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Stern CS, Plotsker EL, Rubenstein R, Mehrara E, Haglich K, Zoghbi Y, Mehrara BJ, Nelson JA. Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study. Plast Reconstr Surg 2023; 152:1153-1162. [PMID: 36995175 DOI: 10.1097/prs.0000000000010473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND Few studies have examined whether preoperative three-dimensional surface imaging can accurately predict breast volume. Reliably predicting breast volume preoperatively can assist with breast reconstruction planning, patient education, and perioperative risk stratification. METHODS The authors conducted a review of patients who underwent mastectomy from 2020 to 2021 and included all patients who had preoperative VECTRA XT three-dimensional imaging. VECTRA Analysis Module (VAM) and VECTRA Body Sculptor (VBS) were used for volumetric analysis using standard anatomical breast borders. Breast weights were obtained intraoperatively. Predictive accuracy was defined as VAM estimates ±10% of mastectomy specimen weight or ±100 g of mastectomy weight. RESULTS The study included 179 patients (266 breasts). There was no significant difference ( P = 0.22) between mean mastectomy weight of 620.8 ± 360.3 g and mean VAM estimate of 609.5 ± 361.9 g. Mean VBS estimate was 498.9 ± 337.6 g, which differed from mean mastectomy weight ( P < 0.001). When defining predictive accuracy as ±100 g, 58.7% of VAM and 44.4% of VBS estimates were accurate. Body mass index, body surface area, and ptosis grade significantly affected VAM and VBS breast volume predictions. CONCLUSIONS VAM is more accurate at predicting mastectomy weight than VBS, likely because of VAM's analysis of surface topography rather than discrete surface landmarks. Discrepancies between VECTRA estimates and mastectomy weight were likely attributable to differences between surgical mastectomy borders and breast borders used in volumetric analysis. Surgeons should consider the physical characteristics of patients when using three-dimensional imaging. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, I.
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Affiliation(s)
- Carrie S Stern
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Ethan L Plotsker
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Robyn Rubenstein
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Ellie Mehrara
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Kathryn Haglich
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Yasmina Zoghbi
- Division of Plastic Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai
| | - Babak J Mehrara
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Jonas A Nelson
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
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Jin L, Wang X, Liu Z, Xiong X, Sun Y, Meng X, Li W, Fang B. An Innovative method for intraoperative guidance of nasal shape in rhinoplasty: Application of a convenient, sterilizable, patient-specific film model. J Plast Reconstr Aesthet Surg 2023; 84:634-641. [PMID: 36635107 DOI: 10.1016/j.bjps.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/26/2022] [Accepted: 06/05/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUNDS 3D simulation is increasingly used in rhinoplasty. However, during the operation, there is no tool to directly link the 3D simulation results with the intraoperative operation. Doctors rely on 3D simulation results only according to their intuition. Recently, the authors have discovered a simple, low-cost, and practical method for intraoperative assessment: a film model can be made according to the contour of the nose shape in its midsagittal view. The authors aimed to evaluate the effectiveness of the innovative method for intraoperative assessment of nasal shape in rhinoplasty. METHODS Thirty-nine patients who underwent rhinoplasty for the first time between January 2019 and January 2021 were included in this study. All the patients confirmed ideal nasal shape based on preoperative three-dimensional photography (INOVA 3D-EX). In the guide group, procedures were based on guide of the film model and a picture of 3D simulation, and in the control group, procedures were performed based on the surgeon's intuition and a picture of 3D simulation. RESULTS There were no statistical differences in basic data between the two groups before operation. Both groups showed a satisfactory correlation. Except for the columellar lobular angle, the ICC of nasal length, nasal depth, dorsum height, columella length, nasofrontal angle, nasorostral angle, and nasolabial angle were all stronger in the guide group than in the control group. CONCLUSION This study demonstrates the usefulness of the nasal-shaped film model, which is made according to the contour of the nose shape in its midsagittal view. This approach is simple, low-cost, and practical.
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Affiliation(s)
- Lewei Jin
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
| | - Zeyang Liu
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bairong Fang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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To JK, Vu AN, Ediriwickrema LS, Browne AW. Comparison of a custom Photogrammetry for Anatomical CarE (PHACE) system with other Low- Cost Facial Scanning Devices. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.16.23288631. [PMID: 37131657 PMCID: PMC10153299 DOI: 10.1101/2023.04.16.23288631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose To compare a custom Photogrammetry for Anatomical CarE (PHACE) system with other cost-effective 3-dimensional (3D) facial scanning systems to objectively characterize morphology and volume of periorbital and adnexal anatomy. Methods The imaging systems evaluated include the low-cost custom PHACE system and commercial software product for the iPhone called Scandy Pro (iScandy) application (Scandy, USA), and the mid-priced Einscan Pro 2X (Shining3D Technologies, China) device and Array of Reconstructed Cameras 7 (ARC7) facial scanner (Bellus3D, USA). Imaging was performed on a manikin facemask and humans with various Fitzpatrick scores. Scanner attributes were assessed using mesh density, reproducibility, surface deviation, and emulation of 3D printed phantom lesions affixed above the superciliary arch (brow line). Results The Einscan served as a reference for lower cost imaging systems because it qualitatively and quantitatively renders facial morphology with the highest mesh density, reproducibility (0.13 ± 0.10 mm), and volume recapitulation (approximately 2% of 33.5 μL). Compared to the Einscan, the PHACE system (0.35 ± 0.03 mm, 0.33 ± 0.16 mm) demonstrated non-inferior mean accuracy and reproducibility root mean square (RMS) compared to the iScandy (0.42 ± 0.13 mm, 0.58 ± 0.09 mm), and significantly more expensive ARC7 (0.42 ± 0.03 mm, 0.26 ± 0.09 mm). Similarly, the PHACE system showed non-inferior volumetric modeling when rendering a 124 μL phantom lesion compared to the iScandy and more costly ARC7 (mean percent difference from the Einscan: 4.68 ± 3.73%, 9.09 ± 0.94%, and 21.99 ± 17.91% respectively). Conclusions The affordable PHACE system accurately measures periorbital soft tissue as well as other established mid-cost facial scanning systems. Additionally, the portability, affordability, and adaptability of PHACE can facilitate widespread adoption of 3D facial anthropometric technology as an objective measurement tool in ophthalmology.
