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Exploring the Impact of Using Patient-Specific 3D Prints during Consent for Skull Base Neurosurgery
Objectives Informed consent is fundamental to good practice. We hypothesized that a personalized three-dimensional (3D)-printed model of skull base pathology would enhance informed consent and reduce patient anxiety.
Design Digital images and communication in medicine (DICOM) files were 3D printed. After a standard pre-surgery consent clinic, patients completed part one of a two-part structured questionnaire. They then interacted with their personalized 3D printed model and completed part two. This explored their perceived involvement in decision-making, anxiety, concerns and also their understanding of lesion location and surgical risks. Descriptive statistics were used to report responses and text classification tools were used to analyze free text responses.
Setting and Participants In total,14 patients undergoing elective skull base surgery (with pathologies including skull base meningioma, craniopharyngioma, pituitary adenoma, Rathke cleft cyst, and olfactory neuroblastoma) were prospectively identified at a single unit.
Results After 3D model exposure, there was a net trend toward reduced patient-reported anxiety and enhanced patient-perceived involvement in treatment. Thirteen of 14 patients (93%) felt better about their operation and 13/14 patients (93%) thought all patients should have access to personalized 3D models. After exposure, there was a net trend toward improved patient-reported understanding of surgical risks, lesion location, and extent of feeling informed. Thirteen of 14 patients (93%) felt the model helped them understand the surgical anatomy better. Analysis of free text responses to the model found mixed sentiment: 47% positive, 35% neutral, and 18% negative.
Conclusion In the context of skull base neurosurgery, personalized 3D-printed models of skull base pathology can inform the surgical consent process, impacting the levels of patient understanding and anxiety.
Early work was presented as a poster at the Congress of the European Association of Neurological Surgeons in Hamburg, in October, 2021.
Ethics Boards/ Approval
The NHS Lothian Caldicott Guardian (ref 20173) issued approval of handling of patient data. Given no identifiable data was used, and that this was an observational study of outcomes with no treatments offered, no further ethical committees were consulted.
S.M., S.J., A.Q., and M.H. all contributed to and partook in the execution of the study and collection of data, with S.M. and M.H. writing the report. M.H. acted as a supervisor and guarantor for the study.
As this study was conducted by a postgraduate student, any published data will be held in its repository. As such, the data within has not been deposited or shared elsewhere, or prior to this submission, with the exception of the abstract referred to on the first page.
Received: 02 March 2022
Accepted: 20 June 2022
Accepted Manuscript online:
27 June 2022
Article published online:
13 September 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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