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用于耳廓重建的3D打印患者特异性模型的技术。

The technique for 3D printing patient-specific models for auricular reconstruction.

作者信息

Flores Roberto L, Liss Hannah, Raffaelli Samuel, Humayun Aiza, Khouri Kimberly S, Coelho Paulo G, Witek Lukasz

机构信息

Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine New York, NY 10010, USA.

DDS Candidate New York University College of Dentistry, New York, NY 10010, USA.

出版信息

J Craniomaxillofac Surg. 2017 Jun;45(6):937-943. doi: 10.1016/j.jcms.2017.03.022. Epub 2017 Apr 6.

Abstract

PURPOSE

Currently, surgeons approach autogenous microtia repair by creating a two-dimensional (2D) tracing of the unaffected ear to approximate a three-dimensional (3D) construct, a difficult process. To address these shortcomings, this study introduces the fabrication of patient-specific, sterilizable 3D printed auricular model for autogenous auricular reconstruction.

METHODS

A high-resolution 3D digital photograph was captured of the patient's unaffected ear and surrounding anatomic structures. The photographs were exported and uploaded into Amira, for transformation into a digital (.stl) model, which was imported into Blender, an open source software platform for digital modification of data. The unaffected auricle as digitally isolated and inverted to render a model for the contralateral side. The depths of the scapha, triangular fossa, and cymba were deepened to accentuate their contours. Extra relief was added to the helical root to further distinguish this structure. The ear was then digitally deconstructed and separated into its individual auricular components for reconstruction. The completed ear and its individual components were 3D printed using polylactic acid filament and sterilized following manufacturer specifications.

RESULTS

The sterilized models were brought to the operating room to be utilized by the surgeon. The models allowed for more accurate anatomic measurements compared to 2D tracings, which reduced the degree of estimation required by surgeons. Approximately 20 g of the PLA filament were utilized for the construction of these models, yielding a total material cost of approximately $1.

CONCLUSION

Using the methodology detailed in this report, as well as departmentally available resources (3D digital photography and 3D printing), a sterilizable, patient-specific, and inexpensive 3D auricular model was fabricated to be used intraoperatively. This technique of printing customized-to-patient models for surgeons to use as 'guides' shows great promise.

摘要

目的

目前,外科医生通过对未受影响的耳朵进行二维(2D)描记来近似三维(3D)结构,以此进行自体小耳畸形修复,这是一个困难的过程。为解决这些缺点,本研究介绍了用于自体耳廓重建的患者特异性、可消毒的3D打印耳廓模型的制作方法。

方法

拍摄患者未受影响的耳朵及其周围解剖结构的高分辨率3D数码照片。将照片导出并上传到Amira中,转换为数字(.stl)模型,然后导入到Blender中,Blender是一个用于数据数字修改的开源软件平台。将未受影响的耳廓进行数字分离并反转,以生成对侧的模型。加深耳舟、三角窝和耳甲艇的深度以突出其轮廓。在耳轮根部增加额外的凸起以进一步区分该结构。然后将耳朵进行数字解构并分离成其各个耳廓组件以进行重建。使用聚乳酸细丝对完成的耳朵及其各个组件进行3D打印,并按照制造商的规格进行消毒。

结果

将消毒后的模型带到手术室供外科医生使用。与2D描记相比,这些模型能够进行更精确的解剖测量,减少了外科医生所需的估计程度。制作这些模型大约使用了20克聚乳酸细丝,材料总成本约为1美元。

结论

使用本报告中详细介绍的方法以及部门现有的资源(3D数码摄影和3D打印),制作了一个可消毒、患者特异性且廉价的3D耳廓模型,用于术中使用。这种为外科医生打印定制患者模型以供“指导”的技术显示出巨大的前景。

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