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Affiliation(s)
- Josiah K To
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California Irvine, Irvine California
| | - Anderson N Vu
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California Irvine, Irvine California
| | - Lilangi S Ediriwickrema
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California Irvine, Irvine California
- Institute for Clinical and Translational Science, University of California Irvine, Irvine California
| | - Andrew W Browne
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California Irvine, Irvine California
- Department of Biomedical Engineering, University of California Irvine, Irvine California
- Institute for Clinical and Translational Science, University of California Irvine, Irvine California
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Kuehle R, Kuebler M, Fuchs J, Weichel F, Moratin J, Freier K, Engel M, Hoffmann J, Ristow O, Freudlsperger C. The value of prebent reconstruction plates and in-house 3D printing. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101381. [PMID: 36642249 DOI: 10.1016/j.jormas.2023.101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Reconstruction plates, prebent on 3D printed models, are a cheap, quick, and safe solution to improve mandibular reconstruction procedures. The European Medical Device Regulation has changed recently and severely affects 3D printing in hospitals. Therefore, its legitimation must be discussed. This retrospective observational Case-Control Study aimed to evaluate the impact of prebent reconstruction plates on the condylar position in the temporomandibular joint after continuity resection of the mandible in oncological cases. MATERIALS AND METHODS We included patients who underwent segmental mandibular resection without exarticulation of the condyle or history of prior surgery. The patients were divided into groups with prebent plates on a stereolithographic model and intraoperatively bent reconstruction plates. The segmental defects were categorized using the Jewer Classification. Computed Tomography (CT) scans before and after surgery were analyzed using a standardized method to measure the metric movement of the condyles, as well as their angulation to reference planes to quantify positional changes (primary outcome measures). The influence of the defect location, according to the Jewer classification, was evaluated as a secondary outcome measure. RESULTS 73 patients, including 33 with preformed reconstruction plates, were included. We could show significantly fewer rotational deviations in cases of prefabricated osteosynthesis in the coronal plane (p<0,001) and in the sagittal plane (p<0,027). DISCUSSION Using preformed reconstruction plates on 3D printed models improves the correct anatomical position of the condyle after mandibular resection. Especially Jewer-class-L defects seem to benefit from individualized reconstruction plates.
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Affiliation(s)
- Reinald Kuehle
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
| | - Medea Kuebler
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Jennifer Fuchs
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Frederic Weichel
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Julius Moratin
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Kolja Freier
- University of Heidelberg Saarland, Department of Oral and Maxillofacial Surgery, Kirrberger Straße 100, D-66421 Homburg/Saar, Germany
| | - Michael Engel
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Jürgen Hoffmann
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Oliver Ristow
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Christian Freudlsperger
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
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Application of 3D Imaging-Assisted Precise Aesthetic Evaluation in Midfacial Depression Treatment. Aesthetic Plast Surg 2022; 46:2799-2806. [PMID: 35475937 DOI: 10.1007/s00266-022-02867-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/13/2022] [Indexed: 01/01/2023]
Abstract
Most Chinese have unpleasant facial profile of midfacial depression, which could be caused by multiple reasons. In the past, LeFort osteotomy and orthodontic methods were applied for surgical treatment of midfacial concavity. As the development of plastic surgery filling techniques, nasal base filling or concurrent comprehensive rhinoplasty has been widely used to improve midfacial depression. However, most of the related studies focus on surgical techniques or filling materials, yet lack accurate and objective aesthetic evaluation. In the current study, we used 3D imaging to collect 3D facial profile of 66 patients suffering from midfacial depression. Related linear distance and angles were measured accurately using 3D software. Patient satisfaction and physician evaluation were also collected in the follow-up period. The results showed that patients' midfacial depression were significantly improved after the surgery and the overall patient satisfaction was 100%. Our study demonstrated the positive role of nasal base filling in improving the midfacial depression, and illustrated the advantages of 3D imaging technology in personalized preoperative communication, surgical simulation and postoperative effect evaluation.Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Khatib B, Gelesko S, Amundson M, Cheng A, Patel A, Bui T, Dierks EJ, Bell RB. Updates in Management of Craniomaxillofacial Gunshot Wounds and Reconstruction of the Mandible. Oral Maxillofac Surg Clin North Am 2021; 33:359-372. [PMID: 34210400 DOI: 10.1016/j.coms.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article includes updates in the management of mandibular trauma and reconstruction as they relate to maxillomandibular fixation screws, custom hardware, virtual surgical planning, and protocols for use of computer-aided surgery and navigation when managing composite defects from gunshot injuries to the face.
