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Three-Dimensional Affordable Stone Models for Cleft Lip Markings

A Prospective Study of Learner Satisfaction

Kantar, Rami S. MD; Gonchar, Marina DMD, MS; Maliha, Samantha G. BA; Ramly, Elie P. MD; Alfonso, Allyson R. BS, BA; Cohen, Oriana MD; Eisemann, Bradley S. MD; Diaz-Siso, J. Rodrigo MD; Saadeh, Pierre B. MD; Flores, Roberto L. MD

doi: 10.1097/SAP.0000000000001813

Introduction Knowledge of surgical markings for unilateral cleft lip (UCL) repair is critical for surgical competency. However, few appropriate models are accessible to residents and affordable and accurately reproduce this 3-dimensional (3D) deformity. We propose that cleft care units have the capability of creating affordable 3D stone models to teach UCL markings.

Methods Polyvinyl siloxane and SnapStone were used to create UCL stone models. Thirteen plastic surgery residents were prospectively recruited, provided with a textbook chapter and online module for studying surgical markings for UCL repair, and then asked to perform the markings on a UCL stone model and standardized patient photograph. Learner satisfaction was evaluated using a modified survey based on the Student Evaluation of Educational Quality survey.

Results The production time of each model was 10 minutes, whereas the cost was $1.84. Participants reported that the stone model was more stimulating (4.77 ± 0.44 vs 3.92 ± 0.86; U = 38.0; P = 0.008), increased their interest more (4.70 ± 0.48 vs 3.53 ± 1.20; U = 33.5; P = 0.005), allowed better learning (4.61 ± 0.51 vs 3.08 ± 0.86; U = 10.0; P < 0.001), was clearer (4.62 ± 0.51 vs 3.15 ± 0.90; U = 12.5; P < 0.001), and was more effective for learning cleft lip markings (4.77 ± 0.44 vs 3.08 ± 1.04; U = 9.0; P < 0.001). They were also more likely to recommend it (4.85 ± 0.38 vs 3.15 ± 1.07; U = 7.0; P < 0.001).

Conclusions Plastic surgery residents report that 3D cleft lip stone models are superior training tools to learn cleft lip markings compared with patient photographs. These educational tools have the potential to overcome significant financial, logistic, and time constraints in teaching cleft lip surgery markings.

From the The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY.

Received October 29, 2018, and accepted for publication, after revision November 26, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Roberto L. Flores, MD, Cleft Lip & Palate Program, The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 307 E 33rd St, New York City, NY 10016. E-mail:

Online date: April 4, 2019

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