1
|
Breik O, Idle M, Martin T, Praveen P, Parmar S. Three-Dimensional Computer-Assisted Surgical Planning and Manufacturing in Complex Maxillary Reconstruction. Atlas Oral Maxillofac Surg Clin North Am 2020; 28:151-164. [PMID: 32741512 DOI: 10.1016/j.cxom.2020.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Omar Breik
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK.
| | - Matthew Idle
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK
| | - Timothy Martin
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK
| | - Prav Praveen
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK
| | - Satyesh Parmar
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK
| |
Collapse
|
2
|
Breik O, Goodrum H, Koria H, Edmondson S, Praveen P, Parmar S. Rehabilitation post maxillary and mandibular reconstruction: Current status and future approaches. Oral Oncol 2020; 105:104663. [DOI: 10.1016/j.oraloncology.2020.104663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
|
3
|
Luu K, Pakdel A, Wang E, Prisman E. In house virtual surgery and 3D complex head and neck reconstruction. J Otolaryngol Head Neck Surg 2018; 47:75. [PMID: 30541624 PMCID: PMC6290522 DOI: 10.1186/s40463-018-0320-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 11/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background 3-Dimensional (3D) printing can be applied to virtual planning and creation of surgical guides for mandibular reconstruction. Such systems are becoming increasingly prevalent in head and neck reconstruction. However, third party access to this technology is costly and removes the opportunity to design, create, and modify the bony reconstructions, as third party technology is a black box. This series is a pilot study to document the feasibility of an in-house software tool. The objectives of this study are to describe the design of an automated in house system and assess the accuracy of this in house automated software tool for mandibular reconstruction in a simulated environment. Methods Software was written to automate the preoperative planning and surgical guide creation process. In a simulation lab, Otolaryngology residents were tasked with resecting and reconstructing a simulated mandible using the 3D-printed cutting guides. A control group of residents performed resection and reconstruction using the traditional method without cutting guides. T-test analysis was performed to compare specific aspects of the final reconstructions including: change from native mandibular width and projection, segment gap distance, and reconstruction time. Results Mandibular reconstruction was successful in all participants using the 3D printed system. The guided group performed significantly better on the measurement of change in Mandibular overlap, projection, segment gap volume. There was a non-significant trend towards better mandibular width and operative time for the guided group. Conclusions This study confirms functionality and feasibility of using an in house automated software for planning and creating surgical guides.
Collapse
Affiliation(s)
- Kimberly Luu
- Division of Otolaryngology, Head & Neck Surgery, University of British Columbia, 2775 Laurel Street, DHCC 4th. Floor, Vancouver, BC, V5Z 1M9, Canada.
| | - Amirreza Pakdel
- Division of Otolaryngology, Head & Neck Surgery, University of British Columbia, 2775 Laurel Street, DHCC 4th. Floor, Vancouver, BC, V5Z 1M9, Canada
| | - Edward Wang
- Division of Otolaryngology, Head & Neck Surgery, University of British Columbia, 2775 Laurel Street, DHCC 4th. Floor, Vancouver, BC, V5Z 1M9, Canada
| | - Eitan Prisman
- Division of Otolaryngology, Head & Neck Surgery, University of British Columbia, 2775 Laurel Street, DHCC 4th. Floor, Vancouver, BC, V5Z 1M9, Canada
| |
Collapse
|
4
|
Kass JI, Prisman E, Miles BA. Guide design in virtual planning for scapular tip free flap reconstruction. Laryngoscope Investig Otolaryngol 2018; 3:162-168. [PMID: 30062130 PMCID: PMC6057217 DOI: 10.1002/lio2.162] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 03/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background Virtual surgical planning (VSP), intraoperative cutting guides and stereolithographic models, provides the head and neck reconstructive surgeon with powerful tools for complex reconstruction planning. Despite its use in fibular osteocutaneous reconstruction, application to the scapular tip has not been as widely reported. Methods From 2013 to 2014, four cases of either mandibular or maxillary reconstruction were completed with the scapular tip osseous free flap. All four cases underwent preoperative VSP with patient‐specific guide design. Results Patient‐specific guides were generated for scapular tip harvest. Guide placement was improved using a stabilizing flange and bracket design. With minimal disruption of the overlying periosteum a wedge osteotomy was successfully implemented in one case. Conclusions Unlike the fibula and iliac crest donor sites, the scapular tip has overlying muscle attachments that make intraoperative osteotomies challenging. Attention to key aspects of scapular anatomy, including the fibrous tip and extensive overlying muscle, permits effective guide design. Level of evidence 4