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Affiliation(s)
- Baber Khatib
- Advanced Craniomaxillofacial and Trauma Surgery/Head and Neck Oncologic and Microvascular Reconstructive Surgery, Department of Surgery, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Portland Hospital, 4805 NE Glisan Street, Portland, OR 97213, USA; Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA.
| | - Savannah Gelesko
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA
| | - Melissa Amundson
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA
| | - Allen Cheng
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Head and Neck Cancer Program, Legacy Good Samaritan Medical Center, 1015 NW 22nd Avenue, Portland, OR 97210, USA
| | - Ashish Patel
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA
| | - Tuan Bui
- Oral and Maxillofacial Pathology, Sanford Health, E - 1717 S University Drive Fargo, ND 58103, USA
| | - Eric J Dierks
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA
| | - R Bryan Bell
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA; Robert W. Franz Cancer Research Center, Earle A. Chiles Research Institute at Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA
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Qureshi UA, Calaguas S, Frank E, Inman J. Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery. Facial Plast Surg 2020; 36:760-767. [PMID: 33368133 DOI: 10.1055/s-0040-1721116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The field of facial plastic and reconstructive surgery is privy to a myriad of technological advancements. As innovation in areas such as imaging, computer applications, and biomaterials progresses at breakneck speed, the potential for clinical application is endless. This review of recent progress in the implementation of new technologies in facial plastic surgery highlights some of the most innovative and impactful developments in the past few years of literature. Patient-specific surgical modeling has become the gold standard for oncologic and posttraumatic reconstructive surgery, with demonstrated improvements in operative times, restoration of anatomical structure, and patient satisfaction. Similarly, reductions in revision rates with improvements in learner technical proficiency have been noted with the use of patient-specific models in free flap reconstruction. In the cosmetic realm, simulation-based rhinoplasty implants have drastically reduced operative times while concurrently raising patient postoperative ratings of cosmetic appearance. Intraoperative imaging has also seen recent expansion in its adoption driven largely by reports of eradication of postoperative imaging and secondary-often complicated-revision reconstructions. A burgeoning area likely to deliver many advances in years to come is the integration of bioprinting into reconstructive surgery. Although yet to clearly make the translational leap, the implications of easily generatable induced pluripotent stem cells in replacing autologous, cadaveric, or synthetic tissues in surgical reconstruction are remarkable.
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Affiliation(s)
| | - Shannon Calaguas
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Ethan Frank
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Jared Inman
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
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Secondary Correction of Midface Fractures. Atlas Oral Maxillofac Surg Clin North Am 2020; 29:139-150. [PMID: 33516535 DOI: 10.1016/j.cxom.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Three-dimensional acquisition technologies for facial soft tissues – Applications and prospects in orthognathic surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:721-728. [DOI: 10.1016/j.jormas.2020.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022]
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Nightingale RC, Ross MT, Allenby MC, Woodruff MA, Powell SK. A Method for Economical Smartphone‐Based Clinical 3D Facial Scanning. J Prosthodont 2020; 29:818-825. [DOI: 10.1111/jopr.13274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Renee Christine Nightingale
- Science and Engineering Faculty Queensland University of Technology (QUT) Brisbane Queensland Australia
- Institute of Health and Biomedical Innovation Queensland University of Technology (QUT) Kelvin Grove Queensland Australia
| | - Maureen Therese Ross
- Science and Engineering Faculty Queensland University of Technology (QUT) Brisbane Queensland Australia
- Institute of Health and Biomedical Innovation Queensland University of Technology (QUT) Kelvin Grove Queensland Australia
| | - Mark Colin Allenby
- Science and Engineering Faculty Queensland University of Technology (QUT) Brisbane Queensland Australia
- Institute of Health and Biomedical Innovation Queensland University of Technology (QUT) Kelvin Grove Queensland Australia
| | - Maria Ann Woodruff
- Science and Engineering Faculty Queensland University of Technology (QUT) Brisbane Queensland Australia
- Institute of Health and Biomedical Innovation Queensland University of Technology (QUT) Kelvin Grove Queensland Australia
| | - Sean Keiran Powell
- Science and Engineering Faculty Queensland University of Technology (QUT) Brisbane Queensland Australia
- Institute of Health and Biomedical Innovation Queensland University of Technology (QUT) Kelvin Grove Queensland Australia
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Harrison P, Patel A, Cheng A, Bell RB. Three-Dimensional Computer-Assisted Surgical Planning, Manufacturing, and Intraoperative Navigation in Oncologic Surgery. Atlas Oral Maxillofac Surg Clin North Am 2020; 28:129-144. [PMID: 32741510 DOI: 10.1016/j.cxom.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Phillip Harrison
- Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney, Suite 300, Portland, OR 97209, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA.
| | - Ashish Patel
- Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney, Suite 300, Portland, OR 97209, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA. https://twitter.com/patelmddds
| | - Allen Cheng
- Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA. https://twitter.com/allenchengddsmd
| | - R Bryan Bell
- Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Earle A. Chiles Research Institute in the Robert W. Franz Cancer Center, Providence Cancer Institute, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA. https://twitter.com/rbryanbell
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Roughley M. Pores, Pimples and Pathologies: 3D Capture and Detailing of the Human Skin for 3D Medical Visualisation and Fabrication. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:141-160. [DOI: 10.1007/978-3-030-47483-6_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Patel A, Harrison P, Cheng A, Bray B, Bell RB. Fibular Reconstruction of the Maxilla and Mandible with Immediate Implant-Supported Prosthetic Rehabilitation: Jaw in a Day. Oral Maxillofac Surg Clin North Am 2019; 31:369-386. [PMID: 31164268 DOI: 10.1016/j.coms.2019.03.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The fibula free flap is a workhorse flap used to reconstruct ablative, osseous defects in the upper and lower jaws. Traditionally, the fibula free flap is inset into the defect freehand; dental implants are placed secondarily; and final prosthetic rehabilitation often occurs more than 1 year after ablative surgery. Virtual surgical planning and rapid prototyping of cutting guides and guide stents for head and neck reconstruction have facilitated improved accuracy in fibular transfer. This article describes the Jaw in a Day technique, allowing maxillary or mandibular resection, fibular free flap reconstruction, immediate implant placement, and prosthetic rehabilitation in a single operation.
