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Craniofacial Reconstruction by a Cost-Efficient Template-Based Process Using 3D Printing. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1582. [PMID: 29263977 PMCID: PMC5732683 DOI: 10.1097/gox.0000000000001582] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/03/2017] [Indexed: 12/04/2022]
Abstract
Craniofacial defects often result in aesthetic and functional deficits, which affect the patient’s psyche and wellbeing. Patient-specific implants remain the optimal solution, but their use is limited or impractical due to their high costs. This article describes a fast and cost-efficient workflow of in-house manufactured patient-specific implants for craniofacial reconstruction and cranioplasty. As a proof of concept, we present a case of reconstruction of a craniofacial defect with involvement of the supraorbital rim. The following hybrid manufacturing process combines additive manufacturing with silicone molding and an intraoperative, manual fabrication process. A computer-aided design template is 3D printed from thermoplastics by a fused deposition modeling 3D printer and then silicone molded manually. After sterilization of the patient-specific mold, it is used intraoperatively to produce an implant from polymethylmethacrylate. Due to the combination of these 2 straightforward processes, the procedure can be kept very simple, and no advanced equipment is needed, resulting in minimal financial expenses. The whole fabrication of the mold is performed within approximately 2 hours depending on the template’s size and volume. This reliable technique is easy to adopt and suitable for every health facility, especially those with limited financial resources in less privileged countries, enabling many more patients to profit from patient-specific treatment.
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Renard Y, Hossu G, Chen B, Krebs M, Labrousse M, Perez M. A guide for effective anatomical vascularization studies: useful ex vivo methods for both CT and MRI imaging before dissection. J Anat 2017; 232:15-25. [PMID: 29023687 DOI: 10.1111/joa.12718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 01/10/2023] Open
Abstract
The objective of this study was to develop a simple and useful injection protocol for imaging cadaveric vascularization and dissection. Mixtures of contrast agent and cast product should provide adequate contrast for two types of ex vivo imaging (MRI and CT) and should harden to allow gross dissection of the injected structures. We tested the most popular contrast agents and cast products, and selected the optimal mixture composition based on their availability and ease of use. All mixtures were first tested in vitro to adjust dilution parameters of each contrast agent and to fine-tune MR imaging acquisition sequences. Mixtures were then injected in 24 pig livers and one human pancreas for MR and computed tomography (CT) imaging before anatomical dissection. Colorized latex, gadobutrol and barite mixture met the above objective. Mixtures composed of copper sulfate (CuSO4 ) gadoxetic acid (for MRI) and iodine (for CT) gave an inhomogeneous signal or extravasation of the contrast agent. Agar did not harden sufficiently for gross dissection but appears useful for CT and magnetic resonance imaging (MRI) studies without dissection. Silicone was very hard to inject but achieved the goals of the study. Resin is particularly difficult to use but could replace latex as an alternative for corrosion instead of dissection. This injection protocol allows CT and MRI images to be obtained of cadaveric vascularization and anatomical casts in the same anatomic specimen. Post-imaging processing software allow easy 3D reconstruction of complex anatomical structures using this technique. Applications are numerous, e.g. surgical training, teaching methods, postmortem anatomic studies, pathologic studies, and forensic diagnoses.
