Three-dimensional (3D) Printed Model to Plan the Endoscopic Treatment of Upper Airway Stenosis

Whitmore

et al. 2021

Anaesth Intensive Care

Although a wide range of medical applications for three-dimensional printing technology have been recognised, little has been described about its utility in critical care medicine. The aim of this review was to identify three-dimensional printing applications related to critical care practice. A scoping review of the literature was conducted via a systematic search of three databases. A priori specified themes included airway management, procedural support, and simulation and medical education. The search identified 1544 articles, of which 65 were included. Ranging across many applications, most were published since 2016 in non – critical care discipline-specific journals. Most studies related to the application of three-dimensional printed models of simulation and reported good fidelity; however, several studies reported that the models poorly represented human tissue characteristics. Randomised controlled trials found some models were equivalent to commercial airway-related skills trainers. Several studies relating to the use of three-dimensional printing model simulations for spinal and neuraxial procedures reported a high degree of realism, including ultrasonography applications three-dimensional printing technologies. This scoping review identified several novel applications for three-dimensional printing in critical care medicine. Three-dimensional printing technologies have been under-utilised in critical care and provide opportunities for future research.

Section: Resultsmentioning

confidence: 99%

“…21 Three other studies included printed models to plan and rehearse intubation preoperatively in complex cases related to a laryngectomy, tracheal stenosis and a head and neck cancer. 22–24…”

Section: Resultsmentioning

confidence: 99%

Applications of 3D printing in critical care medicine: A scoping review

Whitmore

et al. 2021

Anaesth Intensive Care

“…The distance between the proximal end of the stenosis and vocal cord could be precisely shown by the 3D model, which could facilitate clinical decision making for each patient. Furthermore, the 3D model could also be used for resident teaching and patient education ( 10 , 15 ). However, it should be noted that the major limitation of customized stents is the time required to manufacture the stent.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experience With a Novel Metallic Segmented Transcordal Stent Modified With Three-Dimensional Printing for Inoperable Malignant Laryngotracheal Stenosis

et al. 2021

BackgroundThis study aims to assess the feasibility of a novel metallic segmented transcordal stent modified with three-dimensional (3D) printing for treating inoperable malignant laryngotracheal stenosis and the tolerability of the stent.MethodsThis was a retrospective study. The stents were individually customized with the aid of 3D printing model based on the anatomic features of each patient’s airway. The stent was composed of two separate segments that corresponded to the larynx and the upper trachea. The stents were barrel-shaped at the proximal end to prevent migration. The proximal end of the stent was located slightly above the vocal cord. The technical and clinical success of stenting procedure, patient tolerability, and stent-related complications of patients were evaluated.ResultsTen patients with dyspnea caused by malignant laryngotracheal stenosis underwent implantation of such stents. Technical and clinical success of the stenting procedure were achieved in all patients. For all patients, basic communication in life could be maintained by speaking softly. During follow-up, one patient showed intolerance to the stent, and the stent was retrieved 2 weeks after stenting. Stent migration was found in one patient, and the position of the stent was readjusted. Granulation tissue proliferation was found in two patients and was treated with cryotherapy by bronchoscopy. There were no deaths associated with stenting.ConclusionsThe individually customized metallic segmented transcordal stent is feasible and tolerable for patients with inoperable malignant laryngotracheal stenosis. The implantation of this stent may serve as a novel alternative treatment for patients who are not suitable for surgery or tracheotomy.

Journal of Otolaryngology - Head & Neck Surgery

“…Three-dimensional (3D) printing is being employed in a variety of surgical specialties to improve patient care and is becoming standard of care in some [1]. These models enable preoperative in vitro planning [2,3], production of tailor-made grafts and stents [4,5], advanced training of surgical residents and improved patient education [6]. In otolaryngology, recent studies reported the use of 3D models of the larynx and trachea for laryngotracheal reconstruction (LTR) rehearsal [7], for training in endoscopic balloon dilations of subglottic stenosis [8], for creating tissue-engineered airway grafts [9,10], and for other procedures [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Three dimensional printed models of the airway for preoperative planning of open Laryngotracheal surgery in children: Surgeon's perception of utility

Wasserzug

Fishman

Neiderman

et al. 2021

Background Preoperative planning of open laryngotracheal surgery is important for achieving good results. This study examines the surgeon’s perception of the importance of using life size 3D printed models of the pediatric airway on surgical decision making. Methods Life-size three-dimensional models of the upper airway were created based on CT images of children scheduled for laryngotracheal-reconstruction and cricotracheal resection with anastomosis. Five pediatric airway surgeons evaluated the three-dimensional models for determining the surgical approach, incision location and length, graft length, and need for single or double-stage surgery of seven children (median age 4.4 years, M:F ratio 4:3). They rated the importance of the three-dimensional model findings compared to the direct laryngoscopy videos and CT findings for each domain on a validated Likert scale of 1–5. Results The mean rating for all domains was 3.6 ± 0.63 (“moderately important” to “very important”), and the median rating was 4 (“very important”). There was full agreement between raters for length of incision and length of graft. The between-rater agreement was 0.608 (“good”) for surgical approach, 0.585 (“moderate”) for incision location, and 0.429 (“moderate”) for need for single- or two-stage surgery. Conclusion Patient-specific three-dimensional printed models of children’s upper airways were scored by pediatric airway surgeons as being moderately to very important for preoperative planning of open laryngotracheal surgery. Large–scale, objective outcome studies are warranted to establish the reliability and efficiency of these models. Graphical abstract