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Affiliation(s)
- Ashish Patel
- The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA. https://twitter.com/PatelMDDDS
| | - Phillip Harrison
- The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA
| | - Allen Cheng
- The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Legacy Cancer Institute, Legacy Good Samaritan Medical Center, 1015 Northwest 22nd Avenue, Portland, OR 97210, USA
| | - Brian Bray
- The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Private Practice, Portland Prosthodontics, 5050 Northeast Hoyt Street, Suite 640, Portland, OR 97213, USA
| | - R Bryan Bell
- The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA.
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Cohen SR, Wood D. Commentary on: Enhancing Facelift With Simultaneous Submalar Implant Augmentation. Aesthet Surg J 2019; 39:363-364. [PMID: 30219895 DOI: 10.1093/asj/sjy183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Steven R Cohen
- plastic surgeon in private practice in San Diego, CA
- Clinical Professor of Plastic Surgery, University of California at San Diego, San Diego, CA
| | - Danielle Wood
- student at Texas Christian University, Fort Worth, TX
- clinical research assistant at a private plastic surgery practice, San Diego, CA
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15
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Khatib B, Patel A, Dierks EJ, Bell RB, Cheng A. The Biaxial Double-Barrel Fibula Flap-A Simplified Technique for Fibula Maxillary Reconstruction. J Oral Maxillofac Surg 2018; 77:412-425. [PMID: 30347200 DOI: 10.1016/j.joms.2018.09.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Previously described techniques for microvascular fibula reconstruction of Brown Class II to IV maxillectomy defects are complex, require multiple osteotomies, result in a short pedicle, and inadequately reconstruct the dental alveolus in preparation for endosseous implants. This report describes a simplified technique for Brown Class II to IV defects that re-creates facial support, allows for dental reconstruction with appropriately positioned implants, and maintains adequate pedicle length. MATERIALS AND METHODS A retrospective chart review was performed of all patients with Brown Class II to IV maxillectomy defects immediately reconstructed with a biaxial double-barrel fibula flap technique. The reconstructive surgeon evaluated each patient at least 1 month after reconstruction for enophthalmos, facial symmetry, nasal patency, satisfactory jaw position, deglutition, intelligible speech, and intraoperative need for vein grafting. RESULTS The sample was composed of 6 patients (mean age, 54 yr; range, 33 to 78 yr; 67% women) who underwent reconstruction with the biaxial double-barrel fibula flap technique for Brown Class II to IV defects. None of these patients required vein grafting. None of these patients had flap failure. Diagnoses for these patients were a hybrid odontogenic tumor (n = 1), squamous cell carcinoma (n = 3), adenoid cystic carcinoma (n = 1), and sinonasal melanoma (n = 1). All 6 patients had excellent facial contour and malar projection, regular oral intake, 100% intelligible speech, and a new maxillary skeletal Class I relation without need for intraoperative vein grafting. One patient developed enophthalmos related to inferior rectus sacrifice and removal of orbital fat. Complications included development of nasal synechia and occlusion of the maxillary sinus ostium (n = 1). CONCLUSIONS The biaxial double-barrel fibula flap technique achieves the goals of providing adequate facial support and an alveolar segment amenable to implant dentistry. It allows for intelligible speech, deglutition, orbital support, and separation of the oronasal, orbital, and sinus cavities. In addition, it minimizes the need for vein grafting.
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Affiliation(s)
- Baber Khatib
- Assistant Clinical Professor, Maxillofacial Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC; Previously, Fellow, Head and Neck Oncologic and Microvascular Reconstructive Surgery, Providence Cancer Center Head and Neck Institute, Portland, OR.
| | - Ashish Patel
- Attending Head and Neck/Microvascular Surgeon, Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, Portland; Consultant, Head and Neck Institute, Portland, OR
| | - Eric J Dierks
- Director of Maxillofacial Trauma, Trauma Service, Legacy Emanuel Medical Center, Portland; Consultant, Head and Neck Institute, Portland, OR
| | - R Bryan Bell
- Medical Director, Providence Oral, Head and Neck Cancer Program and Clinic, Earle A. Chiles Research Institute at the Robert W. Franz Cancer Center, Providence Cancer Institute, Portland; Director, Fellowship in Head and Neck Oncologic and Microvascular Reconstructive Surgery, Head and Neck Institute, Portland, OR
| | - Allen Cheng
- Director, Head and Neck Cancer Program, Legacy Good Samaritan Medical Center, Portland; Consultant, Head and Neck Institute, Portland, OR
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Use of Intraoperative Computed Tomography in Craniomaxillofacial Trauma Surgery. J Oral Maxillofac Surg 2018; 76:1016-1025. [DOI: 10.1016/j.joms.2017.12.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/24/2017] [Accepted: 12/01/2017] [Indexed: 11/18/2022]
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Khatib B, Cuddy K, Cheng A, Patel A, Sim F, Amundson M, Gelesko S, Bui T, Dierks EJ, Bell RB. Functional Anatomic Computer Engineered Surgery Protocol for the Management of Self-Inflicted Gunshot Wounds to the Maxillofacial Skeleton. J Oral Maxillofac Surg 2018; 76:580-594. [DOI: 10.1016/j.joms.2017.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khatib B, Gelesko S, Amundson M, Cheng A, Patel A, Bui T, Dierks EJ, Bell RB. Updates in Management of Craniomaxillofacial Gunshot Wounds and Reconstruction of the Mandible. Facial Plast Surg Clin North Am 2018; 25:563-576. [PMID: 28941508 DOI: 10.1016/j.fsc.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article includes updates in the management of mandibular trauma and reconstruction as they relate to maxillomandibular fixation screws, custom hardware, virtual surgical planning, and protocols for use of computer-aided surgery and navigation when managing composite defects from gunshot injuries to the face.
