Using 3D printing and AR navigation for training plastic surgeons in harvesting the perpendicular plate of the ethmoid bone for rhinoplasty

CHEN Hongyu; PAN Xingyi; LI Zijun; JIN Mengying; AN Yang

doi:10.3969/j.issn.1673-7040.2026.01.013

Abstract：Objective To compare the effectiveness of a training system combining 3D printing with an augmented reality(AR)navigation system versus traditional video instruction for training plastic surgery specialists in harvesting the perpendicular plate of the ethmoid bone.Methods Fourteen specialist physicians trained at Peking University Third Hospital between January 2024 and December 2025 were randomly assigned to an AR group(n=7)or a video group(n=7).The AR group underwent preoperative simulation training using 3D-printed patient-specific head models with an AR navigation system,whereas the video group learned solely by watching instructional surgical videos.Subsequently,both groups independently performed simulated harvesting of the perpendicular plate of the ethmoid on eight differ-ent 3D-printed models without navigation guidance.The positioning errors at key anatomical points and the operation time were recorded and statistically compared.Results The median overall operative error in the AR group(6.250 mm)was significantly lower than that in the video group(7.810 mm),P＜0.0001,with the difference being more pronounced in models with complex anatomical structures.In indi-vidual model analysis,the AR group showed significantly lower error rates on the more structurally complex models ① and ④ compared to the video group(P=0.0020 and 0.0112,respectively).Regarding operation time,the average time for the AR group(32.02±21.83)s was slightly higher than that for the video group(21.49±11.28)s,but the difference was not statistically significant(P=0.2235).Analysis of errors at key points revealed that the greatest errors occurred at the posterior edge of the perpendicular plate(points C and E),and the errors in the AR group were lower than those in the video group in this region as well.Conclusion The integrated training system combining 3D printing and AR navigation can significantly improve the spatial localization and operative accuracy of plastic surgeons in harvesting the perpendicular plate of the ethmoid bone,particularly in cases with complex anatomy.This system provides an effective tool for simulation training in high-risk,precision-demanding surgeries and demonstrates promising potential for clinical application and educational dissemination.