Schlegel Lauren, Malani Eric, Belko Sara, Kumar Ayan, Barbarite Eric, Krein Howard, Heffelfinger Ryan, Hutchinson Morgan, Pugliese Robert
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Health Design Lab, Thomas Jefferson University, Philadelphia, PA, USA.
3D Print Med. 2023 Jul 13;9(1):20. doi: 10.1186/s41205-023-00185-9.
For difficult or rare procedures, simulation offers an opportunity to provide education and training. In developing an adequate model to utilize in simulation, 3D printing has emerged as a useful technology to provide detailed, accessible, and high-fidelity models. Nasal osteotomy is an essential step in many rhinoplasty surgeries, yet it can be challenging to perform and difficult to receive adequate exposure to this nuanced portion of the procedure. As it currently stands, there are limited opportunities to practice nasal osteotomy due to the reliance on cadaveric bones, which are expensive, difficult to obtain, and require appropriate facilities and personnel. While previous designs have been developed, these models leave room for improvement in printing efficiency, cost, and material performance. This manuscript aims to describe the methodology for the design of an updated nasal osteotomy training model derived from anatomic data and optimized for printability, usability, and fidelity. Additionally, an analysis of multiple commercially available 3D printing materials and technologies was conducted to determine which offered superior equivalency to bone.
This model was updated from a first-generation model previously described to include a more usable base and form, reduce irrelevant structures, and optimize geometry for 3D printing, while maintaining the nasal bones with added stabilizers essential for function and fidelity. For the material comparison, this updated model was printed in five materials: Ultimaker Polylactic Acid, 3D Printlife ALGA, 3DXTECH SimuBone, FibreTuff, and FormLabs Durable V2. Facial plastic surgeons tested the models in a blinded, randomized fashion and completed surveys assessing tactile feedback, audio feedback, material limitation, and overall value.
A model optimizing printability while maintaining quality in the area of interest was developed. In the material comparison, SimuBone emerged as the top choice amongst the evaluating physicians in an experience-based subjective comparison to human bone during a simulated osteotomy procedure using the updated model.
The updated midface model that was user-centered, low-cost, and printable was designed. In material testing, Simubone was rated above other materials to have a more realistic feel.
对于困难或罕见的手术，模拟为提供教育和培训提供了机会。在开发适用于模拟的模型时，3D打印已成为一种有用的技术，可提供详细、可触及且高保真的模型。鼻骨截骨术是许多鼻整形手术中的关键步骤，但该操作具有挑战性，且难以充分接触到该手术中这一细微部分。就目前情况而言，由于依赖尸体骨骼，鼻骨截骨术的练习机会有限，尸体骨骼昂贵、难以获取，且需要适当的设施和人员。虽然之前已经开发出了一些设计，但这些模型在打印效率、成本和材料性能方面仍有改进空间。本手稿旨在描述一种更新的鼻骨截骨术训练模型的设计方法，该模型源自解剖数据，并针对可打印性、可用性和逼真度进行了优化。此外，还对多种商用3D打印材料和技术进行了分析，以确定哪种材料与骨骼具有更高的等效性。
该模型是在先前描述的第一代模型的基础上更新而来，包括更实用的底座和形状，减少无关结构，并为3D打印优化几何形状，同时保留鼻骨并添加对功能和逼真度至关重要的稳定剂。在材料比较方面，这个更新后的模型用五种材料进行打印：Ultimaker聚乳酸、3D Printlife ALGA、3DXTECH SimuBone、FibreTuff和FormLabs Durable V2。面部整形外科医生以盲法、随机方式对模型进行测试，并完成评估触觉反馈、听觉反馈、材料局限性和总体价值的调查。
开发出了一种在保持感兴趣区域质量的同时优化可打印性的模型。在材料比较中，在使用更新后的模型进行模拟截骨手术期间，基于经验的主观比较中，与人类骨骼相比，SimuBone成为评估医生的首选。
设计出了以用户为中心、低成本且可打印的更新后的中面部模型。在材料测试中，Simubone的评分高于其他材料，给人更逼真的感觉。