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Affiliation(s)
- Baber Khatib
- Advanced Craniomaxillofacial and Trauma Surgery/Head and Neck Oncologic and Microvascular Reconstructive Surgery, Department of Surgery, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Portland Hospital, 4805 NE Glisan Street, Portland, OR 97213, USA; Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA.
| | - Savannah Gelesko
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA
| | - Melissa Amundson
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA
| | - Allen Cheng
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Head and Neck Cancer Program, Legacy Good Samaritan Medical Center, 1015 NW 22nd Avenue, Portland, OR 97210, USA
| | - Ashish Patel
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA
| | - Tuan Bui
- Oral and Maxillofacial Pathology, Sanford Health, E - 1717 S University Drive Fargo, ND 58103, USA
| | - Eric J Dierks
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA
| | - R Bryan Bell
- Head & Neck Surgical Associates, 1849 NW Kearney Street #302, Portland, OR 97209, USA; Department of Surgery, Trauma Service, Legacy Emanuel Medical Center, 2801 N Gantentenbein Avenue, Portland, OR 97227, USA; Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA; Robert W. Franz Cancer Research Center, Earle A. Chiles Research Institute at Providence Cancer Center, 4805 NE Glisan Street, Portland, OR 97213, USA
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Krefer AG, Lie MMI, Borba GB, Gamba HR, Lavarda MD, Abreu de Souza M. A method for generating 3D thermal models with decoupled acquisition. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 151:79-90. [PMID: 28947008 DOI: 10.1016/j.cmpb.2017.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/30/2017] [Accepted: 08/09/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Both thermal imaging and 3D scanning offer convenient advantages for medical applications, namely, being contactless, non-invasive and fast. Consequently, many approaches have been proposed to combine both sensing modalities in order to acquire 3D thermal models. The predominant approach is to affix a 3D scanner and a thermal camera in the same support and calibrate them together. While this approach allows straightforward projection of thermal images over the 3D mesh, it requires their simultaneous acquisition. In this work, a method for generation of 3D thermal models that allows combination of separately acquired 3D mesh and thermal images is presented. Among the advantages of this decoupled acquisition are increased modularity of acquisition procedures and reuse of legacy equipment and data. METHODS The proposed method is based on the projection of thermal images over a 3D mesh. Unlike previous methods, it is considered that the 3D mesh and the thermal images are acquired separately, so camera pose estimation is required to determine the correct spatial positioning from which to project the images. This is done using Structure from Motion, which requires a series of interest points correspondences between the images, for which the SIFT method was used. As thermal images of human skin are predominantly homogeneous, an intensity transformation is proposed to increase the efficacy of interest point detection and make the approach feasible. Before projection, the adequate alignment of the 3D mesh in space is determined using Particle Swarm Optimization. For validation of the method, the design and implementation of a test object is presented. It can be used to validate other methods and can be reproduced with common printed circuit board manufacturing processes. RESULTS The proposed approach is accurate, with an average displacement error of 1.41 mm (s = 0.74 mm) with the validation test object and 4.58 mm (s = 2.12 mm) with human subjects. CONCLUSIONS The proposed method is able to combine separately a acquired 3D mesh and thermal images into an accurate 3D thermal model. The results with human subjects suggest that the method can be successfully employed in medical applications.
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Affiliation(s)
- Andriy Guilherme Krefer
- Graduate School on Electrical Engineering - CPGEI, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
| | - Maiko Min Ian Lie
- Graduate School on Electrical Engineering - CPGEI, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
| | - Gustavo Benvenutti Borba
- Graduate School on Biomedical Engineering - PPGEB, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
| | - Humberto Remigio Gamba
- Graduate School on Electrical Engineering - CPGEI, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
| | - Marcos Dinís Lavarda
- Graduate School on Biomedical Engineering - PPGEB, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
| | - Mauren Abreu de Souza
- Graduate School on Biomedical Engineering - PPGEB, Department of Electronics - DAELN, Federal University of Technology - Paraná - UTFPR, Av. Sete de Setembro 3165, 80230-901, Curitiba, Paraná, Brazil.
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Kwon D, Iloreta A, Miles B, Inman J. Open Anterior Skull Base Reconstruction: A Contemporary Review. Semin Plast Surg 2017; 31:189-196. [PMID: 29075157 DOI: 10.1055/s-0037-1607273] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Skull base extirpative and reconstructive surgery has undergone significant changes due to technological and operative advances. While endoscopic resection and reconstruction will continue to advance skull base surgery for the foreseeable future, traditional open surgical approaches and reconstructive techniques are still contemporarily employed as best practices in certain tumors or patient-specific anatomical cases. Skull base surgeons should strive to maintain a working knowledge and technical skill set to manage these challenging cases where endoscopic techniques have previously failed, are insufficient from anatomical constraints, or tumor biology with margin control supersedes the more minimally invasive approach. This review focuses on the reconstructive techniques available to the open skull base surgeon as an adjunct to the endoscopic reconstructive options. Anatomic considerations, factors relating to the defect or patient, reconstructive options of nonvascular grafts, local and regional flaps, and free tissue transfer are outlined using the literature and author's experience. Future directions in virtual surgical planning and emerging technologies will continue to enhance open and endoscopic skull base surgeon's preparation, performance, and outcomes in this continually developing interdisciplinary field.
