Jump to content

TissueDB/Simulators/Cleft Palate Repair Simulator (Nicholas)

From Appropedia
▼This page was built from limited source data.The full text of the source publication was not available during page creation. Build instructions and material specifications may be incomplete. If you have access to the source publication, please help improve this page.


General Information

The Cleft Palate Repair Simulator (Nicholas) is a low-cost trainer for cleft palate surgery.[1] It pairs a reusable 3D-printed skeletal base with a disposable silicone soft-tissue cartridge that presents hard-palate mucoperiosteum, oral and nasal soft-palate mucosa, and velar musculature.[1] Trainees practise the vomerine mucosal flap and intra-velar veloplasty techniques on tissue that lifts and dissects like the real palate.[1] The source authors note it also accommodates the Furlow opposing Z-palatoplasty.[1] Only the cartridge is consumed per session, so repeat practice costs a fraction of the first build, and an adjustable mounting frame grades oral access for different trainee levels.[1]

Field Details
General Information A low-cost cleft palate trainer in two parts: a reusable 3D-printed skeletal base and a disposable silicone soft-tissue cartridge.[1] The cartridge holds hard-palate mucoperiosteum, velar musculature, and oral and nasal soft-palate mucosa, cast at tissue-appropriate firmness.[1] Open-access STL files let institutions print their own base.[1]
Features and Basic Operation Reusable skeletal base carries a disposable soft-tissue cartridge; a mounting frame with three axis points and an adjustable lower jaw provides graded oral access. One base accepts both cleft lip and cleft palate cartridges.[1]
Current Development Status Built and tested; shown validity under certain circumstances in a pilot with UK plastic surgery trainees.[1]
Estimated Build Time and Cost Not stated in source; depends on local 3D-printing and silicone-casting throughput.[1], Approximately US$80.[1]
Specialized Tools and Equipment To build the base, a Stratasys PolyJet (photopolymer) 3D printer; to build the cartridge, 3D surface scanning, mould-making, and silicone casting. In use, standard surgical instruments (operator-supplied).[1]
Version Not stated in source
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).[1]

Tissues

Tissue Qty Material Cost Notes
Hard palate mucoperiosteum 1 per cartridge Silicone Part of ~US$30 cartridge Oral mucosa with attached periosteum, cast as a single liftable sheet representing the vomerine mucosal flap. Silicone firmness not stated in source.[1]
Soft palate oral mucosa 1 per cartridge Silicone Part of ~US$30 cartridge Oral surface of the soft palate. Silicone firmness not stated in source.[1]
Soft palate nasal mucosa 1 per cartridge Silicone Part of ~US$30 cartridge Nasal surface of the soft palate. Silicone firmness not stated in source.[1]
Velar musculature (levator and tensor veli palatini) 1 per cartridge Silicone Part of ~US$30 cartridge Muscle of the soft palate — the levator and tensor veli palatini targeted in intra-velar veloplasty. Silicone firmness not stated in source.[1]


Structural Parts

Part Name Qty Material Cost Notes
3D-printed skeletal base (lower jaw, upper head, axis-point hardware) 1 set VeroWhite photopolymer (Stratasys PolyJet) ~US$45 (reusable) Infant cranio-facial skeletal base, 3D-printed in VeroWhite photopolymer. Three axis points give translational and rotational adjustment at the lower jaw plus rotation of the whole simulator; the lower jaw adjusts to limit oral access for graded difficulty. Open-access STL files allow local manufacture, and the same base accepts both cleft lip and cleft palate cartridges.[1]
Standard surgical instruments and sutures Operator-supplied Not part of the simulator build Operator-supplied Standard surgical instruments used in the workshop; specific types not enumerated in source.[1]


Build Instructions

The source paper describes the construction workflow at p.2 col 2 to p.4 of Nicholas et al. (2022).[1] The institutional manufacturing steps:

