Department of Otolaryngology, University of Pittsburgh Medical Center, UPMC Eye & Ear Institute, 203 Lothrop Street, Suite 519, Pittsburgh, PA, 15213, United States.
Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Faculty Pavilion, 7th Floor, Pittsburgh, PA, 15224, United States.
Int J Pediatr Otorhinolaryngol. 2023 Aug;171:111655. doi: 10.1016/j.ijporl.2023.111655. Epub 2023 Jul 13.
Pediatric cranial base pathology is anatomically complex and surgical treatment is oftentimes difficult to conceptualize for patients and their families. Three-dimensional (3D) models of the sinuses and cranial base have the potential to enhance patient understanding in numerous domains. Our objective is to assess the use of 3D models in pre-operative parental and patient counseling prior to endoscopic endonasal skull base surgery in the pediatric population.
A survey was designed to assess parent and patient-perceived utility of 3D-printed models in surgical counseling prior to pediatric skull base surgery.
A total of 10 patients were included. The median age was 9 years (range = 5 months-15 years). Pathology included juvenile nasopharyngeal angiofibroma (JNA) (N = 4), fibrous dysplasia of the maxilla and sphenoid (N = 1), juvenile ossifying fibroma (N = 1), nasal dermoid (N = 2, one with intracranial extension), encephalocele (N = 1), and parapharyngeal ectopic glial tissue (N = 1). Nearly all parents agreed or strongly agreed that 3D printed models were helpful in explaining the patient's skull base pathology (N = 10), surgical plan (N = 10), and possible complications (N = 9). All parents strongly agreed that 3D models should be used routinely in pre-operative counseling for endoscopic endonasal surgery. According to a majority of parents, patients older than 4 years old found the models helpful in understanding their pathology (75%) and surgery (88%).
By allowing direct three-dimensional visualization of the target pathology, 3D models serve as a useful adjunct in enhancing patient comprehension of the pathologic entity, planned surgery, and potential complications prior to pediatric endoscopic endonasal skull base surgery.
小儿颅底病变解剖结构复杂，患者及其家属通常难以理解手术治疗方案。鼻窦和颅底的三维（3D）模型具有增强患者多方面理解的潜力。我们的目的是评估 3D 模型在小儿内镜经鼻颅底手术前患者及其家属的术前咨询中的应用。
设计了一项调查，以评估父母和患者对小儿颅底手术前 3D 打印模型在手术咨询中的应用的看法。
共纳入 10 例患者。中位年龄为 9 岁（范围 5 个月-15 岁）。病变包括青少年鼻咽血管纤维瘤（JNA）（n=4）、上颌骨和蝶骨纤维结构不良（n=1）、青少年骨化性纤维瘤（n=1）、鼻皮样囊肿（n=2，1 例伴有颅内延伸）、脑膨出（n=1）和咽旁异位胶质组织（n=1）。几乎所有家长均表示 3D 打印模型有助于解释患者的颅底病变（n=10）、手术计划（n=10）和可能的并发症（n=9）。所有家长均强烈表示 3D 模型应常规用于内镜经鼻手术的术前咨询。根据大多数家长的意见，年龄大于 4 岁的患者认为模型有助于了解其病变（75%）和手术（88%）。
3D 模型可直接对目标病变进行三维可视化，有助于增强患者对病变实体、计划手术和潜在并发症的理解，可作为小儿内镜经鼻颅底手术的有用辅助手段。
