Department of Plastic & Reconstructive Surgery, Institute of Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Plastic & Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2023 Apr;64(4):291-296. doi: 10.3349/ymj.2022.0547.
Ear reconstruction is one of the most difficult areas in the field of reconstructive surgery. Due to limitations of the current practice, a novel method of auricular reconstruction is needed. Major advancements in three-dimensional (3D) printing technique have rendered the process of ear reconstruction more favorable. Herein, we present our experience in designing and clinically using 3D implants in both 1st and 2nd stage ear reconstruction surgery.
After obtaining 3D CT data from each patient, a 3D geometric ear model was created using mirroring and segmentation processes. The 3D-printed implant design resembles but does not exactly match the normal ear shape, and can be inserted in harmony with the currently used surgical technique. The 2nd stage implant was designed to minimize dead space and support the posterior ear helix. The 3D implants were finally fabricated with a 3D printing system and used in ear reconstruction surgery in our institute.
The 3D implants were manufactured for application to the currently used two-stage technique while maintaining the shape of the patient's normal ear. The implants were successfully used for ear reconstruction surgery in microtia patients. A few months later, the 2nd stage implant was used in the 2nd stage operation.
The authors were able to design, fabricate, and apply patient-specific 3D-printed ear implants for 1st and 2nd stage ear reconstruction surgeries. This design, combined with 3D bioprinting technique, may be a future alternative for ear reconstruction.
耳部重建是整形外科学领域中最具挑战性的领域之一。由于目前的实践存在局限性，需要一种新的耳廓重建方法。三维（3D）打印技术的重大进步使耳部重建过程更加有利。在此，我们介绍了我们在第一期和第二期耳再造手术中设计和临床应用 3D 植入物的经验。
从每位患者获取 3D CT 数据后，使用镜像和分割过程创建 3D 几何耳模型。3D 打印植入物的设计类似于但不完全匹配正常耳形状，并且可以与当前使用的手术技术和谐地插入。第二期植入物的设计旨在最小化死腔并支撑后耳螺旋。最后使用 3D 打印系统制造 3D 植入物，并在我们的研究所进行耳部重建手术。
3D 植入物是为应用于目前使用的两期技术而制造的，同时保持患者正常耳朵的形状。植入物成功地用于小耳畸形患者的耳部重建手术。几个月后，第二期植入物用于第二期手术。
作者能够设计、制造和应用患者特异性 3D 打印耳植入物进行第一期和第二期耳部重建手术。这种设计结合 3D 生物打印技术可能是未来耳部重建的一种替代方法。
