Low-cost Design and Manufacturing of Surgical Guides for Mandibular Reconstruction Using a Fibula

Numajiri, Toshiaki; Nakamura, Hiroko; Sowa, Yoshihiro; Nishino, Kenichi

doi:10.1097/gox.0000000000000682

Cited by 40 publications

(23 citation statements)

References 12 publications

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“…Despite both the availability (in the USA) and ongoing refinement of virtual planning software systems, it is still not in routine use [3]. Additionally, this technology is not readily available internationally [4]. Applications for its use thus far, in the head and neck, have included complex craniofacial surgery, osseous reconstruction following resection of both benign and malignant tumors and osteoradionecrosis (ORN) [1, 2, 5–8].…”

Section: Introductionmentioning

confidence: 99%

Using 3D computer planning for complex reconstruction of mandibular defects

et al. 2016

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For complex reconstruction of osseous defects of the head and neck, three-dimensional (3D) computer planning has been available for over 20 years. However, despite its availability and recent refinements, it is a technology that has not been widely adopted. While 3D computer planning has been proposed to improve surgical precision, reduce operating time and enhance functional outcomes, the objective evidence supporting these claims is limited. Here we review the recent literature that supports the use of 3D computer planning for complex osseous defects of the mandible. We highlight a case example where 3D modeling played a critical role, particularly during the virtual surgical planning stage. Finally, we propose that routine post-operative 3D analysis become an essential element in determining operative success. Critical evaluation of outcomes will better define its use in complex reconstruction of osseous defects.

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Section: Introductionmentioning

confidence: 99%

Using 3D computer planning for complex reconstruction of mandibular defects

et al. 2016

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“…37 Another study noted a 1.33-mm deviation for mandible osteotomy. 51 Two studies in particular noted that ear trauma was easily reapproximated using high fidelity mirror models of the opposite side of the patient. 52,53 While highresolution imaging is a routine part of trauma and orthognathic management, implementation of some 3D printing strategies may be cost-prohibitive in settings with low trauma volume.…”

Section: Three-dimensional Printing and Patient-specific Modelingmentioning

confidence: 99%

“…37 Another study found a 2.4-mm deviation for a mandibular reconstruction with a fibula free flap. 51 Examples of reconstruction guides used for a fibula free flap case in our institution are shown in ►Figs. 1 and 2.…”

Section: Flap Reconstructionmentioning

confidence: 99%

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

et al. 2020

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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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“…Bringing the 3D printing process in-house (IH) has the benefit of lowering cost and production time for reconstruction of secondary or delayed reconstructions. Numajiri et al 23 reported that 3D printing surgical guides for mandibular reconstruction could be produced for $400. Others demonstrated that a mock patient-specific craniofacial reconstruction model could be produced for about $250.…”

Section: Introductionmentioning

confidence: 99%

Cost Analysis for In-house versus Industry-printed Skull Models for Acute Midfacial Fractures

Lor

Massary

Chung

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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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.

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Low-cost Design and Manufacturing of Surgical Guides for Mandibular Reconstruction Using a Fibula

Cited by 40 publications

References 12 publications

Using 3D computer planning for complex reconstruction of mandibular defects

Using 3D computer planning for complex reconstruction of mandibular defects

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

Cost Analysis for In-house versus Industry-printed Skull Models for Acute Midfacial Fractures

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