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... Nevertheless, there are multiple studies where PET-G was utilized to create a mold for the PMMA cranial implants. Kim et al. [164], Parthasarathyet [165] as well as Surme [166] used various techniques of mold preparation, whereas they all reported the avoidance of local and systemic PMMA-associated toxic adverse reactions as well as brain or dural tissue destruction. In each study, the operation time was significantly decreased with the preservation of high aesthetic value. ...
The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.
... Class 3. Procedures classification refers to 3DP objects used intraoperatively to facilitate procedures (42.9%); it was further subdivided into four subtypes: contour model, guides, splints, and implants. Type I-Contour models 10,11,13,14,20,29,32,34,46,48,52,53,[60][61][62]64,67,68,72,82,84,86,89,96,109,110,118,122,125,135,136 (10.8%) are positivespace models based on either real or virtually modeled anatomy, such as a virtually mirrored contralateral ear, printed and used as a reference to reconstruct a congenitally absent ear. 13 negative-space models based on actual patient anatomy, designed to contour to a segment of anatomy and allow for precise cutting or drilling that avoids critical structures, enabling precise screw placement in spinal surgery, for example. ...
... Airway support 23,63,113 Cranioplasty/cranial vault remodeling 31,39,40,54,56,83,84,89 Dentistry/oral surgery 33,48,[60][61][62]64,68,70,72,77,81,85 Distraction osteogenesis 32,37,41,43,44,51,59,65,73,91 Ex-utero intrapartum treatment of craniofacial abnormalities 57 Microtia repair/prosthesis 9,11,[13][14][15] Nasal alveolar molding/orthodontics 12,38,42,47,49 Orbital reconstruction 53,86,88 Orthognathic surgery 75 Repair of skull base defect 35 Tumor resection 97,100,143,146,147 Cardiothoracic Coarctation of aorta 25,118 Double outlet right ventricle 24,[105][106][107]112,119,120 Heart transplant 109 Other congenital heart disease 26,[101][102][103]108,117,121,144 Other vascular anomalies 24,107,110,116,139 Pulmonary atresia 104,107 Transposition of the great arteries 27,36,107 Truncus arteriosus 27 Ventricular septal defect 105,106,110,111,114,119,120 Upper extremity Hand transplant 123,126 Prosthetic hands 16,19,21,22,123,124,127 Tumor resection 17 Lower extremity Clubfoot 130 Developmental hip dysplasia 128,129,134 Limb lengthening 135 Slipped capital femoral epiphysis 131 Corrective osteotomies 29 Tumor resection 20,137,141,142 Genitourinary ...
Three-dimensional printing (3DP) addresses distinct clinical challenges in pediatric care including: congenital variants, compact anatomy, high procedural risk, and growth over time. We hypothesized that patient-specific applications of 3DP in pediatrics could be categorized into concise, discrete categories of use.
Terms related to “three-dimensional printing” and “pediatrics” were searched on PubMed, Scopus, Ovid MEDLINE, Cochrane CENTRAL, and Web of Science. Initial search yielded 2122 unique articles; 139 articles characterizing 508 patients met full inclusion criteria.
Four categories of patient-specific 3DP applications were identified: Teaching of families and medical staff (9.3%); Developing intervention strategies (33.9%); Procedural applications, including subtypes: contour models, guides, splints, and implants (43.0%); and Material manufacturing of shaping devices or prosthetics (14.0%). Procedural comparative studies found 3DP devices to be equivalent or better than conventional methods, with less operating time and fewer complications.
Patient-specific applications of Three-Dimensional Printing in Medicine can be elegantly classified into four major categories: Teaching, Developing, Procedures, and Materials, sharing the same TDPM acronym. Understanding this schema is important because it promotes further innovation and increased implementation of these devices to improve pediatric care.
This article classifies the pediatric applications of patient-specific three-dimensional printing.
This is a first comprehensive review of patient-specific three-dimensional printing in both pediatric medical and surgical disciplines, incorporating previously described classification schema to create one unifying paradigm.
