Sinonasal teratocarcinosarcoma is a rare, highly aggressive tumor of the anterior skull base composed of malignant epithelial, mesenchymal, and neural tissue. Examination of cases in patients in minority populations is important in order to better understand the behavior of this neoplasm and outcomes of treatment in our nation's diverse population.
Introduction: Stereolithography, also known as 3D printing (3DP), is a versatile and useful technology with many healthcare applications. While 3DP has gained tremendous popularity, it remains a daunting and perceptibly time-consuming process for the inexperienced user, with most turning to commercially printed products. Commercial vendors are expensive. We propose that 3DP is feasible for the inexperienced user with the appropriate knowledge and tools. Methods: A 3DP protocol was created for model design and printing using open-source software and a low-cost desktop printer. It was betatested by 3 inexperienced users. The fidelity of the protocol was then tested in direct comparison to industry models made for 3 patients undergoing mandibular distraction osteogenesis, using standard cephalometric measurements. Results: All inexperienced testers were able to successfully create a 3D model using the easy-to-follow protocol without the use of any other resources. The models were created in a mean time of 170 minutes. All cephalometric measurements on the open-source printed models were equal to within 0.5 to 1.0 mm of the respective industry models. Conclusions: As the 3DP process is simplified and desktop printers and materials become more affordable, we anticipate that its implementation will become more commonplace. We describe a step-by-step, protocol using open-source software and affordable materials to create 3D models.
Introduction: Mandibular Distraction Osteogenesis (MDO) is an alternative to tracheostomy and works via lengthening the mandible in order to reduce glossoptosis and airway obstruction. While many patients who undergo mandibular distraction avoid the use of a tracheostomy, some patients will require re-distraction or tracheostomy, often due to recurrence of sleep apnea. This paper explores the potential factors that are associated with MDO failure, defined as requiring re-distraction or tracheostomy over other patients who succeed with the initial procedure. Methods: A retrospective review of all patients who had an obstructed airway, 0 to 18 years of age, and underwent MDO at a single institution from 2008 to 2019 was performed. Fisher’s exact analysis, log-rank analysis, and Kaplan-Meier estimates were used to identify associated factors to failure post-MDO. Results: Forty-five patients satisfied the inclusion criteria, of which 11 patients required re-distraction or tracheostomy post-MDO. Of the parameters assessed, postoperative complications and age >1 month were associated with increased odds of failure ( P < .05). Syndromic status trended toward significance as an associated factor ( P < .1). Tonsillectomy & adenoidectomy before initial MDO was associated with postoperative complications ( P < .05). Conclusion: Our retrospective analysis not only corroborates the results of others in regards to the natural association of postoperative complications and syndromic status with MDO failure, but also suggest that prior tonsillectomy & adenoidectomy, and age at surgery in our series may play a role as well.
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