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Guo D, Zloty DM, Kossintseva I. Efficacy and Safety of Anxiolytics in Mohs Micrographic Surgery: A Randomized, Double-Blinded, Placebo-Controlled Trial. Dermatol Surg 2023; 49:989-994. [PMID: 37606659 DOI: 10.1097/dss.0000000000003905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Patient anxiety can complicate surgical outcomes by elevating blood pressure, increasing the need for postoperative pain management, and reducing overall patient satisfaction. Despite the use of anxiolytic medications in outpatient procedures, there is limited comparative evidence on the efficacy and safety of these agents in Mohs micrographic surgery. OBJECTIVE To compare the effectiveness and safety of different preprocedural anxiolytic agents in Mohs surgery on perioperative patient anxiety and patient satisfaction. MATERIALS AND METHODS A double-blinded, randomized, placebo-controlled trial was conducted of 6 different preprocedural anxiolytic agents (lorazepam, diazepam, alprazolam, gabapentin, pregabalin, and melatonin) in 350 patients undergoing Mohs surgery. Anxiety and vital signs were recorded. RESULTS Diazepam demonstrated a statistically significant, sustained reduction in anxiety levels compared with placebo ( p = .03). Gabapentin significantly reduced early anxiety ( p = .02). Alprazolam showed a trend to early anxiety reduction ( p = .08). Lorazepam ( p = .73), pregabalin ( p = .53), and melatonin ( p = .24) failed to reduce patient anxiety compared with placebo at any time point. No anxiolytic significantly impacted any patient vital sign or cognition. CONCLUSION Although short-acting benzodiazepines and gamma-aminobutyric acid medications may have transient anxiolytic effects, a single oral dose of 5 mg of diazepam can provide a sustained anxiolytic effect in Mohs surgery, with excellent patient safety.
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Affiliation(s)
- Danny Guo
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - David M Zloty
- Department of Dermatology and Skin Science, UBC, Vancouver, British Columbia, Canada
| | - Irèn Kossintseva
- Department of Dermatology and Skin Science, UBC, Vancouver, British Columbia, Canada
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2
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Srifuengfung M, Abraham J, Avidan MS, Lenze EJ. Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment. Am J Geriatr Psychiatry 2023; 31:996-1008. [PMID: 37482501 PMCID: PMC10592367 DOI: 10.1016/j.jagp.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
The intervals before and after major surgery is a high-risk period for older adults; in this setting, anxiety and depression are common and serious problems. We comprehensively reviewed current evidence on perioperative anxiety and depression in older adults, focusing on epidemiology, impact, correlates, medication risks, and treatment. Principles of perioperative mental healthcare are proposed based on the findings. Prevalence estimates of clinically significant anxiety and depression range from 5% to 45% for anxiety and 6% to 52% for depression, depending on surgical populations and measurement tools. Anxiety and depression may increase risk for surgical complications and reduce patient participation during rehabilitation. Medical comorbidities, pain, insomnia, cognitive impairment, and delirium are common co-occurring problems. Concomitant uses of central nervous system acting medications (benzodiazepines, anticholinergics, and opioids) amplify the risks of delirium and falls. Based on these findings, we propose that anxiety and depression care should be part of perioperative management in older adults; components include education, psychological support, opioid-sparing pain management, sleep management, deprescribing central nervous system active medications, and continuation and optimization of existing antidepressants. More research is needed to test and improve these care strategies.
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Affiliation(s)
- Maytinee Srifuengfung
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO; Department of Psychiatry (MS), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Joanna Abraham
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO; Institute for Informatics (JA), Washington University School of Medicine, St. Louis, MO
| | - Michael S Avidan
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO
| | - Eric J Lenze
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO
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3
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Yousif J, Alkhouri F, St Claire K, Potts G. A practical guide to reducing preoperative and intraoperative patient anxiety in dermatologic surgery. Int J Dermatol 2023; 62:1154-1159. [PMID: 37529942 DOI: 10.1111/ijd.16802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Dermatologists perform a variety of procedures including excisions, biopsies, and other minor surgical procedures. Patients can experience anxiety in anticipation of their surgeries or may develop anxiety during the procedure. Since most dermatologic procedures occur with the patient awake and alert, the physician can offer comforting methods to alleviate some of that anxiety. AIMS We wanted to provide a review of available methods that dermatologists can use to reduce patient anxiety. MATERIALS & METHODS In this paper, we review the current literature on methods that can be used in dermatology offices to reduce overall patient anxiety levels. RESULTS In the preoperative stage, providers can offer educational content to explain the procedure to their patients. Whether it be through telephone calls, educational videos, or utilization of visual models, educating the patient regarding their procedure may reduce their anxiety. Intraoperatively, there are multiple methods that can be used such as music, guided imagery, coloring books, medications, hypnosis, and distraction techniques. DISCUSSION & CONCLUSION There is a variety of approaches that can be easily implemented in the office and can help in reducing the anxiety of the patients to allow for a pleasant patient experience and an overall satisfactory procedure outcome.
