Fabrication of 3D-Printed Implant for Two-Stage Ear Reconstruction Surgery and Its Clinical Application
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Ear reconstruction is one of the most difficult areas in the field of reconstructive surgery. Due to limitations of the cur rent practice, a novel method of auricular reconstruction is needed. Major advancements in three-dimensional (3D) printing technique have rendered the process of ear reconstruction more favorable. Herein, we present our experience in designing and clinically using 3D implants in both 1st and 2nd stage ear reconstruction surgery. Materials and Methods: After obtaining 3D CT data from each patient, a 3D geometric ear model was created using mirroring and segmentation processes. The 3D-printed implant design resembles but does not exactly match the normal ear shape, and can be inserted in harmony with the currently used surgical technique. The 2nd stage implant was designed to minimize dead space and support the posterior ear helix. The 3D implants were finally fabricated with a 3D printing system and used in ear re construction surgery in our institute. Results: The 3D implants were manufactured for application to the currently used two-stage technique while maintaining the shape of the patient’s normal ear. The implants were successfully used for ear reconstruction surgery in microtia patients. A few months later, the 2nd stage implant was used in the 2nd stage operation. Conclusion: The authors were able to design, fabricate, and apply patient-specific 3D-printed ear implants for 1st and 2nd stage ear reconstruction surgeries. This design, combined with 3D bioprinting technique, may be a future alternative for ear reconstruction.
Abstract
Purpose: Ear reconstruction is one of the most difficult areas in the field of reconstructive surgery. Due to limitations of the cur rent practice, a novel method of auricular reconstruction is needed. Major advancements in three-dimensional (3D) printing technique have rendered the process of ear reconstruction more favorable. Herein, we present our experience in designing and clinically using 3D implants in both 1st and 2nd stage ear reconstruction surgery. Materials and Methods: After obtaining 3D CT data from each patient, a 3D geometric ear model was created using mirroring and segmentation processes. The 3D-printed implant design resembles but does not exactly match the normal ear shape, and can be inserted in harmony with the currently used surgical technique. The 2nd stage implant was designed to minimize dead space and support the posterior ear helix. The 3D implants were finally fabricated with a 3D printing system and used in ear re construction surgery in our institute. Results: The 3D implants were manufactured for application to the currently used two-stage technique while maintaining the shape of the patient’s normal ear. The implants were successfully used for ear reconstruction surgery in microtia patients. A few months later, the 2nd stage implant was used in the 2nd stage operation. Conclusion: The authors were able to design, fabricate, and apply patient-specific 3D-printed ear implants for 1st and 2nd stage ear reconstruction surgeries. This design, combined with 3D bioprinting technique, may be a future alternative for ear reconstruction.
참고문헌 (22)
- Tanzer RC, "Total reconstruction of the external ear", Plast Reconstr Surg Transplant Bull, 23, pp.1~15 (1959)
- Brent B, "The correction of microtia with autogenous cartilage grafts : II. Atypical and complex deformities", Plast Reconstr Surg, 66, pp.13~21 (1980)
- Nagata S, "A new method of total reconstruction of the auricle for microtia", Plast Reconstr Surg, 92, pp.187~201 (1993)
- Reinisch JF, "Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap", Facial Plast Surg, 25, pp.181~189 (2009)
- Nagata S, "Total auricular reconstruction with a three-dimensional costal cartilage framework", Ann Chir Plast Esthet, 40, pp.371~399 (1995)
- 황건, "White radish and swine scapular cartilage models for auricular framework carving training", Archives of Craniofacial Surgery, 21(4), pp.225~228 (2020), 대한두개안면성형외과학회[DOI]
- Jae Hyeok Choi, "Cranioplasty and temporal hollowing correction with a three-dimensional printed bioresorbable mesh and double vertical suture anchor muscle sling: a case report", Archives of Craniofacial Surgery, 23(4), pp.178~182 (2022), 대한두개안면성형외과학회
- Lee JS, "Three-dimensional cell printing of large-volume tissues : application to ear regeneration", Tissue Eng Part C Methods, 23, pp.136~145 (2017)
- Lee JM, "Artificial auricular cartilage using silk fibroin and polyvinyl alcohol hydrogel", Int J Mol Sci, 18, pp.1707~ (2017)
- Chen HY, "Pursuing mirror image reconstruction in unilateral microtia : customizing auricular framework by application of three-dimensional imaging and three-dimensional printing", Plast Reconstr Surg, 139, pp.1433~1443 (2017)
- Flores RL, "The technique for 3D printing patient-specific models for auricular reconstruction", J Craniomaxillofac Surg, 45, pp.937~943 (2017)
- Park JY, "Development of a 3D cell printed structure as an alternative to autologs cartilage for auricular reconstruction", J Biomed Mater Res B Appl Biomater, 105, pp.1016~1028 (2017)
- Jung BK, "Ideal scaffold design for total ear reconstruction using a three-dimensional printing technique", J Biomed Mater Res B Appl Biomater, 107, pp.1295~1303 (2019)
- Beahm EK, "Auricular reconstruction for microtia : part I. Anatomy, embryology, and clinical evaluation", Plast Reconstr Surg, 109, pp.2473~2482 (2002)
- Walton RL, "Auricular reconstruction for microtia : part II. Surgical techniques", Plast Reconstr Surg, 110, pp.234~249 (2002)
- Janis JE, "Otoplasty", Plast Reconstr Surg, 115, pp.60e~72e (2005)
- Wilkes GH, "Microtia reconstruction", Plast Reconstr Surg, 134, pp.464e~479e (2014)
- Baluch N, "Auricular reconstruction for microtia: a review of available methods", Plast Surg(Oakv), 22, pp.39~43 (2014)
- Williams JD, "Porous high-density polyethylene implants in auricular reconstruction", Arch Otolaryngol Head Neck Surg, 123, pp.578~583 (1997)
- Kim YS, "Salvage of ear framework exposure in total auricular reconstruction", Ann Plast Surg, 78, pp.178~183 (2017)
- Wu JM, "Autogenous costal cartilage with Medpor: a compound auricular framework applied to one-stage total ear reconstruction", Zhonghua Zheng Xing Wai Ke Za Zhi, 20, pp.121~123 (2004)
- Park SH, "New application of three-dimensional printing biomaterial in nasal reconstruction", Laryngoscope, 127, pp.1036~1043 (2017)
