{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:26:26Z","timestamp":1786652786766,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Princess Margaret Cancer Foundation (PMCF)\u2014Image Guided Surgery Fund GTx"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Adequate surgical margins are essential in oral cancer treatment, this is, however, difficult to appreciate during training. With advances in training aids, we propose a silicone-based surgical simulator to improve training proficiency for the ablation of oral cavity cancers. A silicone-based tongue cancer model constructed via a 3D mold was compared to a porcine tongue model used as a training model. Participants of varying surgical experience were then asked to resect the tumors with clear margins, and thereafter asked to fill out a questionnaire to evaluate the face and content validity of the models as a training tool. Eleven participants from the Otolaryngology-Head and Neck Surgery unit were included in this pilot study. In comparison to the porcine model, the silicone model attained a higher face (4 vs. 3.6) and content validity (4.4 vs. 4.1). Tumor consistency was far superior in the silicone model compared to the porcine model (4.1 vs. 2.8, p = 0.0042). Fellows and staff demonstrated a better margin clearance compared to residents (median 3.5 mm vs. 1.0 mm), and unlike the resident group, there was no incidence of positive margins. The surgical simulation was overall useful for trainees to appreciate the nature of margin clearance in oral cavity cancer ablation.<\/jats:p>","DOI":"10.3390\/jpm14050450","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T08:08:32Z","timestamp":1714032512000},"page":"450","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of a 3D Printed Silicone Oral Cavity Cancer Model for Surgical Simulations"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-9331","authenticated-orcid":false,"given":"Donovan","family":"Eu","sequence":"first","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery-Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, National University Health Systems, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-4146","authenticated-orcid":false,"given":"Michael J.","family":"Daly","sequence":"additional","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Taboni","sequence":"additional","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery-Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, \u201cAzienda Ospedale Universit\u00e0 di Padova\u201d University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Sahovaler","sequence":"additional","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery-Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Department of Oral and Maxillofacial Surgery, University College London Hospitals, London NW1 2BU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley N.","family":"Gilbank","sequence":"additional","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Irish","sequence":"additional","affiliation":[{"name":"Guided Therapeutic (GTx) Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery-Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.oraloncology.2012.01.015","article-title":"The impact of pathologic close margin on the survival of patients with early stage oral squamous cell carcinoma","volume":"48","author":"Chen","year":"2012","journal-title":"Oral Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/S0002-9610(05)80555-0","article-title":"Significance of positive margins in oral cavity squamous carcinoma","volume":"160","author":"Loree","year":"1990","journal-title":"Am. J. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40463-020-00483-w","article-title":"The impact of close surgical margins on recurrence in oral squamous cell carcinoma","volume":"50","author":"Solomon","year":"2021","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1177\/0194599814551718","article-title":"Positive surgical margins in early stage oral cavity cancer: An analysis of 20,602 cases","volume":"151","author":"Luryi","year":"2014","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E2197","DOI":"10.1002\/hed.24075","article-title":"Resection margins in oral cancer surgery: Room for improvement","volume":"38","author":"Smits","year":"2016","journal-title":"Head Neck"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/01.PRS.0000173550.42201.B5","article-title":"Ox tongue: An alternative model for surgical training","volume":"116","author":"Hiratsuka","year":"2005","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1002\/bjs.9482","article-title":"Systematic review of skills transfer after surgical simulation-based training","volume":"101","author":"Dawe","year":"2014","journal-title":"Br. J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1016\/j.surge.2020.07.013","article-title":"Development and decay of procedural skills in surgery: A systematic review of the effectiveness of simulation-based medical education interventions","volume":"19","author":"Higgins","year":"2021","journal-title":"Surgeon"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4523","DOI":"10.2147\/CMAR.S171251","article-title":"Trends in clinical features and survival of oral cavity cancer: Fifty years of experience with 3362 consecutive cases from a single institution","volume":"10","author":"Chen","year":"2018","journal-title":"Cancer Manag. