European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Int J Oral Maxillofac Surg. 2021 Jun;50(6):815-819. doi: 10.1016/j.ijom.2020.10.006. Epub 2020 Nov 6.
Bone-anchored epitheses have acquired an important role in auricle reconstruction. The purpose of this technical note is to present a fully in-house digital workflow for the design and three-dimensional (3D) printing of an optimal ear epithesis guide. Two hemifacial microsomia patients with grade IV microtia were treated accordingly. The upper dental arch was optically scanned and a cone beam computed tomography scan of the cranium was obtained. The composite and soft tissue models created were exported into 3D sculpting software. The unaffected ear was virtually mirrored onto the affected side and two ideal implant positions were defined in relation to bone thickness, contralateral symmetry, and housing of the retaining bar. A bite wafer was virtually designed on the upper dental arch and connected to the mirrored ear. The pilot guide was 3D-printed and allowed for correct positioning and orientation during surgery. The prosthetic pinna was manufactured in a conventional way. A bar with retaining clips was used to anchor the prosthetic pinna. Clinically satisfactory results were obtained in two grade IV microtia cases. The fully digital workflow presented to design and 3D-print an optimal ear epithesis guide offers a good alternative to the existing techniques.
骨锚式赝复体在耳廓重建中具有重要作用。本技术说明的目的是介绍一种完全内部化的数字工作流程，用于设计和三维（3D）打印最佳耳假体导板。我们对两名单侧颜面发育不全伴 IV 级小耳畸形的患者进行了相应治疗。对患者的上颌牙弓进行光学扫描，并对颅骨进行锥形束计算机断层扫描。将创建的复合组织和软组织模型导出到 3D 雕刻软件中。将正常侧耳虚拟镜像到患侧，并根据骨厚度、对侧对称性和保留杆的容纳情况确定两个理想的植入位置。在上颌牙弓上虚拟设计咬合片，并将其与镜像耳连接。3D 打印导板，以便在手术中正确定位和定向。然后以传统方式制造带有固定夹的杆以固定假体耳。在两名 IV 级小耳畸形患者中均获得了临床满意的结果。用于设计和 3D 打印最佳耳假体导板的完全数字化工作流程为现有技术提供了一种很好的替代方案。
