Gleissner H, Castrillon-Oberndorfer G, Gehrlich St
Klinik für Mund-, Kiefer- und plastische Gesichtschirurgie, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Bavaria, Germany.
MKG Praxis Regensburg, Bavaria, Germany.
Craniomaxillofac Trauma Reconstr. 2022 Dec;15(4):369-378. doi: 10.1177/19433875211050721. Epub 2021 Sep 30.
This study aimed to introduce 3D printing in a municipal hospital to improve the treatment of craniomaxillofacial patients and optimize costs and operating time. Thus we describe the implementation of low-cost in-house 3D printing to facilitate orbital- and mandible reconstruction in CMF surgery. Moreover, we address legal requirements, safety at work, fire- and data protection. Finally, we want to share our experiences using 3D printing and point out its advantages in providing better patient care.
We outline the setup of in-house 3D printing and focus on obeying German health care regulations. We based our approach on a fused deposition modeling 3D printer and free software. As proof of concept, we treated 4 cases of severe orbital trauma and 1 case of mandibular reconstruction. We printed a 3D patient-specific model for each case and adapted a titanium mesh implant, respectively, a titanium reconstruction plate before performing the surgery.
Our approach reduced costs, duration of anesthesia, operating time, recovery time, and postoperative swelling and increased the revenue. Functional outcome in orbital reconstruction like eye movement and double vision, was improved compared to the conventional technique. No severe complications like loss-of-vision or surgical revision occurred. Likewise, mandibular reconstruction showed no plate loosening or plate fracture.
The implementation of cost-efficient 3D printing resulted in successful patient treatment with excellent outcomes. Our practice guide offers a 3D printing workflow and could be adapted to fit the needs of other specialties like neurosurgery, orthopedic surgery as well.
本研究旨在将3D打印技术引入一家市级医院，以改善颅颌面患者的治疗效果，并优化成本和手术时间。因此，我们描述了低成本内部3D打印技术的实施，以促进颅颌面外科手术中的眼眶和下颌骨重建。此外，我们还讨论了法律要求、工作安全、防火和数据保护。最后，我们希望分享我们使用3D打印的经验，并指出其在提供更好的患者护理方面的优势。
我们概述了内部3D打印的设置，并重点遵守德国医疗保健法规。我们的方法基于熔融沉积建模3D打印机和免费软件。作为概念验证，我们治疗了4例严重眼眶创伤和1例下颌骨重建病例。我们为每个病例打印了一个3D患者特异性模型，并在手术前分别定制了钛网植入物和钛重建板。
我们的方法降低了成本、麻醉持续时间、手术时间、恢复时间和术后肿胀，并增加了收入。与传统技术相比，眼眶重建的功能结果如眼球运动和复视得到了改善。没有发生视力丧失或手术翻修等严重并发症。同样，下颌骨重建也没有出现钢板松动或骨折。
实施具有成本效益的3D打印技术可成功治疗患者并取得优异结果。我们的实践指南提供了一个3D打印工作流程，也可进行调整以满足神经外科、骨科等其他专科的需求。
