Purpose:
This study seeks to test a novel technique of custom-printed midface contour models with orbital floor “stamps” to guide reconstruction of orbital floor blowout fractures, with or without concomitant zygomaticomaxillary complex injury.
Methods:
A series of 4 consecutive patients with orbital floor blowout fractures (including 3 with zygomatic maxillary complex fractures) were retrospectively examined for outcomes associated with orbital floor reconstruction using 3-dimensional–printed stamps and midface models. Data collected included demographics, pre- and postoperative visual globe malposition, motility, and visual field disturbances. Three-dimensional printing methodology is reported, as well as associated costs and time required to generate the models and stamps.
Results:
The cost of producing a midface-contour model and orbital floor stamps was $131, inclusive of labor and materials. Cases averaged 170 minutes to segment, design, and print. Patients with preoperative diplopia and motility restrictions had resolution of their symptoms. Two patients had resolution of their enophthalmos, while one patient with a concomitant zygomaticomaxillary fracture had persistent mild enophthalmos.
Conclusions:
Midface contour models and orbital floor stamps may be produced in a timely and cost-effective manner. Use of these “homemade” stamps allows for patient-specific custom-contoured orbital floor reconstruction. Further studies are warranted to examine long-term visual and esthetic outcomes for these patients.
Background:
Industry-printed (IP) 3-dimensional (3D) models are commonly used for secondary midfacial reconstructive cases but not for acute cases due to their high cost and long turnaround time. We have begun using in-house (IH) printed models for complex unilateral midface trauma. We hypothesized that IH models would decrease cost and turnaround time, compared with IP models.
Methods:
We retrospectively examined cost and turnaround time data from midface trauma cases performed in 2017–2019 using 3D models (total, n = 15; IH, n = 10; IP, n = 5). Data for IH models were obtained through itemized cost reports from our Biomedical Engineering Department, where the models were printed. Data associated with IP models were obtained through itemized cost reports from our industry vendor. Perioperative data were collected from electronic medical records.
Results:
The average cost for IH models ($236.38 ± 26.17) was significantly less (
P
< 0.001) than that for IP models ($1677.82 ± 488.43). Minimal possible time from planning to model delivery was determined. IH models could be produced in as little as 4.65 hours, whereas the IP models required a minimum of 5 days (120 hours) from order placement. There were no significant differences in average operating room time (
P
= 0.34), surgical complications, or subjective outcomes, but there was a significant difference in estimated blood loss (
P
= 0.04).
Conclusion:
Utilization of IH 3D skull models is a creative and practical adjunct to complex unilateral midfacial trauma that also reduces cost and turnaround time compared with IP 3D models.
pathways, including purine and pyrimidine synthesis, were inhibited after JQ-1 treatment. Finally, real-time PCR showed that GART, TYMS, MTR and DHFR were upregulated after MTX treatment. However, these genes were downregulated after combination with JQ-1. Conclusion: Our results indicated that the combination of DHFR inhibitor MTX and BRD4/MYC inhibitor JQ-1 could induce synthetic lethality in pancreatic cancer both in vitro and in vivo, by disturbing nucleotide biosynthesis pathways. This study may provide us with a promising strategy by using MTX and JQ-1, to increase the efficacy of chemotherapy of pancreatic cancer.
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