Collapse
Affiliation(s)
- Jason I Kass
- Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital Harvard Medical School Boston Massachusetts U.S.A
| | - Eitan Prisman
- Vancouver General Hospital Vancouver British Columbia Canada.,the Division of Otolaryngology Head and Neck Surgery, Gordon & Leslie Diamond Health Care Centre University of British Columbia Vancouver British Columbia Canada
| | - Brett A Miles
- Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai New York New York U.S.A
| |
Collapse
|
5
|
Zhu W, Zhao Y, Ma Q, Wang Y, Wu Z, Weng X. 3D-printed porous titanium changed femoral head repair growth patterns: osteogenesis and vascularisation in porous titanium. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:62. [PMID: 28251470 DOI: 10.1007/s10856-017-5862-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) is a major cause of morbidity, and total hip arthroplasty is both traumatic and expensive. Here, we created a gelatine scaffold embedded in uniquely shaped, 3D-printed porous titanium parts, which could attract and promote the proliferation of osteoblasts as well as bone regeneration, as the extracellular matrix (ECM) does in vivo. Interestingly, after hybridisation with platelets, the scaffold exhibited a low yet considerable rate of stable, safe and long-term growth factor release. Additionally, a novel ONFH model was constructed and verified. Scaffolds implanted in this model were found to accelerate bone repair. In conclusion, our scaffold successfully simulates the ECM and considerably accelerates bone regeneration, in which platelets play an indispensable role. We believe that platelets should be emphasised as carriers that may be employed to transport drugs, cytokines and other small molecules to target locations in vivo. In addition, this novel scaffold is a useful material for treating ONFH. An overview of the novel scaffold mimicking the extracellular environment in bone repair. a and b: A gelatine scaffold was cross-linked and freeze-dried within 3D-printed porous titanium. c: Platelets were coated onto the gelatine microscaffold after freeze-drying platelet-rich plasma. d: The microscaffold supported the migration of cells into the titanium pores and their subsequent growth, while the platelets slowly released cell factors, exerting bioactivity.
Collapse
Affiliation(s)
- Wei Zhu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yan Zhao
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Qi Ma
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yingjie Wang
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Zhihong Wu
- Beijing Key Laboratory for Genetic Research of Bone and Joint Disease, Central Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing, 100730, P.R. China.
| | - Xisheng Weng
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| |
Collapse
|
6
|
Shakir S, Naran S, Neral M, Wollstein R. Titanium versus Stainless-Steel Plating in the Surgical Treatment of Distal Radius Fractures: A Randomized Trial. J Hand Microsurg 2016; 8:155-158. [PMID: 27999458 DOI: 10.1055/s-0036-1593731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022] Open
Abstract
Our purpose was to compare postoperative complications and rate of plate removal in titanium and stainless-steel plating of distal radius fractures (DRF). Patients following DRF were randomly fixed with titanium or stainless-steel plates using the same plating system. Complications, second surgeries, and plate prominence were documented. A total of 41 patients were treated with stainless-steel and 22 with titanium plates. Average follow-up was 60 ± 5.6 months. There was no difference in demographics, fracture characteristics, or follow-up between the groups. Plate prominence was found in 50% of radiographs (mean distance: 1.4 mm). Four titanium plates and three stainless-steel plates were removed (11%). Mean time to plate removal was 18.4 ± 4.6 months. There was no difference in removal rates between the groups. Plate material and prominence, age, fracture comminution and smoking status were not associated with plate removal. Our results support using volar and dorsal plates regardless of the plate material.
Collapse
Affiliation(s)
- Sameer Shakir
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Sanjay Naran
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Mithun Neral
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Ronit Wollstein
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States; Division of Hand and Upper Extremity Surgery, Department of Orthopedic Surgery, Technion Israel Institute of Technology School of Medicine, Haifa, Israel
| |
Collapse
|
7
|
Cornelius CP, Giessler GA, Wilde F, Metzger MC, Mast G, Probst FA. Iterations of computer- and template assisted mandibular or maxillary reconstruction with free flaps containing the lateral scapular border – Evolution of a biplanar plug-on cutting guide. J Craniomaxillofac Surg 2016; 44:229-41. [DOI: 10.1016/j.jcms.2015.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/13/2015] [Accepted: 11/10/2015] [Indexed: 11/17/2022] Open
|