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106684","DOI":"10.1016\/j.oraloncology.2024.106684","article-title":"Impact of tumor subsite on survival outcomes in oral squamous cell carcinoma: A retrospective cohort study from 2000 to 2019","volume":"149","author":"Justesen","year":"2024","journal-title":"Oral Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.2106\/JBJS.16.01304","article-title":"Cone-Beam Computed Tomography-Guided Navigation in Complex Osteotomies Improves Accuracy at All Competence Levels: A Study Assessing Accuracy and Reproducibility of Joint-Sparing Bone Cuts","volume":"100","author":"Sternheim","year":"2018","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_13","unstructured":"Vsardcau, E. (2008, January 2\u20134). MeshLab: An Open-Source Mesh Processing Tool. Proceedings of the Sixth Eurographics Italian Chapter Conference, Salerno, Italy."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1245\/s10434-009-0467-8","article-title":"Effect of surgeon training, specialization, and experience on outcomes for cancer surgery: A systematic review of the literature","volume":"16","author":"Bilimoria","year":"2009","journal-title":"Ann. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"349","DOI":"10.4300\/JGME-D-14-00612.1","article-title":"The Effect of Restricting Residents\u2019 Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review","volume":"7","author":"Bolster","year":"2015","journal-title":"J. Grad. Med. Educ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1016\/j.jsurg.2021.06.001","article-title":"ACGME 2011 Duty Hours Restrictions and Their Effects on Surgical Residency Training and Patients Outcomes: A Systematic Review","volume":"78","author":"Awan","year":"2021","journal-title":"J. Surg. Educ."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.amjsurg.2017.08.053","article-title":"Assessing the 16 hour intern shift limit: Results of a multi-center, mixed-methods study of residents and faculty in general surgery","volume":"215","author":"Coverdill","year":"2018","journal-title":"Am. J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"105499","DOI":"10.1016\/j.oraloncology.2021.105499","article-title":"The impact of positive margin on survival in oral cavity squamous cell carcinoma","volume":"122","author":"Patel","year":"2021","journal-title":"Oral Oncol."},{"key":"ref_19","first-page":"e3389","article-title":"In-Situ Simulation Enhances Emergency Preparedness in Pediatric Care Practices","volume":"10","author":"Kalidindi","year":"2018","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"b1802","DOI":"10.1136\/bmj.b1802","article-title":"Effect of virtual reality training on laparoscopic surgery: Randomised controlled trial","volume":"338","author":"Larsen","year":"2009","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.pedn.2019.09.017","article-title":"Medical Emergencies in the Primary Care Setting: An Evidence Based Practice Approach Using Simulation to Improve Readiness","volume":"49","author":"Monachino","year":"2019","journal-title":"J. Pediatr. Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40463-020-00411-y","article-title":"Assessment of a virtual reality temporal bone surgical simulator: A national face and content validity study","volume":"49","author":"Compton","year":"2020","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e773","DOI":"10.1016\/j.wneu.2017.12.169","article-title":"Three-Dimensional Printed Skull Base Simulation for Transnasal Endoscopic Surgical Training","volume":"111","author":"Zheng","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1177\/0003489414539922","article-title":"Simulation model for transcervical laryngeal injection providing real-time feedback","volume":"123","author":"Ainsworth","year":"2014","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/0310057X20925827","article-title":"A three-dimensional (3D) printed paediatric trachea for airway management training","volume":"48","author":"Carter","year":"2020","journal-title":"Anaesth. Intensive Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E132","DOI":"10.1002\/lary.26326","article-title":"Pediatric laryngeal simulator using 3D printed models: A novel technique","volume":"127","author":"Kavanagh","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"10631","DOI":"10.1038\/s41598-020-67575-5","article-title":"Patient-specific and hyper-realistic phantom for an intubation simulator with a replaceable difficult airway of a toddler using 3D printing","volume":"10","author":"Ock","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1002\/ohn.630","article-title":"SimLife(R): A New Dynamic Model for Head and Neck Surgical Oncology Simulation","volume":"170","author":"Rulliere","year":"2024","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.21037\/aot.2020.03.03","article-title":"Simulations and simulators in head and neck endocrine surgery","volume":"5","author":"Razavi","year":"2020","journal-title":"Ann. Thyroid."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"20341","DOI":"10.1038\/s41598-023-47225-2","article-title":"A novel approach to microsurgical teaching in head and neck surgery leveraging modern 3D technologies","volume":"13","author":"Weber","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1007\/s11307-022-01783-5","article-title":"3D-Printed Tumor Phantoms for Assessment of In Vivo Fluorescence Imaging Analysis Methods","volume":"25","author":"LaRochelle","year":"2023","journal-title":"Mol. Imaging Biol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/5\/450\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:33:50Z","timestamp":1760106830000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/5\/450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,25]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["jpm14050450"],"URL":"https:\/\/doi.org\/10.3390\/jpm14050450","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,25]]}}}