  1. Step 1: Source a formaldehyde-preserved infant pathology specimen from an institutional pathology museum. Nicholas et al. note that patient CT scans were too widely spaced due to radiation-exposure limits in living infants, so a preserved specimen was preferred for fine-cut CT geometry.[1]
  2. Step 2: Acquire a fine-cut CT scan of the specimen to capture skeletal detail. CT slice thickness is not specified in the source paper.
  3. Step 3: 3D-print the skeletal base in VeroWhite photopolymer on a Stratasys PolyJet process. Open-access STL files referenced in the source paper allow local manufacture. Print orientation, layer height, and total print time are not specified in the source paper.
  4. Step 4: Wax-model each anatomical soft-tissue layer (hard-palate mucoperiosteum, velar musculature, soft-palate oral mucosa, soft-palate nasal mucosa) onto the skeletal base.
  5. Step 5: Three-dimensionally surface-scan each waxed layer to capture its geometry.
  6. Step 6: Generate a per-layer mould from each scan. Mould material is not specified in the source paper.
  7. Step 7: Cast each anatomical layer in silicone of layer-appropriate shore hardness. Specific shore hardness values per layer are not specified in the source paper.
  8. Step 8: Assemble the cast layers into the disposable soft-tissue cartridge.
  9. Step 9: Secure the cartridge into the reusable skeletal base using the lower jaw, upper head, and three axis-point hardware.

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



References

[1][2][3][4][5][6][7]

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 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 75:3817–3825. DOI: 10.1016/j.bjps.2022.06.079. PMID: 36068135. © 2022 BAPRAS, published by Elsevier Ltd. All rights reserved.
  2. ↑ Cheng H, Podolsky DJ, Fisher DM, Wong KW, Lorenz HP, Khosla RK, Drake JM, Forrest CR (2018). "Teaching Palatoplasty Using a High-Fidelity Cleft Palate Simulator." Plastic and Reconstructive Surgery 141(1):91e–98e. DOI: 10.1097/PRS.0000000000003957. PMID: 29280875.
  3. ↑ Vadodaria S, Watkin N, Thiessen F, Ponniah A (2007). "The first cleft palate simulator." Plastic and Reconstructive Surgery 120(1):259–261. DOI: 10.1097/01.prs.0000264394.27150.0d. PMID: 17572573.
  4. ↑ Rogers-Vizena CR, Saldanha FYL, Hosmer AL, Weinstock PH (2018). "A New Paradigm in Cleft Lip Procedural Excellence: Creation and Preliminary Digital Validation of a Lifelike Simulator." Plastic and Reconstructive Surgery 142(5):1300–1304. DOI: 10.1097/PRS.0000000000004924. PMID: 30511984.
  5. ↑ Podolsky DJ, Wong Riff KW, Drake JM, Forrest CR, Fisher DM (2018). "A High Fidelity Cleft Lip Simulator." Plastic and Reconstructive Surgery — Global Open 6(9):e1871. DOI: 10.1097/GOX.0000000000001871. PMID: 30349777. PMCID: PMC6191228.
  6. ↑ Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, STROCSS Group (2019). "STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery." International Journal of Surgery 72:156–165. DOI: 10.1016/j.ijsu.2019.11.002. PMID: 31704426.
  7. ↑ Witt PD, Wahlen JC, Marsh JL, Grames LM, Pilgram TK (1998). "The effect of surgeon experience on velopharyngeal functional outcome following palatoplasty: is there a learning curve?" Plastic and Reconstructive Surgery 102(5):1375–1384. DOI: 10.1097/00006534-199810000-00009. PMID: 9773991.




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.

Property "SimulatorProcedure" (as page type) with input value "Cleft palate repair. The simulator supports the vomerine mucosal flap and intra-velar veloplasty techniques described in the source paper's printed manual, and the authors note it also accommodates the Furlow opposing Z-palatoplasty.'"`UNIQ--ref-00000002-QINU`"' Mandibular adjustment on the base restricts oral access to graded difficulty levels for trainees at different stages of cleft surgery exposure.'"`UNIQ--ref-00000003-QINU`"'" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process.


Page data
Keywords cleft palate, cleft palate repair, vomerine mucosal flap, intra-velar veloplasty, Furlow Z-palatoplasty, palatoplasty simulator, 3D-printed simulator, VeroWhite, Stratasys PolyJet, silicone cartridge, Nicholas, Evelina London, Oxford, Brunel University, Birmingham Children's, plastic surgery trainee, UK plastic surgery, JPRAS, BAPRAS, cleft surgery training, STROCSS 2019, low-cost simulator, paediatric plastic surgery
SDG
Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 3 pages link here
Views 5 page views (analytics)
Created May 13, 2026 by Arturo Pelayo
Last edit May 26, 2026 by Arturo Pelayo
Cite as Arturopelayo (2026). "TissueDB/Simulators/Cleft Palate Repair Simulator (Nicholas)". Appropedia. Retrieved June 4, 2026.
API queries basic, semantic, html, files, more
Cookies help us deliver our services. By using our services, you agree to our use of cookies.