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Affiliation(s)
- Yohann Renard
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France.,Department of Anatomy, Faculty of Medicine and University Hospital, University of Reims Champagne-Ardenne, Reims, France.,IADI, INSERM U947, University of Lorraine, Nancy, France
| | - Gabriela Hossu
- IADI, INSERM U947, University of Lorraine, Nancy, France.,INSERM CIT1433, CIC-IT, University Hospital of Nancy, Nancy, France
| | - Bailiang Chen
- IADI, INSERM U947, University of Lorraine, Nancy, France.,INSERM CIT1433, CIC-IT, University Hospital of Nancy, Nancy, France
| | - Marine Krebs
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France
| | - Marc Labrousse
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Manuela Perez
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France.,IADI, INSERM U947, University of Lorraine, Nancy, France
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Chen N, Zhu K, Wang C, Sun X. 3D printing technique for guiding complicated cardiovascular surgery. J Thorac Dis 2017; 9:E945-E946. [PMID: 29266100 DOI: 10.21037/jtd.2017.08.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nan Chen
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China
| | - Kai Zhu
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China
| | - Chunsheng Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China
| | - Xiaoning Sun
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China
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Choi YD, Kim Y, Park E. Patient-Specific Augmentation Rhinoplasty Using a Three-Dimensional Simulation Program and Three-Dimensional Printing. Aesthet Surg J 2017; 37:988-998. [PMID: 28520846 DOI: 10.1093/asj/sjx046] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The convergence of three-dimensional (3D) simulation, tissue engineering, and 3D printing technology is creating a paradigm shift in plastic surgery. In augmentation rhinoplasty, determining the ideal material and design method has been a critical issue for many years. Thus, these technologies are expected to make important contributions to augmentation rhinoplasty. Objectives We sought to validate the feasibility of the 3D carving simulation and patient-specific implant fabrication system (3D carving system) in a clinical trial using reproducibility tests. Methods Patient-specific implants were designed using a program developed in-house with preoperative computed tomography (CT). Negative molds of the implant were fabricated by a 3D printer and silicone was injected into these molds. Ten actual silicone implants were fabricated and compared with virtually designed implants. Seven patients underwent surgery and postoperative CT to confirm implant positioning. Results Virtually designed implants were produced into actual implants within 0.07 mm with a 0.17% ± 0.11% difference. The percentage within the gap was the highest at the cephalic end of the implant and reduced from the cephalic to caudal end (most cephalic point: 100%; rightmost and leftmost point of the implant at the caudal end of the nasal bone: 57.1% and 71.4%, respectively; rightmost and leftmost point at the supratip break: 28.6% and 28.6%, respectively; and most caudal point: 0%). Conclusions The 3D carving system can facilitate rhinoplasty by enabling the more intuitive, rapid, and accurate fabrication of implants irrespective of surgeon experience level. Level of Evidence 4.
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Affiliation(s)
- Yim Don Choi
- Dr Choi is a Researcher and Dr Park is a Professor, Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. Dr Kim is a Senior Researcher, Center for Bionics, Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - Youngjun Kim
- Dr Choi is a Researcher and Dr Park is a Professor, Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. Dr Kim is a Senior Researcher, Center for Bionics, Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - EunSoo Park
- Dr Choi is a Researcher and Dr Park is a Professor, Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. Dr Kim is a Senior Researcher, Center for Bionics, Korea Institute of Science and Technology, Seoul, Republic of Korea
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Chen Z, Luo C, Shang X, Han Y. [Application progress of digital technology in auricle reconstruction]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:1135-1140. [PMID: 29798575 PMCID: PMC8458414 DOI: 10.7507/1002-1892.201701023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/10/2017] [Indexed: 11/03/2022]
Abstract
Objective To review the application progress of digital technology in auricle reconstruction. Methods The recently published literature concerning the application of digital technology in auricle reconstruction was extensively consulted, the main technology and its specific application areas were reviewed. Results Application of digital technology represented by three-dimensional (3D) data acquisition, 3D reconstruction, and 3D printing is an important developing trend of auricle reconstruction. It can precisely guide auricle reconstruction through fabricating digital ear model, auricular guide plate, and costal cartilage imaging. Conclusion Digital technology can improve effectiveness and decrease surgical trauma in auricle reconstruction. 3D bioprinting of ear cartilage future has bright prospect and needs to be further researched.