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Affiliation(s)
- Jenna Yousif
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Faris Alkhouri
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI, USA
| | - Kayla St Claire
- Department of Dermatology, Wayne State University, Detroit, MI, USA
| | - Geoffrey Potts
- Department of Dermatology, Wayne State University, Detroit, MI, USA
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Daly CM, Scott JF, Bibee KP. Patient Anxiety Related to Patient-Perceived Delays in Surgical Treatment of Skin Cancer. Dermatol Surg 2023; 49:352-354. [PMID: 36735797 DOI: 10.1097/dss.0000000000003716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patients undergoing dermatologic surgery report higher anxiety levels than those undergoing nonsurgical treatments. However, little is known about the association between patient-perceived delays in skin cancer surgery and patient-reported anxiety. OBJECTIVE To examine the relationship between patient-perceived delays in surgery and patient-reported anxiety. METHODS MATERIALS Patients undergoing wide local excision or Mohs micrographic surgery were recruited to complete a survey to assess perception of surgical delay and anxiety related to skin cancer surgery using the validated Psychosocial Screen for Cancer-Revised. Demographic and surgical characteristics were collected through chart review. Chi-square and Student t -tests were used to compare demographic and surgical information between patients who did and did not perceive a surgical delay. Differences in anxiety and depression scores for patients who did and did not report a delay were assessed using univariate and multivariate regressions. RESULTS Twenty-seven percent ( N = 33) of patients perceived a surgical delay. Perception of surgical delay was associated with increased time between biopsy and surgery ( p = .0001) and increased self-reported anxiety scores after controlling for various demographic and surgical factors ( p = .038). CONCLUSION Patient-perceived delays in dermatologic surgery are associated with increased time to surgery and patient-reported anxiety.
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Affiliation(s)
- Caroline M Daly
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Jeffrey F Scott
- Department of Dermatology, Johns Hopkins University, Baltimore, Maryland
| | - Kristin P Bibee
- Department of Dermatology, Johns Hopkins University, Baltimore, Maryland
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5
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Cerci FB, Portilla N, Tolkachjov SN. Cupcake Mohs: A simple analogy to differentiate Mohs micrographic surgery and "bread-loaf" processing. Int J Dermatol 2022; 61:e467-e469. [PMID: 34783008 DOI: 10.1111/ijd.15971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Felipe B Cerci
- Clínica Cepelle, Curitiba, Brazil.,Post-graduate Program - Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba, Brazil
| | - Nataly Portilla
- Department of Dermatology, Clínica Erasmo, Valledupar, Colombia
| | - Stanislav N Tolkachjov
- Epiphany Dermatology, Dallas, TX, USA.,Texas A&M College of Medicine, Dallas, TX, USA.,Department of Dermatology, The University of Texas at Southwestern Medical Center, Dallas, TX, USA.,Division of Dermatology, Baylor Scott & White, Dallas, TX, USA
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Analysis of Factors Contributing to Perioperative Mohs Micrographic Surgery Anxiety: Patient Survey Study at an Academic Center. Dermatol Surg 2022; 48:1279-1282. [PMID: 36194729 DOI: 10.1097/dss.0000000000003600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND High perioperative patient anxiety is predictive of worse postoperative pain and quality of life. Several Mohs micrographic surgery (MMS) patient characteristics influence anxiety; however, the contributions of certain factors remain uncertain. OBJECTIVE Investigate factors influencing perioperative MMS patient anxiety, especially those with debated impact or unclear data. METHODS The authors surveyed 145 adult patients receiving MMS performed by a single MMS surgeon from 2018 to 2020. Patients self-reported demographics, history, and 10-point visual analog scale anxiety assessments at multiple stages. Health care provider (HCP)-perceived anxiety assessments were queried. A stepwise multiple regression modeling approach was used to explore potential factors. RESULTS Younger age, female sex, and a self-reported history of anxiety confirmed by prior HCP diagnosis were significant predictors of pre-MMS anxiety. Postoperative anxiety increased with more layers removed and higher pre-MMS anxiety. HCP-perceived patient anxiety increased with younger patient age, more layers removed, prior skin cancer removal, and HCP-perceived pre-MMS patient anxiety. CONCLUSION Anxiety-reducing interventions should target young female patients with a history of HCP-diagnosed anxiety, and patients with more layers removed. Prior skin cancer removal is associated with increased HCP-perceived intraoperative patient anxiety; however, it is not significant for patient-reported anxiety. Pre-MMS consultation may not be effective for anxiety reduction.
