TissueDB/Simulators/Cleft Palate Repair Simulator (Nicholas)

The Cleft Palate Repair Simulator (Nicholas) is a low-cost trainer for infant cleft palate repair, built as a 3D-printed skeletal base that carries a disposable silicone soft-tissue cartridge.^[1] Trainees use it to practise the vomerine mucosal flap and intra-velar veloplasty, and the source notes it also accommodates the Furlow opposing Z-palatoplasty.

Field	Details
Features and Basic Operation	The silicone soft-tissue cartridge is disposable, swapped out between repairs. The base's mandibular component can be adjusted to restrict oral access and grade difficulty. The base can be made locally from the open-access STL files.
Current Development Status	Built and evaluated in an educational pilot study with surgical trainees; not clinically validated.
Estimated Build Time and Cost	US$80
Specialized Tools and Equipment	To make the base: a 3D printer that prints VeroWhite, plus plastic molding of the printed base. To make the cartridge: 3D surface scanning, mold-making, and silicone casting. In use: standard surgical instruments and sutures (operator-supplied).
Version	Version 1
Development Team Contact Information	Nicholas R, Heinze Z, Papavasiliou T, Fiadeiro R, Atherton D, Timoney N, Echlin K — Evelina London Children's Hospital, Oxford University Hospitals, Brunel University London, and Birmingham Children's Hospital. Corresponding author: R. Nicholas (rebeccanicholas@ymail.com).

Tissues

Tissue	Qty	Material	Cost	Notes
Hard palate mucoperiosteum	1 per cartridge	Silicone	—	Mucoperiosteum of the hard palate — the layer raised in the vomerine mucoperiosteal flap. Cast in silicone; the source varies shore hardness to mimic each tissue but does not give specific values.
Soft palate oral mucosa	1 per cartridge	Silicone	—	Oral surface of the soft palate. Cast in silicone; firmness not stated in source.
Soft palate nasal mucosa	1 per cartridge	Silicone	—	Nasal surface of the soft palate. Cast in silicone; firmness not stated in source.
Velar musculature	1 per cartridge	Silicone	—	Muscle layer of the soft palate, released and repositioned in intra-velar veloplasty. The source labels this layer "muscle" and does not name the individual muscles. Cast in silicone; firmness not stated in source.

Structural Parts

Part Name	Qty	Material	Cost	Notes
Skeletal base (lower jaw and upper head)	1 set	Hard plastic (molded)	US$47	Reusable cranio-facial skeletal base. The source generated it by fine-cut CT of a preserved pathology specimen, 3D-printed it in VeroWhite, then molded the base in hard plastic. It carries a mandibular component that can be adjusted to restrict oral access and allow increasing levels of difficulty, and the disposable cartridge seats into it. Open-access STL files allow local manufacture.

Build Instructions

The source describes the construction workflow in the Methods of Nicholas et al. (2022). The institutional manufacturing steps:

Step 1: Take a fine-cut CT scan of a formaldehyde-preserved pathology specimen. The source used a preserved specimen because living-infant CT scans were too widely spaced to give the needed skeletal detail, owing to radiation-exposure limits.
Step 2: 3D-print the skeletal base in VeroWhite from the CT geometry. Print orientation, layer height, and print time are not stated in source.
Step 3: Mold the skeletal base in hard plastic from the 3D print. Open-access STL files allow the base to be made locally.
Step 4: Wax-model each soft-tissue layer (hard-palate mucoperiosteum, soft-palate oral mucosa, soft-palate nasal mucosa, and muscle) onto the skeletal base.
Step 5: 3D surface-scan each waxed layer to capture its geometry.
Step 6: Generate a mold for each layer from its scan. Mold material is not stated in source.
Step 7: Cast each layer in silicone, varying the shore hardness to mimic each tissue. Specific shore-hardness values are not stated in source.
Step 8: Build up the cast layers in sequence to form the disposable soft-tissue cartridge.
Step 9: Seat the cartridge into the base, which carries the adjustable mandibular component used to grade oral access.

For learner-facing setup, operation, and stepwise procedural instruction (the vomerine mucosal flap and intra-velar veloplasty), see the printed manual described in Nicholas et al. (2022) and the corresponding SELF Module for cleft palate repair training.

References

↑ Nicholas R, Heinze Z, Papavasiliou T, Fiadeiro R, Atherton D, Timoney N, Echlin K (2022). "Educational impact of a novel cleft palate surgical simulator: Improvement in surgical trainees' knowledge and confidence." Journal of Plastic, Reconstructive & Aesthetic Surgery 75(10):3817–3825. DOI: 10.1016/j.bjps.2022.06.079. PMID: 36068135. © 2022 BAPRAS, published by Elsevier Ltd. All rights reserved.

Simulator data
Alternative names	Cleft palate surgical simulator (the source paper's own title language). The source authors do not assign an acronym for the simulator.

Page data
Keywords	cleft palate repair, vomerine mucosal flap, intra-velar veloplasty, infant palate, silicone cartridge, Furlow palatoplasty, Nicholas, low-cost simulator, TissueDB
SDG
Authors	Arturopelayo
License	CC-BY-SA-4.0
Language	English (en)
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Created	May 13, 2026 by Arturo Pelayo
Last edit	June 21, 2026 by StandardWikitext bot
Cite as	Arturopelayo (2026). "TissueDB/Simulators/Cleft Palate Repair Simulator (Nicholas)". Appropedia. Retrieved June 24, 2026.
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[nicholas2022-1] Nicholas R, Heinze Z, Papavasiliou T, Fiadeiro R, Atherton D, Timoney N, Echlin K (2022). "Educational impact of a novel cleft palate surgical simulator: Improvement in surgical trainees' knowledge and confidence." Journal of Plastic, Reconstructive & Aesthetic Surgery 75(10):3817–3825. DOI: 10.1016/j.bjps.2022.06.079. PMID: 36068135. © 2022 BAPRAS, published by Elsevier Ltd. All rights reserved.

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