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Affiliation(s)
- Zhaoyang Chen
- Department of Plastic & Reconstructive Surgery, Chinese PLA Medical School, Beijing, 100853, P.R.China
| | - Chuncai Luo
- Department of Radiology, Chinese PLA Medical School, Beijing, 100853, P.R.China
| | - Xiao Shang
- Xi'an University of Posts & Telecommunications, Xi'an Shaanxi, 710121, P.R.China
| | - Yan Han
- Department of Plastic & Reconstructive Surgery, Chinese PLA Medical School, Beijing, 100853,
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Gawedzinski J, Pawlowski ME, Tkaczyk TS. Quantitative evaluation of performance of 3D printed lenses. OPTICAL ENGINEERING (REDONDO BEACH, CALIF.) 2017; 56:084110. [PMID: 29238114 PMCID: PMC5724772 DOI: 10.1117/1.oe.56.8.084110] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We present an analysis of the shape, surface quality, and imaging capabilities of custom 3D printed lenses. 3D printing technology enables lens prototypes to be fabricated without restrictions on surface geometry. Thus, spherical, aspherical and rotationally non-symmetric lenses can be manufactured in an integrated production process. This technique serves as a noteworthy alternative to multistage, labor-intensive, abrasive processes such as grinding, polishing and diamond turning. Here, we evaluate the quality of lenses fabricated by Luxexcel using patented Printoptical© technology that is based on an inkjet printing technique by comparing them to lenses made with traditional glass processing technologies (grinding, polishing etc.). The surface geometry and roughness of the lenses were evaluated using white-light and Fizeau interferometers. We have compared peak-to-valley wavefront deviation, root-mean-squared wavefront error, radii of curvature and the arithmetic average of the roughness profile (Ra) of plastic and glass lenses. Additionally, the imaging performance of selected pairs of lenses was tested using 1951 USAF resolution target. The results indicate performance of 3D printed optics that could be manufactured with surface roughness comparable to that of injection molded lenses (Ra < 20 nm). The RMS wavefront error of 3D printed prototypes was at a minimum 18.8 times larger than equivalent glass prototypes for a lens with a 12.7 mm clear aperture, but when measured within 63% of its clear aperture, 3D printed components' RMS wavefront error was comparable to glass lenses.
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Affiliation(s)
- John Gawedzinski
- Department of Bioengineering, Rice University, Houston, TX, 77005
| | | | - Tomasz S. Tkaczyk
- Department of Bioengineering, Rice University, Houston, TX, 77005
- Electrical and Computer Engineering, Rice University, Houston, TX, 77005
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LoPresti M, Daniels B, Buchanan EP, Monson L, Lam S. Virtual surgical planning and 3D printing in repeat calvarial vault reconstruction for craniosynostosis: technical note. J Neurosurg Pediatr 2017; 19:490-494. [PMID: 28156217 DOI: 10.3171/2016.10.peds16301] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Repeat surgery for restenosis after initial nonsyndromic craniosynostosis intervention is sometimes needed. Calvarial vault reconstruction through a healed surgical bed adds a level of intraoperative complexity and may benefit from preoperative and intraoperative definitions of biometric and aesthetic norms. Computer-assisted design and manufacturing using 3D imaging allows the precise formulation of operative plans in anticipation of surgical intervention. 3D printing turns virtual plans into anatomical replicas, templates, or customized implants by using a variety of materials. The authors present a technical note illustrating the use of this technology: a repeat calvarial vault reconstruction that was planned and executed using computer-assisted design and 3D printed intraoperative guides.
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Affiliation(s)
- Melissa LoPresti
- Departments of Neurosurgery and
- Divisions of Pediatric Neurosurgery and
| | - Bradley Daniels
- Departments of Neurosurgery and
- Divisions of Pediatric Neurosurgery and
| | - Edward P. Buchanan
- Plastic Surgery, Baylor College of Medicine; and
- Pediatric Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Laura Monson
- Plastic Surgery, Baylor College of Medicine; and
- Pediatric Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Sandi Lam
- Departments of Neurosurgery and
- Divisions of Pediatric Neurosurgery and
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Chepelev L, Giannopoulos A, Tang A, Mitsouras D, Rybicki FJ. Medical 3D printing: methods to standardize terminology and report trends. 3D Print Med 2017; 3:4. [PMID: 30050981 PMCID: PMC6036766 DOI: 10.1186/s41205-017-0012-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/19/2017] [Indexed: 11/26/2022] Open
Abstract
