Pursuing Mirror Image Reconstruction in Unilateral Microtia
Autor: | Ning-Hung Chen, Chun-Shin Chang, Li-Shia Ng, Ting-Chen Lu, Zung-Chung Chen, Hsin-Yu Chen |
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Rok vydání: | 2017 |
Předmět: |
Male
Esthetics Iterative reconstruction Unilateral microtia Sampling Studies 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Humans Medicine Computer vision Child 030223 otorhinolaryngology Congenital Microtia Retrospective Studies Haptic technology Manufacturing technology business.industry Orientation (computer vision) Microtia Prostheses and Implants Skin Transplantation 030206 dentistry Plastic Surgery Procedures medicine.disease Treatment Outcome Three dimensional imaging Child Preschool Three dimensional printing Printing Three-Dimensional Female Surgery Artificial intelligence business Follow-Up Studies |
Zdroj: | Plastic and Reconstructive Surgery. 139:1433-1443 |
ISSN: | 0032-1052 |
Popis: | BACKGROUND Advances in three-dimensional imaging and three-dimensional printing technology have expanded the frontier of presurgical design for microtia reconstruction from two-dimensional curved lines to three-dimensional perspectives. This study presents an algorithm for combining three-dimensional surface imaging, computer-assisted design, and three-dimensional printing to create patient-specific auricular frameworks in unilateral microtia reconstruction. METHODS Between January of 2015 and January of 2016, six patients with unilateral microtia were enrolled. The average age of the patients was 7.6 years. A three-dimensional image of the patient's head was captured by 3dMDcranial, and virtual sculpture carried out using Geomagic Freeform software and a Touch X Haptic device for fabrication of the auricular template. Each template was tailored according to the patient's unique auricular morphology. The final construct was mirrored onto the defective side and printed out with biocompatible acrylic material. RESULTS During the surgery, the prefabricated customized template served as a three-dimensional guide for surgical simulation and sculpture of the MEDPOR framework. Average follow-up was 10.3 months. Symmetric and good aesthetic results with regard to auricular shape, projection, and orientation were obtained. One case with severe implant exposure was salvaged with free temporoparietal fascia transfer and skin grafting. CONCLUSIONS The combination of three-dimensional imaging and manufacturing technology with the malleability of MEDPOR has surpassed existing limitations resulting from the use of autologous materials and the ambiguity of two-dimensional planning. This approach allows surgeons to customize the auricular framework in a highly precise and sophisticated manner, taking a big step closer to the goal of mirror-image reconstruction for unilateral microtia patients. CLINCIAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV. |
Databáze: | OpenAIRE |
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