an educational tool that is low cost and customizable.