Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Radiology, Yale New Haven Hospital. York Street, New Haven, Connecticut.
Otol Neurotol. 2019 Feb;40(2):246-253. doi: 10.1097/MAO.0000000000002073.
Patient-specific 3D printed models are useful presurgical planning tools because they accurately represent the anatomy and drilling characteristics of the middle cranial fossa (MCF) approach to the internal auditory canal (IAC).
The MCF approach to the IAC can be challenging due to variability of the bony architecture along the floor of the middle fossa. Patient-specific 3D printed models may enhance surgeon knowledge of a given patient's anatomy when preparing for MCF surgery.
Six temporal bone models were printed from photoacrylic resin based on CT data obtained from cadaveric specimens using a desktop stereolithography 3D printer. Critical structures to avoid injuring, the facial nerve and membranous labyrinth, were modeled as hollow cavities and filled with indicator paint. Two neurotologists each drilled three 3D printed models and the corresponding cadaveric specimens, and then completed a 41-item visual analog scale questionnaire (score range of each item: 0-10) to assess the model's accuracy, utility, and potential as a training tool.
Drilling the model was favorably rated (median score 9.2; range 7.3-9.6) for its ability to provide surgeons with an accurate mental image of the corresponding cadaveric anatomy. Overall similarity of feel of drilling the model in comparison to human bone was moderate (median 7.6; range 6.6-9.0). Surgeons would use this model to prepare for future cases (median 9.4; range 5.1-9.9) and felt it had excellent utility for training purposes (median 9.3; range 8.4-9.9).
Patient-specific 3D printed models provide an anatomically accurate and favorable tool for preparing for MCF surgery.
患者特异性 3D 打印模型是有用的术前规划工具，因为它们准确地代表了中颅窝（MCF）入路至内听道（IAC）的解剖结构和钻骨特征。
由于中颅窝底部的骨结构存在差异，因此 MCF 入路至 IAC 可能具有挑战性。患者特异性 3D 打印模型可以增强外科医生对特定患者解剖结构的了解，从而为 MCF 手术做准备。
根据从尸体标本获得的 CT 数据，使用桌面立体光刻 3D 打印机，从光聚合树脂打印出 6 个颞骨模型。将面神经和膜迷路等重要的结构建模为空心腔，并填充指示漆，以避免损伤。两位神经耳科医生每人钻 3 个 3D 打印模型和相应的尸体标本，然后完成 41 项视觉模拟量表问卷（每个项目的评分范围为 0-10），以评估模型的准确性、实用性和作为培训工具的潜力。
钻孔模型的评分较高（中位数为 9.2；范围为 7.3-9.6），因为它能够为外科医生提供与相应尸体解剖结构的准确心理图像。与人类骨骼相比，模型钻孔的感觉相似性中等（中位数为 7.6；范围为 6.6-9.0）。外科医生将使用该模型为未来的病例做准备（中位数为 9.4；范围为 5.1-9.9），并认为它在培训目的方面具有出色的实用性（中位数为 9.3；范围为 8.4-9.9）。
患者特异性 3D 打印模型为 MCF 手术的准备提供了一种解剖学上准确且有利的工具。
