{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:31:50Z","timestamp":1781753510855,"version":"3.54.5"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Endoscope-assisted repair of craniosynostosis is a safe and efficacious alternative to open techniques. However, this procedure is challenging to learn, and there is significant variation in both its execution and outcomes. Surgical simulators may allow trainees to learn and practice this procedure prior to operating on an actual patient. The purpose of this study was to develop a realistic, relatively inexpensive simulator for endoscope-assisted repair of metopic and sagittal craniosynostosis and to evaluate the models\u2019 fidelity and teaching content.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Two separate, 3D-printed, plastic powder\u2013based replica skulls exhibiting metopic (age 1 month) and sagittal (age 2 months) craniosynostosis were developed. These models were made into consumable skull \u201ccartridges\u201d that insert into a reusable base resembling an infant\u2019s head. Each cartridge consists of a multilayer scalp (skin, subcutaneous fat, galea, and periosteum); cranial bones with accurate landmarks; and the dura mater. Data related to model construction, use, and cost were collected. Eleven novice surgeons (residents), 9 experienced surgeons (fellows), and 5 expert surgeons (attendings) performed a simulated metopic and sagittal craniosynostosis repair using a neuroendoscope, high-speed drill, rongeurs, lighted retractors, and suction\/irrigation. All participants completed a 13-item questionnaire (using 5-point Likert scales) to rate the realism and utility of the models for teaching endoscope-assisted strip suturectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The simulators are compact, robust, and relatively inexpensive. They can be rapidly reset for repeated use and contain a minimal amount of consumable material while providing a realistic simulation experience. More than 80% of participants agreed or strongly agreed that the models\u2019 anatomical features, including surface anatomy, subgaleal and subperiosteal tissue planes, anterior fontanelle, and epidural spaces, were realistic and contained appropriate detail. More than 90% of participants indicated that handling the endoscope and the instruments was realistic, and also that the steps required to perform the procedure were representative of the steps required in real life.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Both the metopic and sagittal craniosynostosis simulators were developed using low-cost methods and were successfully designed to be reusable. The simulators were found to realistically represent the surgical procedure and can be used to develop the technical skills required for performing an endoscope-assisted craniosynostosis repair.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.2.peds18121","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T13:55:32Z","timestamp":1527861332000},"page":"128-136","source":"Crossref","is-referenced-by-count":29,"title":["Development of synthetic simulators for endoscope-assisted repair of metopic and sagittal craniosynostosis"],"prefix":"10.3171","volume":"22","author":[{"given":"Kyle W.","family":"Eastwood","sequence":"first","affiliation":[{"name":"Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto;"},{"name":"Institute of Biomaterials and Biomedical Engineering, University of Toronto;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek P.","family":"Bodani","sequence":"additional","affiliation":[{"name":"Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto;"},{"name":"Institute of Biomaterials and Biomedical Engineering, University of Toronto;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faizal A.","family":"Haji","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, Western University, London, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Looi","sequence":"additional","affiliation":[{"name":"Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto;"},{"name":"Institute of Biomaterials and Biomedical Engineering, University of Toronto;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani E.","family":"Naguib","sequence":"additional","affiliation":[{"name":"Institute of Biomaterials and Biomedical Engineering, University of Toronto;"},{"name":"Department of Mechanical and Industrial Engineering, University of Toronto; and"},{"name":"Smart and Adaptive Polymer Laboratory (SAPL), University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Drake","sequence":"additional","affiliation":[{"name":"Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto;"},{"name":"Institute of Biomaterials and Biomedical Engineering, University of Toronto;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.3171\/jns.2002.97.6.1367","article-title":"New laboratory model for neurosurgical training that simulates live surgery","volume":"97","author":"Aboud E","year":"2002","unstructured":"Aboud E, Al-Mefty O, Ya\u015fargil MG: New laboratory model for neurosurgical training that simulates live surgery. 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