Langdon Cristóbal, Hinojosa-Bernal José, Munuera Josep, Gomez-Chiari Marta, Haag Oliver, Veneri Antonio, Valldeperes Ariadna, Valls Arnau, Adell Nuria, Santamaria Vicente, Cruz-Martinez Ofelia, Morales-La Madrid Andrés
Department of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain.
Department of Pediatric Neurosurgery, Hospital Sant Joan de Deu, Barcelona, Spain.
Int J Pediatr Otorhinolaryngol. 2023 May;168:111543. doi: 10.1016/j.ijporl.2023.111543. Epub 2023 Apr 5.
Pediatric endoscopic skull base surgery is challenging due to the intricate anatomy of the skull base and the presence of tumors with varied pathologies. The use of three-dimensional (3D) printing technologies in skull base surgeries has been found to be highly beneficial. A systematic review of the literature was performed to investigate the published studies that reported the effectiveness of 3D printing in pediatric endoscopic skull base surgery.
Pub Med, Embase, Science Direct, The Cochrane Library, and Scopus were searched from January 01, 2000, until June 30, 2022. Original articles of any design reporting on the effectiveness of 3D printing in pediatric endoscopic skull base surgery were included. Information related to study population, conditions, models used, and key findings of study were extracted. Quality of included studies was evaluated using the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Studies. To exemplify the use of 3D technology in this scenario, we report a complex clival chordoma case.
Six research articles were retrieved and included for qualitative analysis. Four of the six studies were conducted in the United States, followed by two in China. According to these studies, 3D reconstruction and printed models were more beneficial than CT/MRI images when discussing surgery with patients. In clinical training, these models were more helpful than 2D images in understanding the pathology when used in conjunction with image-guiding systems. It has been found that patient-specific 3D modeling, simulations, and rehearsal are the most efficient preoperative planning techniques, particularly in the pediatric population, for the treatment of complicated skull base surgeries. All the studies had a moderate risk of bias.
3D printing technologies assist in printing complex skull base tumors and the structures around them in three dimensions at the point of care and at the time needed, enabling the choice of the appropriate surgical strategy, thus minimizing surgery-related complications.
由于颅底解剖结构复杂且存在多种病理类型的肿瘤，小儿内镜颅底手术具有挑战性。已发现三维（3D）打印技术在颅底手术中非常有益。进行了一项文献系统综述，以调查报道3D打印在小儿内镜颅底手术中有效性的已发表研究。
检索了2000年1月1日至2022年6月30日期间的PubMed、Embase、Science Direct、Cochrane图书馆和Scopus。纳入任何设计的关于3D打印在小儿内镜颅底手术中有效性的原始文章。提取了与研究人群、病情、使用的模型以及研究的关键发现相关的信息。使用乔安娜·布里格斯研究所（JBI）的研究批判性评价清单评估纳入研究的质量。为了举例说明3D技术在这种情况下的应用，我们报告了一例复杂的斜坡脊索瘤病例。
检索到6篇研究文章并纳入定性分析。6项研究中有4项在美国进行，其次是中国的2项。根据这些研究，在与患者讨论手术时，3D重建和打印模型比CT/MRI图像更有益。在临床培训中，这些模型与图像引导系统结合使用时，在理解病理方面比二维图像更有帮助。已发现针对患者的3D建模、模拟和预演是治疗复杂颅底手术最有效的术前规划技术，特别是在儿科人群中。所有研究都有中度偏倚风险。
3D打印技术有助于在医疗现场和需要时三维打印复杂的颅底肿瘤及其周围结构，从而能够选择合适的手术策略，最大限度地减少手术相关并发症。
