Personalized Surgery Service in a Tertiary Hospital: A Method to Increase Effectiveness, Precision, Safety and Quality in Maxillofacial Surgery Using Custom-Made 3D Prostheses and Implants

Romero, J. Pamias; Masnou-Pratdesaba, Joan; Sáez‐Barba, Manel; de-Pablo-García-Cuenca, Alba; Siurana-Montilva, Sahyly; Sala‐Cunill, Anna; Valls-Comamala, Victòria; Pujol-Pina, Rosa; Bescós‐Atín, Coro

doi:10.3390/jcm11164791

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…In the same way that the RSNA [ 12 ] created the special interest group on 3D printing for correct technology transfer, we consider it important to collaborate in national networks, with the aim of generating national guidelines and activity codes within radiology, through Scientific Societies. In addition, the establishment of indicators that allow for the assessment of the global process and for the integration of all professionals involved has been suggested by some studies [ 53 ]. However, the heterogeneity of the technology and of the surgical techniques and equipment themselves must be considered.…”

Section: Discussionmentioning

confidence: 99%

Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department

et al. 2022

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Objective: Three-dimensional printing has become a leading manufacturing technique in healthcare in recent years. Doubts in published studies regarding the methodological rigor and cost-effectiveness and stricter regulations have stopped the transfer of this technology in many healthcare organizations. The aim of this study was the evaluation and implementation of a 3D printing technology service in a radiology department. Methods: This work describes a methodology to implement a 3D printing service in a radiology department of a Spanish public hospital, considering leadership, training, workflow, clinical integration, quality processes and usability. Results: The results correspond to a 6-year period, during which we performed up to 352 cases, requested by 85 different clinicians. The training, quality control and processes required for the scaled implementation of an in-house 3D printing service are also reported. Conclusions: Despite the maturity of the technology and its impact on the clinic, it is necessary to establish new workflows to correctly implement them into the strategy of the health organization, adjusting it to the needs of clinicians and to their specific resources. Significance: This work allows hospitals to bridge the gap between research and 3D printing, setting up its transfer to clinical practice and using implementation methodology for decision support.

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Section: Discussionmentioning

confidence: 99%

Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department

et al. 2022

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“…Therefore, a device that easily repositions the fragment and serves as a reinforcement for fixation is desired. Recently, 3D virtual planning and customized 3D printing has been introduced, showing promising results in dentistry [ 13 ] and maxillofacial surgery [ 14 ]. This report presents a case of condyle fracture at the upper neck region treated with custom-made titanium mesh and titanium miniplate, which make it easy to reposition the fragment and keep it in place.…”

Section: Introductionmentioning

confidence: 99%

Condyle Fracture Fixed with Custom-Made Titanium Mesh and a Miniplate: A Case Report

Kawai,

Kawamata,

Suzuki

et al. 2023

Am J Case Rep

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Patient: Male, 20-year-old Final Diagnosis: Condyle fracture Symptoms: Deviation of mandible Clinical Procedure: — Specialty: Dentistry Objective: Unusual or unexpected effect of treatment Background: Open reduction and internal fixation of condyle fractures are sometimes difficult for the upper region. This report presents a case of condyle fracture at the upper neck region treated with a custom-made titanium mesh and a titanium miniplate, which makes it easy to reposition the fragment and keep it in place. Case Report: A 20-year-old man was injured during a soccer match and was referred to our hospital with the symptom of trismus and deviation of the mandible to the left with an opened mouth. Fracture of the right condyle neck region was diagnosed; open reduction and internal fixation was planned under general anesthesia. A custom-made titanium mesh was prepared to make it easy to reposition the fragment and keep it in place because the reduction and fixation were expected to be difficult. The fracture region was exposed using the modified Risdon-Strasbourg approach. The segments were gripped with custom-made titanium mesh, and the condyle head was reduced easily. The segments were fixed with titanium mesh, a miniplate, and screws. Nine months after the operation, the mouth opening was good at 40 mm, there was no deviation of the mandible, and there was no breakage on the titanium mesh or plate. Conclusions: This report presents a case of condyle fracture at the upper neck region reduced and fixed with a custom-made titanium mesh and a titanium miniplate, which make it easy to reposition the fragment and keep it in place.

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Can we improve electrocorticography using a circular grid array in brain tumor surgery?

Freund,

Sherman,

Sabsevitz

et al. 2023

Biomed. Phys. Eng. Express

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Intraoperative electrocorticography (iECoG) is used as an adjunct to localize the epileptogenic zone during surgical resection of brain tumors in patients with focal epilepsies. It also enables monitoring of after-discharges and seizures with EEG during functional brain mapping with electrical stimulation. When seizures or after-discharges are present, they complicate accurate interpretation of the mapping strategy to outline the brain’s eloquent function and affect the surgical procedure. Recurrent seizures during surgery requires urgent treatment and, when occurring during awake craniotomy, may lead to premature termination of brain mapping due to post-ictal confusion or sedation from acute rescue therapy. There are mixed results in studies on efficacy with iECoG in patients with epilepsy and brain tumors influencing survival and functional outcomes following surgery. Commercially available electrode arrays have inherent limitations. These could be improved with customization potentially leading to greater precision in safe and maximal resection of brain tumors. Few studies have assessed customized electrode grid designs as an alternative to commercially available products. High density electrode grids improve spatial delineation of electrophysiologic sources, including epileptiform activity, electrographic seizures, and afterdischarges on iECoG during functional brain mapping. In response to the shortcomings of current iECoG grid technologies, we designed and developed a novel high-density hollow circular electrode grid array. The 360-degree iECoG monitoring capability allows continuous EEG recording during surgery through the aperture with and without electrical stimulation mapping. Compared with linear strip electrodes that are commonly used for iECoG during surgery, the circular grid demonstrates significant benefits in brain tumor surgery. This includes quicker recovery of post-operative motor deficits (2.4 days vs. 9 days, p=0.05), more extensive tumor resection (92.0% vs. 77.6%, p=0.003), lesser reduction in Karnofsky Performance scale postoperatively (-2 vs. -11.6, p=0.007), and more sensitivity to recording afterdischarges. In this narrative review, we discuss the advantages and disadvantages.

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Personalized Surgery Service in a Tertiary Hospital: A Method to Increase Effectiveness, Precision, Safety and Quality in Maxillofacial Surgery Using Custom-Made 3D Prostheses and Implants

Cited by 4 publications

References 20 publications

Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department

Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department

Condyle Fracture Fixed with Custom-Made Titanium Mesh and a Miniplate: A Case Report

Can we improve electrocorticography using a circular grid array in brain tumor surgery?

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