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Affiliation(s)
- Daniel Kwon
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California
| | - Alfred Iloreta
- Division of Rhinology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brett Miles
- Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jared Inman
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California
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Pursuing Mirror Image Reconstruction in Unilateral Microtia: Customizing Auricular Framework by Application of Three-Dimensional Imaging and Three-Dimensional Printing. Plast Reconstr Surg 2017; 139:1433-1443. [PMID: 28538573 DOI: 10.1097/prs.0000000000003374] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Advances in three-dimensional imaging and three-dimensional printing technology have expanded the frontier of presurgical design for microtia reconstruction from two-dimensional curved lines to three-dimensional perspectives. This study presents an algorithm for combining three-dimensional surface imaging, computer-assisted design, and three-dimensional printing to create patient-specific auricular frameworks in unilateral microtia reconstruction. METHODS Between January of 2015 and January of 2016, six patients with unilateral microtia were enrolled. The average age of the patients was 7.6 years. A three-dimensional image of the patient's head was captured by 3dMDcranial, and virtual sculpture carried out using Geomagic Freeform software and a Touch X Haptic device for fabrication of the auricular template. Each template was tailored according to the patient's unique auricular morphology. The final construct was mirrored onto the defective side and printed out with biocompatible acrylic material. RESULTS During the surgery, the prefabricated customized template served as a three-dimensional guide for surgical simulation and sculpture of the MEDPOR framework. Average follow-up was 10.3 months. Symmetric and good aesthetic results with regard to auricular shape, projection, and orientation were obtained. One case with severe implant exposure was salvaged with free temporoparietal fascia transfer and skin grafting. CONCLUSIONS The combination of three-dimensional imaging and manufacturing technology with the malleability of MEDPOR has surpassed existing limitations resulting from the use of autologous materials and the ambiguity of two-dimensional planning. This approach allows surgeons to customize the auricular framework in a highly precise and sophisticated manner, taking a big step closer to the goal of mirror-image reconstruction for unilateral microtia patients. CLINCIAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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22
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Kotelnikov GP, Kolsanov AV, Shcherbovskikh AE, Nikolaenko AN, Prikhod'ko SA, Popov NV, Khassan MA. [Reconstruction of posttraumatic and postoperative defects of lower jaw]. Khirurgiia (Mosk) 2017:69-72. [PMID: 28745712 DOI: 10.17116/hirurgia2017769-72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G P Kotelnikov
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - A V Kolsanov
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - A E Shcherbovskikh
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - A N Nikolaenko
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - S A Prikhod'ko
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - N V Popov
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
| | - M A Khassan
- Samara State Medical University, Health Ministry of the Russian Federation, Samara, Russia
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Abstract
The present report describes the planning and surgery as well as pitfalls and management of a patient with a near total mandibular avulsion injury that was rehabilitated using three-dimensional (3D) laser printing of a titanium lower jaw. Laser-sintering involves zapping layers of powdered metal to recreate a 3D implantable skeletal defect. The process involves using either mirror imaging of the unaffected side or using archival image database of healthy individuals. A 25-year-old man presented with a gunshot injury that left him with a near total avulsed mandible. The patient received state-of-the-art treatment using a laser 3D printed mandible which was connected to the muscles of mastication for functionality. The inner side of the titanium jaw was filled with the patient's comminuted fractured bones in addition to harvested iliac crest bone graft that was covered with the patient's remaining periosteal tissue. The implantation of a near total mandible using 3D laser printing is a fast and predictable process that in selected patients can result in aesthetically as well as functionally excellent results. The authors believe that the future of craniofacial reconstruction will employ these methods for facial bony reconstruction.
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Simunovic F, Schlager S, Montanari M, Iblher N. Prospective 3D analysis of facial soft tissue augmentation with calcium hydroxylapatite. J COSMET LASER THER 2017; 19:283-289. [DOI: 10.1080/14764172.2017.1307411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Filip Simunovic
- Department of Plastic and Hand Surgery, Freiburg University Medical Center, Freiburg, Germany
| | - Stefan Schlager
- Department of Biological Anthropology, University of Freiburg, Freiburg, Germany
| | | | - Niklas Iblher
- Private Practice for Plastic and Aesthetic Surgery, Freiburg, Germany
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Weissler JM, Sosin M, Dorafshar AH, Garcia JR. Combining Virtual Surgical Planning, Intraoperative Navigation, and 3-Dimensional Printing in Prosthetic-Based Bilateral Microtia Reconstruction. J Oral Maxillofac Surg 2017; 75:1491-1497. [PMID: 28137637 DOI: 10.1016/j.joms.2016.12.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/27/2016] [Accepted: 12/27/2016] [Indexed: 12/19/2022]
Abstract
Reconstructing auricular deformities for bilateral microtia is a demanding challenge especially after failed autologous reconstruction. This case report presents a novel application of virtual surgical planning, computer-assisted design, and intraoperative surgical navigation to preplan and execute placement of custom-tailored silicone auricular prostheses and titanium osseointegrated implants for a bone-anchored hearing aid system in a patient with Treacher Collins syndrome in whom autologous reconstruction had previously failed. Through a collaborative approach between the reconstructive surgeon and anaplastologist, the implementation of advanced digital technologies may offer a superior esthetic and functional outcome to patients with previously failed reconstruction.
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Affiliation(s)
- Jason M Weissler
- Postdoctoral Research Fellow, Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Michael Sosin
- General Surgery Resident, Department of Surgery, Medstar Georgetown University Hospital, Washington, DC; Postdoctoral Research Fellow, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD
| | - Amir H Dorafshar
- Associate Professor, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD
| | - Juan R Garcia
- Clinic Director, Johns Hopkins Facial Prosthetics Clinic, and Associate Professor, Department of Art as Applied to Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.
