Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States.
Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States.
Oral Oncol. 2022 Sep;132:105976. doi: 10.1016/j.oraloncology.2022.105976. Epub 2022 Jul 6.
Microvascular free flap reconstruction has remained the standard of care in reconstruction of large tissue defects following ablative head and neck oncologic surgery, especially for bony structures. Computer aided design/computer assisted manufacturing (CAD/CAM) and 3-dimensionally (3D) printed models and devices offer novel solutions for reconstruction of bony defects. Conventional free hand techniques have been enhanced using 3D printed anatomic models for reference and pre-bending of titanium reconstructive plates, which has dramatically improved intraoperative and microvascular ischemia times. Improvements led to current state of the art uses which include full virtual planning (VP), 3D printed osteotomy guides, and patient specific reconstructive plates, with advanced options incorporating dental rehabilitation and titanium bone replacements into the primary surgical plan through use of these tools. Limitations such as high costs and delays in device manufacturing may be mitigated with in house software and workflows. Future innovations still in development include printing custom prosthetics, 'bioprinting' of tissue engineered scaffolds, integration of therapeutic implants, and other possibilities as this technology continues to rapidly advance. This review summarizes the literature and serves as a summary guide to the historic, current, advanced, and future possibilities of 3D printing within head and neck oncologic surgery and bony reconstruction. This review serves as a summary guide to the historic, current, advanced, and future roles of CAD/CAM and 3D printing within the field of head and neck oncologic surgery and bony reconstruction.
游离微血管皮瓣重建一直是头颈部肿瘤术后大面积组织缺损重建的标准治疗方法，尤其是对骨结构。计算机辅助设计/计算机辅助制造 (CAD/CAM) 和三维 (3D) 打印模型和设备为骨缺损的重建提供了新的解决方案。传统的徒手技术已经通过使用 3D 打印解剖模型进行参考和预弯曲钛修复板得到了增强，这大大缩短了手术中和微血管缺血时间。改进带来了当前最先进的应用，包括全虚拟规划 (VP)、3D 打印截骨导板和患者特定的修复板，通过使用这些工具，将牙修复和钛骨置换纳入主要手术计划的高级选项。高成本和设备制造延迟等限制可以通过内部软件和工作流程来减轻。未来的创新仍在开发中，包括打印定制假体、组织工程支架的“生物打印”、治疗性植入物的整合以及随着这项技术的快速发展的其他可能性。这篇综述总结了文献，并对头颈肿瘤外科和骨重建中 3D 打印的历史、当前、先进和未来可能性进行了概述。这篇综述对头颈肿瘤外科和骨重建领域中 CAD/CAM 和 3D 打印的历史、当前、先进和未来作用进行了概述。