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7
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Hirt L, Kern DS, Ojemann S, Grassia F, Kramer D, Thompson JA. Use of three-dimensional printed brain models during deep brain stimulation surgery consultation for patient health literacy: a randomized controlled investigation. World Neurosurg 2022; 162:e526-e533. [DOI: 10.1016/j.wneu.2022.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/12/2022] [Indexed: 12/09/2022]
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8
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Winsett F, Gleghorn K, Croley J, Wagner RF. Managing pain associated with dermatologic procedures. Int J Dermatol 2021; 60:e480-e485. [PMID: 33739460 DOI: 10.1111/ijd.15540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 11/30/2022]
Abstract
Dermatologists are faced with an aging population, accompanied by an increase in the incidence of skin cancer, especially nonmelanoma skin cancer. With this increase in cutaneous malignancy comes an increase in the number of dermatologic procedures being performed. A common concern of dermatologists and dermatology patients is the attenuation and management of pain associated with dermatologic procedures. Fortunately, there are several techniques that may be used in the preoperative, intraoperative, and postoperative periods to manage patient anxiety, minimize injection pain, and safely and effectively treat postoperative pain.
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Affiliation(s)
- Frank Winsett
- Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Kristyna Gleghorn
- Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Julie Croley
- Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Richard F Wagner
- Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas, USA
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Commentary on 3-Dimensional Printing. Dermatol Surg 2020; 46:1506-1507. [PMID: 33252458 DOI: 10.1097/dss.0000000000002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Guo P, Li P, Zhang X, Liu N, Wang J, Yang S, Yu L, Zhang W. The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2020; 111:103747. [DOI: 10.1016/j.ijnurstu.2020.103747] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/09/2023]
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Gupta R, Jonakin H, Reich H, Lindgren BR, Hamilton K, Foman N, McNeil E, Hurliman E. Improving knowledge of Mohs surgery in patients and families with 3D-printed models and video animation: A survey-based cohort study. J Am Acad Dermatol 2020; 85:1349-1350. [PMID: 32961256 DOI: 10.1016/j.jaad.2020.09.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Rachit Gupta
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - Hunter Jonakin
- Department of Art, College of Liberal Arts, University of Minnesota, Minneapolis, Minnesota
| | - Hilary Reich
- Gateway Family Health Clinic; Rainy Lake Medical Center, International Falls, Minnesota; Duluth Dermatology, Duluth, Minnesota
| | | | - Kallie Hamilton
- Veterans Affairs Hospital, Mohs Surgery Service, Minneapolis, Minnesota
| | - Neal Foman
- Department of Dermatology, HealthPartners, St. Paul, Minnesota
| | - Evan McNeil
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Elisabeth Hurliman
- Veterans Affairs Hospital, Mohs Surgery Service, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota.