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Augmented Reality and Wearable Technology in Image-guided Navigation and Preoperative Planning. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1057. [PMID: 27757359 PMCID: PMC5055025 DOI: 10.1097/gox.0000000000001057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 11/26/2022]
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Application of a Novel Semi-Automatic Technique for Determining the Bilateral Symmetry Plane of the Facial Skeleton of Normal Adult Males. J Craniofac Surg 2016; 26:1997-2001. [PMID: 26355983 DOI: 10.1097/scs.0000000000001937] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The accurate assessment of symmetry in the craniofacial skeleton is important for cosmetic and reconstructive craniofacial surgery. Although there have been several published attempts to develop an accurate system for determining the correct plane of symmetry, all are inaccurate and time consuming. Here, the authors applied a novel semi-automatic method for the calculation of craniofacial symmetry, based on principal component analysis and iterative corrective point computation, to a large sample of normal adult male facial computerized tomography scans obtained clinically (n = 32). The authors hypothesized that this method would generate planes of symmetry that would result in less error when one side of the face was compared to the other than a symmetry plane generated using a plane defined by cephalometric landmarks. When a three-dimensional model of one side of the face was reflected across the semi-automatic plane of symmetry there was less error than when reflected across the cephalometric plane. The semi-automatic plane was also more accurate when the locations of bilateral cephalometric landmarks (eg, frontozygomatic sutures) were compared across the face. The authors conclude that this method allows for accurate and fast measurements of craniofacial symmetry. This has important implications for studying the development of the facial skeleton, and clinical application for reconstruction.
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Watanabe M, Buch K, Fujita A, Christiansen CL, Jara H, Sakai O. MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue. Dentomaxillofac Radiol 2015; 44:20150047. [PMID: 25974063 DOI: 10.1259/dmfr.20150047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the location-specific tissue properties and age-related changes of the facial fat and facial muscles using quantitative MRI (qMRI) analysis of longitudinal magnetization (T1) and transverse magnetization (T2) values. METHODS 38 subjects (20 males and 18 females, 0.5-87 years old) were imaged with a mixed turbo-spin echo sequence at 1.5 T. T1 and T2 measurements were obtained within regions of interest in six facial fat regions including the buccal fat and subcutaneous cheek fat, four eyelid fat regions (lateral upper, medial upper, lateral lower and medial lower) and five facial muscles including the orbicularis oculi, orbicularis oris, buccinator, zygomaticus major and masseter muscles bilaterally. RESULTS Within the zygomaticus major muscle, age-associated T1 decreases in females and T1 increases in males were observed in later life with an increase in T2 values with age. The orbicularis oculi muscles showed lower T1 and higher T2 values compared to the masseter, orbicularis oris and buccinator muscles, which demonstrated small age-related changes. The dramatic age-related changes were also observed in the eyelid fat regions, particularly within the lower eyelid fat; negative correlations with age in T1 values (p<0.0001 for age) and prominent positive correlation in T2 values in male subjects (p<0.0001 for male×age). Age-related changes were not observed in T2 values within the subcutaneous cheek fat. CONCLUSIONS This study demonstrates proof of concept using T1 and T2 values to assess age-related changes of the facial soft tissues, demonstrating tissue-specific qMRI measurements and non-uniform ageing patterns within different regions of facial soft tissues.
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Affiliation(s)
- M Watanabe
- 1 Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - K Buch
- 1 Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - A Fujita
- 1 Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - C L Christiansen
- 2 Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - H Jara
- 1 Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - O Sakai
- 1 Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.,3 Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.,4 Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Wilde F, Cornelius CP, Schramm A. Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques. Craniomaxillofac Trauma Reconstr 2014; 7:158-66. [PMID: 25045420 DOI: 10.1055/s-0034-1371356] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 08/24/2013] [Indexed: 10/25/2022] Open
Abstract
We investigated the workflow of computer-assisted mandibular reconstruction that was performed with a patient-specific mandibular reconstruction plate fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) techniques and a fibula flap. We assessed the feasibility of this technique from virtual planning to the completion of surgery. Computed tomography (CT) scans of a cadaveric skull and fibula were obtained for the virtual simulation of mandibular resection and reconstruction using ProPlan CMF software (Materialise(®)/DePuy Synthes(®)). The virtual model of the reconstructed mandible provided the basis for the computer-aided design of a patient-specific reconstruction plate that was milled from titanium using a five-axis milling machine and CAM techniques. CAD/CAM techniques were used for producing resection guides for mandibular resection and cutting guides for harvesting a fibula flap. Mandibular reconstruction was simulated in a cadaveric wet laboratory. No problems were encountered during the procedure. The plate was fixed accurately to the residual bone without difficulty. The fibula segments were attached to the plate rapidly and reliably. The fusion of preoperative and postoperative CT datasets demonstrated high reconstruction precision. Computer-assisted mandibular reconstruction with CAD/CAM-fabricated patient-specific reconstruction plates appears to be a promising approach for mandibular reconstruction. Clinical trials are required to determine whether these promising results can be translated into successful practice and what further developments are needed.
