Montefiore 3D Printing and Innovation Laboratory, Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, Montefiore Green Medical Arts Pavilion, Albert Einstein College of Medicine, 812 Park Ave, Bronx, New York, NY, 10021, US.
Aesthetic Plast Surg. 2021 Dec;45(6):2852-2859. doi: 10.1007/s00266-021-02350-z. Epub 2021 Jun 1.
As computer simulation for rhinoplasty continues to rise, the technology's utility extends beyond increasing patient conversion. Virtual simulation of the surgical result can assist with surgical planning and intraoperative decision-making. 3D printed anatomic models or surgical guides based on 3D images may help align surgeons with their original surgical plan. This study aims to evaluate the utility of 3D printed surgical guides as an intraoperative tool to help establish dorsal height and tip position.
Patients undergoing rhinoplasty had preoperative virtual 3D surgical simulations performed. Simulations were used to create a 3D printed nasal kits containing ceramic models of the preoperative nose and simulated nose, sagittal contour guide, and customized postoperative nasal splint. Nasal guides were sterilized for continual intraoperative assessment of profile contour (i.e., dorsal height and tip position). Postoperative 3D images (1-3 months post-op) were then compared to preoperative simulations. The difference between z coordinates and y coordinates determined the difference in projection and rotation, respectively.
Fifteen patients met inclusion criteria for this study. With the use of 3D printed surgical guides, the final tip position was on average of 0.8±0.7mm from simulated projection and 0.3±0.2mm from simulated rotation. Similarly, projection for the cartilaginous and bony dorsum was within 1.0±0.8 and 0.8±0.7mm of the simulation, respectively.
Virtual simulation is useful in defining aesthetic goals preoperatively, but the potential clinical value extends beyond this. 3D printed rhinoplasty guides extend the simulation's utility to decision-making intraoperatively. This technology offers a novel medium for anatomic reference, which may improve adherence to desired aesthetic goals.
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随着鼻整形术的计算机模拟不断发展，该技术的应用不仅限于提高患者转化率。手术结果的虚拟模拟可以辅助手术规划和术中决策。基于 3D 图像的 3D 打印解剖模型或手术导板可能有助于使外科医生与原始手术计划保持一致。本研究旨在评估 3D 打印手术导板作为术中工具的效用，以帮助确定鼻背高度和鼻尖位置。
接受鼻整形术的患者进行术前虚拟 3D 手术模拟。模拟用于创建包含术前和模拟鼻子的陶瓷模型、矢状轮廓导板以及定制的术后鼻夹板的 3D 打印鼻套件。对鼻导板进行消毒，以便在术中持续评估轮廓（即鼻背高度和鼻尖位置）。然后将术后 3D 图像（术后 1-3 个月）与术前模拟进行比较。z 坐标和 y 坐标之间的差异分别确定投影和旋转的差异。
本研究纳入了 15 名符合条件的患者。使用 3D 打印手术导板，最终鼻尖位置平均距离模拟投影为 0.8±0.7mm，距离模拟旋转为 0.3±0.2mm。同样，软骨和骨性鼻背的投影分别在 1.0±0.8mm 和 0.8±0.7mm 内模拟。
虚拟模拟在术前定义美学目标方面很有用，但潜在的临床价值远不止于此。3D 打印鼻整形术导板扩展了模拟在术中的效用。这项技术为解剖参考提供了一种新的媒介，可能有助于更好地遵守期望的美学目标。
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