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12
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Patel P, Malik K, Khachemoune A. Patient education in Mohs surgery: a review and critical evaluation of techniques. Arch Dermatol Res 2020; 313:217-224. [PMID: 32785836 DOI: 10.1007/s00403-020-02119-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Traditional in-person discussion alone is often used for preoperative education in Mohs micrographic surgery (MMS). The appropriate use of more modern education techniques is not well defined in the MMS literature. OBJECTIVE The authors aim to evaluate patient education techniques for MMS, address education in special populations, and highlight opportunities for improvement. METHODS AND MATERIALS We performed a PubMed literature search with keywords "Mohs" and "education", "teaching", "understanding", "explanation", "preoperative", or "consent" with no restriction on publication time frame due to literature scarcity. RESULTS Teledermatology consultation, MMS videos, 3D models, pamphlets/online materials, and shared medical appointments appear to be effective techniques (GRADE B). Analogies are also anecdotally helpful when integrated into traditional verbal education (GRADE C). The role of preoperative educational phone calls is more controversial (GRADE C). CONCLUSION Regardless of the education technique utilized, no singular technique entirely replaces the traditional in-person discussion. Having access to multiple modalities can be beneficial for patients, allowing them options to choose their preferred method(s) of education. MMS is a difficult topic to conceptualize, and further research into educational techniques is needed to provide clear guidelines for Mohs surgeons.
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Affiliation(s)
- Parth Patel
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kunal Malik
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Amor Khachemoune
- Department of Dermatology, SUNY Downstate, Brooklyn, New York, USA.
- Dermatology Service, Veterans Affairs Hospital, SUNY Downstate, 800 Poly Place Brooklyn, New York, 11209, USA.
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Guo XY, He ZQ, Duan H, Lin FH, Zhang GH, Zhang XH, Chen ZH, Sai K, Jiang XB, Wang ZN, Xie T, Chen ZP, Mou YG. The utility of 3-dimensional-printed models for skull base meningioma surgery. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:370. [PMID: 32355814 PMCID: PMC7186736 DOI: 10.21037/atm.2020.02.28] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Skull base meningioma surgery is often difficult and complicated to perform. Therefore, this study aims to investigate the effectiveness of 3-dimensional (3D)-printed models of skull base meningioma in the representation of anatomical structures, the simulation of surgical plans, and patient education on surgical outcomes. Methods A retrospective study of 35 patients (3D group: 19 patients and non-3D group: 16 patients) with skull base meningioma was conducted. Mimics software was used to create 3D reconstructions (with the skull, blood vessels, nerves, and tumors set to different colors), and 3D solid models were printed to determine the surgical protocols and communication pathways with the patient. Results The 3D-printed model can visually display the relationship of different structures, including the skull, blood vessels, cranial nerves, and tumors. The surgeon should select the proper surgical approaches before surgery through the model and pay attention to protecting the important structures during the operation. According to the models, the surgeon should cut off the blood supply to the tumor to reduce intraoperative bleeding. For patients with skull base bone destruction, the skull base repair should be prepared in advance. Patients and their families should have a thorough understanding of the disease through the model, and there should be effective communication between doctors and patients. Conclusions The 3D-printed model of a skull base meningioma can present the structures in a detailed manner and facilitate in helping the surgeon to develop a surgical plan. At the same time, it helps patients and their families to understand the condition and the surgical plan, which is conducive to better patient education.
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Affiliation(s)
- Xiao-Yu Guo
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Qiang He
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Hao Duan
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Fu-Hua Lin
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Guan-Hua Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiang-Heng Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zheng-He Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Ke Sai
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiao-Bing Jiang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Ning Wang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Tian Xie
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhong-Ping Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Yong-Gao Mou
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
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3D Printed Personalized Corneal Models as a Tool for Improving Patient’s Knowledge of an Asymmetric Disease. Symmetry (Basel) 2020. [DOI: 10.3390/sym12010151] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Additive manufacturing is a vanguard technology that is currently being used in several fields in medicine. This study aims to evaluate the viability in clinical practice of a patient-specific 3D model that helps to improve the strategies of the doctor-patient assistance. Data obtained from a corneal topographer were used to make a virtual 3D model by using CAD software, to later print this model by FDM and get an exact replica of each patient’s cornea in consultation. Used CAD and printing software were open-source, and the printing material was biodegradable and its cost was low. Clinic users gave their feedback by means of a survey about their feelings when perceiving with their senses their own printed cornea. There was 82 surveyed, 73.8% (9.74; SD: 0.45) of them considered that the model had helped them a lot to understand their disease, expressing 100% of them their intention of taking home the printed model. The majority highlighted that this new concept improves both quality and clinical service in consultation. Custom-made individualized printed models allow a new patient-oriented perspective that may improve the communication strategy from the ophthalmologist to the patient, easing patient’s understanding of their asymmetric disease and its later treatment.
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