Understanding these applications is important since three-dimensional printing addresses challenges that are uniquely pediatric including compact anatomy, unique congenital variants, greater procedural risk, and growth over time.
We identified four classifications of patient-specific use: teaching, developing, procedural, and material uses.
By classifying these applications, this review promotes understanding and incorporation of this expanding technology to improve the pediatric care.
... If the craniectomy lap is unavailable due to conditions such as a calvarial neoplasm or bone loss, rib bones like autografts can be harvested for autologous bone graft. However, when a large skull defect or autologous bone resorption is at present, autografts may be insuf icient for achieving good cosmetic outcome and cerebral protection [3,4]. ...
... The reconstruction of cranial bone defects has great importance for the protection of the brain and vital structures. Besides the functional aspects of the procedure, aesthetics should be considered as well by cosmetic restoration of the cranial contours [3]. Although autologous bone is the optimal choice as a bone lap, due to factors as bone resorption and infection, it is not always available [2]. ...
... Three-dimensional (3D) printing of patient-specific anatomical models has shown value as an educational tool and a procedureplanning adjunct. 15,16 Using the technique of stereolithography, anatomical models of patient-specific anatomy have been successfully printed in a clinically feasible fashion using the affordable and high-resolution desktop 3D printers that are now commercially available. A combination of simulation technology and 3D printing provides a good landscape to design realistic high-fidelity models for resident education. ...
Background and objectives:
Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model.
Methods:
We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine. The thoracic spine was segmented from the scan, and a 3-dimensional model of the spine was generated and printed. It was then placed in a customized wooden box and filled with different types of silicone to mimic human tissues. Attending physicians in our institution then tested the final model. They were asked to fill out a brief questionnaire after the identification of the landmarks and epidural space using ultrasound and real-time performance for a thoracic epidural on the model (Supplemental Digital Content 1, http://links.lww.com/AAP/A197). Likert scoring system was used for scoring.
Results:
The time to develop this simulator model took less than 4 days, and the materials cost approximately $400. Fourteen physicians tested the model for determining the realistic sensation while palpating the spinous process, needle entry through the silicone, the "pop" sensation and ultrasound fidelity of the model. Whereas the tactile fidelity scores were "neutral" (3.08, 3.06, and 3.0, respectively), the ultrasound guidance and overall suitability for residents were highly rated as being the most realistic (4.85 and 4.0, respectively).
Conclusions:
It is possible to develop homemade, low-cost, patient-specific, and high-fidelity ultrasound guidance simulators for resident training in thoracic epidurals using 3-dimensional printing technology.
Unilateral lambdoid synostosis is the rarest form of single-suture craniosynostosis. Although various surgical approaches have been described, cranial vault remodeling remains the predominant approach. To aid in surgical planning, preoperative virtual surgical modeling using a patient's presenting computed tomography scan can be used to increase reconstructive precision and to reduce operative time. Presented is a 7-month-old male with unilateral lambdoid synostosis who underwent medically modeled cranial vault reconstruction.
Sinking skin flap syndrome (SSFS), also known as syndrome of the trephined, is one of the complications of decompressive craniectomy. The definitive treatment for the condition is cranioplasty, but there are cases where that is not an option. We report a seventy-seven-year-old male patient with disturbance of consciousness after removal of infected bone flap and debridement. The skin showed marked depression and SSFS was diagnosed. The scalp had contracted due to infection and debridement so as to need skin grafting. Cranioplasty with a full-size bone flap was not an option. Reconstruction of the temporal line with autologous rib graft was performed. The patient became alert after the operation.
Abstract Cranioplasty is a reconstruction operation made to protect intracranial structures. It is applied for the closure of bone defects occurring due to causes such as trauma, tumor, infection, and infarct. Many different products changing from autologous bone grafts to synthetic materials are used for cranioplasty. Three-dimensional printers that are among the popular innovations of today are used gradually more in medical area as in every field of life and they make the surgical operation easier. When customizable materials are combined with technology, the authors come across successful results and less complications. The aim of the authors’ study was to show a 3-dimensional modeling method in 2 patients the authors applied cranioplasty and the advantages provided by this method for the surgeon and the patient.