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Affiliation(s)
- Frank Wilde
- Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital and Academic Hospital of the University of Ulm, Ulm, Germany
| | - Carl-Peter Cornelius
- Oral and Maxillofacial Surgery, Ludwig Maximilians University Hospital of Munich, Munich, Germany
| | - Alexander Schramm
- Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital and Academic Hospital of the University of Ulm, Ulm, Germany
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Dorafshar AH, Brazio PS, Mundinger GS, Mohan R, Brown EN, Rodriguez ED. Found in space: computer-assisted orthognathic alignment of a total face allograft in six degrees of freedom. J Oral Maxillofac Surg 2014; 72:1788-800. [PMID: 24656428 DOI: 10.1016/j.joms.2014.01.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 01/18/2014] [Accepted: 01/18/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Full facial osteomyocutaneous transplantation requires correct 3-dimensional (3D) alignment of donor osseous structures to a new cranial base with minimal reference points and 6 degrees of potential movement. We investigated whether computer-assisted design and manufacturing (CAD/CAM) could enable accurate placement of the facial skeleton. MATERIALS AND METHODS A prospective single-cohort study of Le Fort III-based maxillary-mandibular segment allotransplantation was performed in 5 cadaver pairs and 1 clinical pair. The osteotomies were modeled using computed tomography (CT) data and 3D modeling software and then translated to the donor-recipient pairs using surgical navigation and osteotomy cutting guides. The predicted values were calculated about all rotational axes (pitch, yaw, and roll) and along all translational axes (vertical, horizontal, and anteroposterior) and used as the independent variable. The primary outcome variable of the actual postoperative CT values was compared for fidelity to the prediction using the intraclass correlation coefficient (ICC). The similarity to the donor versus recipient values was calculated as a secondary independent variable, and both predicted and actual measurements were compared with it as a percentage. RESULTS The postoperative fidelity to the plan was adequate to excellent (ICC 0.520 to 0.975) with the exception of lateral translation (2.94 ± 1.31 mm predicted left vs 3.92 ± 2.17 mm right actual displacement; ICC 0.243). The predicted and actual values were not consistently skewed toward the donor or recipient values. CONCLUSIONS We have demonstrated a novel application of CAD/CAM that enables orthognathic alignment of a maxillary-mandibular segment to a new cranial base. Quantification of the alignment in all 6 degrees of freedom delivers precise control compared with the planned changes and allows postoperative quality control.
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Affiliation(s)
- Amir H Dorafshar
- Assistant Professor, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD.
| | - Philip S Brazio
- Resident, Department of Surgery, University of Maryland Medical Center, Baltimore, MD
| | - Gerhard S Mundinger
- Resident, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD
| | - Raja Mohan
- Resident, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD
| | - Emile N Brown
- Resident, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD
| | - Eduardo D Rodriguez
- Professor, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD
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Ting JWC, Rozen WM, Niumsawatt V, Baillieu C, Leung M, Leong JC. Developments in image-guided deep circumflex iliac artery flap harvest: a step-by-step guide and literature review. J Oral Maxillofac Surg 2013; 72:186-97. [PMID: 23993225 DOI: 10.1016/j.joms.2013.06.219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 06/26/2013] [Accepted: 06/27/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE The deep circumflex iliac artery (DCIA) flap has evolved significantly over time in the intricacies of flap design and breadth of surgical application. This has been facilitated by advances in preoperative imaging and planning, in particular, computed tomographic angiography. Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes. PATIENTS AND METHODS The present report comprises a combined literature review and clinical cohort study of 20 consecutive patients to assess the modern technologies applied to DCIA flap planning and harvest. We have also described a step-by-step guide for the implementation of these techniques into clinical practice. RESULTS The protocol for a single, standardized technique of computed tomographic angiography scanning is presented and was applied to a range of techniques in the preoperative planning of DCIA flaps. These include 1) bony and vascular imaging analysis of both donor and recipient sites, 2) stereolithographic "biomodeling" of both donor and recipient bony and vascular anatomy, and 3) the use of preoperative "virtual surgery" with image-guided stereotactic navigation. The application and role of each technique was explored. CONCLUSIONS Modern imaging and stereolithographic techniques are innovations that can substantially improve surgical outcomes in DCIA flap surgery, such as has been highlighted in our clinical experience and in published studies. Notably, few outcome studies have been reported, and the need for larger case series and comparative studies is apparent.
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Affiliation(s)
- Jeannette W C Ting
- Plastic and Reconstructive Surgical Registrar, Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia; Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia.
| | - Warren M Rozen
- Plastic and Reconstructive Surgical Registrar, Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia; Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia
| | - Vachara Niumsawatt
- Plastic and Reconstructive Surgical Registrar, Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia
| | - Charles Baillieu
- Plastic and Reconstructive Surgical Consultant, Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia; Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia
| | - Michael Leung
- Plastic and Reconstructive Surgical Consultant, Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia; Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia
| | - James C Leong
- Plastic and Reconstructive Surgical Consultant, Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia; Department of Surgery, Monash University Faculty of Medicine, Clayton, Victoria, Australia
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Markiewicz MR, Bell RB. Traditional and contemporary surgical approaches to the orbit. Oral Maxillofac Surg Clin North Am 2013; 24:573-607. [PMID: 23107428 DOI: 10.1016/j.coms.2012.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Traditional orbital approaches are nearly a century old and still comprise the foundation of techniques used today. Computer-assisted planning and intraoperative navigation have recently been reported with more prevalence in the literature. The purpose of this article was to review commonly used approaches to the orbit: old and new.
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Affiliation(s)
- Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, 611 Southwest Campus Drive, SDOMS, Portland, OR 97239, USA
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Soft-Tissue Mobility of the Lower Face Depending on Positional Changes and Age. Plast Reconstr Surg 2013; 131:372-381. [DOI: 10.1097/prs.0b013e318278d67c] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gelesko S, Markiewicz MR, Weimer K, Bell RB. Computer-aided orthognathic surgery. Atlas Oral Maxillofac Surg Clin North Am 2012; 20:107-118. [PMID: 22365433 DOI: 10.1016/j.cxom.2012.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Savannah Gelesko
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR 97239, USA
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