Background Medical 3D printing is expanding exponentially, with tremendous potential yet to be realized in nearly all facets of medicine. Unfortunately, multiple informal subdomain-specific isolated terminological ‘silos’ where disparate terminology is used for similar concepts are also arising as rapidly. It is imperative to formalize the foundational terminology at this early stage to facilitate future knowledge integration, collaborative research, and appropriate reimbursement. The purpose of this work is to develop objective, literature-based consensus-building methodology for the medical 3D printing domain to support expert consensus. Results We first quantitatively survey the temporal, conceptual, and geographic diversity of all existing published applications within medical 3D printing literature and establish the existence of self-isolating research clusters. We then demonstrate an automated objective methodology to aid in establishing a terminological consensus for the field based on objective analysis of the existing literature. The resultant analysis provides a rich overview of the 3D printing literature, including publication statistics and trends globally, chronologically, technologically, and within each major medical discipline. The proposed methodology is used to objectively establish the dominance of the term “3D printing” to represent a collection of technologies that produce physical models in the medical setting. We demonstrate that specific domains do not use this term in line with objective consensus and call for its universal adoption. Conclusion Our methodology can be applied to the entirety of medical 3D printing literature to obtain a complete, validated, and objective set of recommended and synonymous definitions to aid expert bodies in building ontological consensus. Electronic supplementary material The online version of this article (doi:10.1186/s41205-017-0012-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leonid Chepelev
- 1Department of Radiology, University of Ottawa, 501 Smyth Road, Box 232, K1H 8L6 Ottawa, ON Canada
| | - Andreas Giannopoulos
- 2Department of Radiology, Applied Imaging Science Lab, Brigham and Women's Hospital, Boston, MA USA
| | - Anji Tang
- 2Department of Radiology, Applied Imaging Science Lab, Brigham and Women's Hospital, Boston, MA USA
| | - Dimitrios Mitsouras
- 2Department of Radiology, Applied Imaging Science Lab, Brigham and Women's Hospital, Boston, MA USA
| | - Frank J Rybicki
- 1Department of Radiology, University of Ottawa, 501 Smyth Road, Box 232, K1H 8L6 Ottawa, ON Canada
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Rogers-Vizena CR, Weinstock P, Livingston K, Prabhu SP. The Current Role of Three-Dimensional Printing in Plastic Surgery. Plast Reconstr Surg 2017; 139:811e-812e. [PMID: 28234884 DOI: 10.1097/prs.0000000000003105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Carolyn R Rogers-Vizena
- Department of Plastic and Oral Surgery, Boston Children's Hospital, and Harvard Medical School
| | - Peter Weinstock
- Harvard Medical School, Simulator Program, Department of Anesthesia, Perioperative, and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital
| | | | - Sanjay P Prabhu
- Harvard Medical School, Department of Radiology, Simulator Program, Boston Children's Hospital, Boston, Mass
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3D Printed Models of Cleft Palate Pathology for Surgical Education. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1029. [PMID: 27757345 PMCID: PMC5055011 DOI: 10.1097/gox.0000000000001029] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/13/2016] [Indexed: 12/14/2022]
Abstract
To explore the potential viability and limitations of 3D printed models of children with cleft palate deformity. BACKGROUND The advantages of 3D printed replicas of normal anatomical specimens have previously been described. The creation of 3D prints displaying patient-specific anatomical pathology for surgical planning and interventions is an emerging field. Here we explored the possibility of taking rare pediatric radiographic data sets to create 3D prints for surgical education. METHODS Magnetic resonance imaging data of 2 children (8 and 14 months) were segmented, colored, and anonymized, and stereolothographic files were prepared for 3D printing on either multicolor plastic or powder 3D printers and multimaterial 3D printers. RESULTS Two models were deemed of sufficient quality and anatomical accuracy to print unamended. One data set was further manipulated digitally to artificially extend the length of the cleft. Thus, 3 models were printed: 1 incomplete soft-palate deformity, 1 incomplete anterior palate deformity, and 1 complete cleft palate. All had cleft lip deformity. The single-material 3D prints are of sufficient quality to accurately identify the nature and extent of the deformities. Multimaterial prints were subsequently created, which could be valuable in surgical training. CONCLUSION Improvements in the quality and resolution of radiographic imaging combined with the advent of multicolor multiproperty printer technology will make it feasible in the near future to print 3D replicas in materials that mimic the mechanical properties and color of live human tissue making them potentially suitable for surgical training.
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