TissueDB/Simulators/Pediatric Front-of-Neck Access Simulator (Kovatch)
The Pediatric Front-of-Neck Access Simulator (Kovatch) is a low-cost, 3D-printed pediatric (about a 5-year-old child) airway trainer for practising needle cricothyroidotomy and other front-of-neck access (FONA) procedures.[1] A medical-grade silicone airway (Shore 45 hardness), cast from a mould that is itself 3D-printed from CT-derived anatomy scaled to about a 5-year-old child, sits inside a pediatric head-and-neck mannequin under a synthetic skin overlay. The trainee palpates the thyroid cartilage, cricoid cartilage and cricothyroid membrane through the skin, then punctures the cricothyroid membrane and places the catheter using the Ravussin catheter technique.
| Field | Details |
|---|---|
| Features and Basic Operation | A single medical-grade silicone tracheal model, scaled to a 5-year-old child, gives palpable thyroid- and cricoid-cartilage landmarks and a puncturable cricothyroid membrane. It is embedded in a pediatric mannequin head and neck under a synthetic skin overlay, so the landmarks are felt through the skin, and it withstands repeated needle cricothyroidotomy via the Ravussin catheter technique with negligible wear. |
| Current Development Status | Content validity rated by six expert airway faculty as suitable for needle-cricothyroidotomy training; transfer to patients not tested.[1] |
| Estimated Build Time and Cost | Not stated in source About 6 hours for the silicone cure (60 °C); full design and printing time not stated in source. |
| Specialized Tools and Equipment | Computer-aided design software (the source used Materialise); a fused-deposition-modelling 3D printer and PLA filament to print the two-part casting mould; a means of holding 60 °C for the 6-hour silicone cure; a milling tool (the source's mannequin was milled to include a hyoid bone); and a Ravussin catheter set (angulated needle stylet, catheter sheath with an airway-circuit connector, Velcro ties and ventilation tubing) to perform the procedure. |
| Version | Version 1 |
| Development Team Contact Information | Kevin J. Kovatch, Allison R. Powell, Kevin Green, Chelsea L. Reighard, Glenn E. Green, Virginia T. Gauger, Deborah M. Rooney and David A. Zopf. Departments of Otolaryngology–Head and Neck Surgery, Pediatric Anesthesiology, Learning Health Sciences, and Biomedical Engineering, University of Michigan / Michigan Medicine / C.S. Mott Children's Hospital, Ann Arbor, MI. Corresponding author: David A. Zopf, MD, MS (davidzop@med.umich.edu). |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Trachea | 1 (silicone cast) | Medical-grade silicone, Shore 45 | US$2.86 | CT-derived child-sized airway: a single molded silicone tracheal model on which the laryngeal cartilages, palpable tracheal rings and cricothyroid membrane are felt as landmarks. |
| Cricothyroid membrane | 1 (integral) | Medical-grade silicone, Shore 45 | — | The procedural target for needle cricothyroidotomy; felt and punctured on the single silicone tracheal model, not a separate part. |
| Thyroid cartilage | 1 (integral) | Medical-grade silicone, Shore 45 | — | Palpable laryngeal landmark above the cricothyroid membrane, on the single silicone tracheal model. |
| Cricoid cartilage | 1 (integral) | Medical-grade silicone, Shore 45 | — | Palpable laryngeal landmark below the cricothyroid membrane, on the single silicone tracheal model. |
| Skin and subcutaneous tissue | 1 overlay | Synthetic skin overlay | — | Commercial synthetic skin overlay (the source used One World DMG) giving the outer neck and landmark palpation; the exact composition is not stated in the source. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Pediatric head and neck mannequin | 1 | Commercial mannequin (brand not stated in source) | — | Houses the silicone airway. The source states the mannequin "was milled to include a hyoid bone"; it does not describe how the airway is seated. Not priced in the source. |
Build Instructions
Build sequence from Kovatch et al. (2020) Methods.
Phase 1: Design and print the casting mold
- Obtain a high-resolution (0.75 mm) computed-tomography scan of a pediatric airway approximating a 5-year-old child.
- Build a 3-dimensional model of the trachea from the CT data in CAD software (the source used Materialise).
- Design a two-part mold — an external casing plus an internal insert that keeps the airway lumen patent.
- Print both mold parts in PLA on a fused-deposition-modelling 3D printer.
Verification: the two mold halves close cleanly around the internal insert with the lumen path clear.
Phase 2: Cast the silicone airway
- Mix medical-grade silicone (Shore 45) per the manufacturer's instructions and pour it into the assembled mold.
- Cure at 60 °C for 6 hours.
- Demould the cured silicone airway after it cools.
Verification: the airway demoulds intact with a patent lumen.
Phase 3: Assemble the trainer
- Prepare a commercial pediatric head-and-neck mannequin. The source's mannequin was milled to include a hyoid bone; it does not describe how the airway cavity itself was prepared.
- Embed the silicone airway in the mannequin neck.
- Overlay the neck with synthetic skin for the outer surface and landmark palpation.
Verification: the thyroid cartilage, cricoid cartilage and cricothyroid membrane are all palpable through the skin overlay.
Limits of the reported evaluation
- The study tested needle cricothyroidotomy via the Ravussin catheter technique; it did not establish suitability for surgical (scalpel) cricothyroidotomy.
- The reference anatomy approximates a 5-year-old child rather than an adult.
- The small expert-faculty study (n=6) reported evidence relevant to test content and internal structure. It did not evaluate transfer of skills to patients.
References
- ↑ 1.0 1.1 Kovatch KJ, Powell AR, Green K, Reighard CL, Green GE, Gauger VT, Rooney DM, Zopf DA. "Development and Multidisciplinary Preliminary Validation of a 3-Dimensional-Printed Pediatric Airway Model for Emergency Airway Front-of-Neck Access Procedures." Anesthesia & Analgesia 2020;130(2):445–451. DOI: 10.1213/ANE.0000000000003774. PMID: 30234534.
| Alternative names | pediatric FONA trainer pediatric front-of-neck access simulator Kovatch pediatric airway model |
|---|
Related simulators
[edit | edit source]Related TissueDB airway trainers: Gauger, Aho, Calvo, D'Auria, Kei, Muller, Carter and Qaim Ali.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Pediatric Front-of-Neck Access Simulator (Kovatch)". Appropedia. Retrieved October 3, 2026. |