Stereolithographic skull models in the surgical planning of fronto-supraorbital bar advancement for non-syndromic trigonocephaly

Modeling Medical Education: The Impact of Three-Dimensional Printed Models on Medical Student Education in Plastic Surgery

PURPOSE

Trainee exposure to craniofacial pathology can be limited due to rare disease presentation, revealing a need for tools that assist in visualizing complex 3D pathologic anatomy. 3D-printed models show potential as a useful aid, allowing for physical manipulation and hands-on experience. This study investigates their educational value in teaching craniofacial pathology and surgical repair.

METHODS

Forty-four medical students randomly assigned to a control group or model group were given a PowerPoint presentation-based module on craniosynostosis and surgical repair. The model group was also provided with 3D-printed models of sagittal, metopic, and bicoronal synostosis, created using patient-specific preoperative computed tomography data. A survey using the Likert scale evaluated participants' learning experience. Pre- and postmodule scores on a 10-question multiple choice quiz were recorded.

RESULTS

The survey showed that students in the model group reported better understanding of the anatomy (4.86 ± 0.15 versus 4.26 ± 0.22; P = 0.0001) and visualization of the pathology (4.76 ± 0.23 versus 4.26 ± 0.25; P = 0.0064), gaining an improved understanding of surgical approach (4.38 ± 0.37 versus 3.83 ± 0.29; P = 0.0266), which was more effectively taught (4.24 ± 0.33 versus 3.30 ± 0.38; P = 0.0007) with the 3D-printed models. The mean pre- and post-module quiz scores between groups were similar.

CONCLUSION

3D-printed models demonstrated an improved learning experience for medical students as shown by survey. These findings suggest a potential use for 3D-printed models in medical education of craniofacial pathology and surgery.

Test-retest validation of a cranial deformity index in unilateral coronal craniosynostosis

Unilateral coronal craniosynostosis (UCS) affects many infants resulting in abnormalities affecting the forehead and orbits. As a result, the deformity caused by UCS is very noticeable and there are several surgical treatment options available to normalize the head shape. However, there is a lack of consistently used outcome measures, resulting in difficulty assessing surgical outcomes and on-going debate over optimal treatments. Current techniques to quantify deformity in UCS are cumbersome, provide limited information, or are based on subjective assessments. In this study, a cranial deformity index was developed to quantify abnormality at the frontal bones for UCS that is accessible, user-friendly, and generates objective surface distance measurements. The cranial deformity index is defined as the Euclidean distance at the point of the largest deviation between the deformed skull compared to a reference skull. In addition, the index was successfully used to quantify post-operative changes in a single case of UCS that underwent corrective surgery. The reproducibility of the index was assessed using test-retest reliability and was demonstrated to be highly reproducible (ICC = 0.93). A user-friendly measurement index that is based on open-source software may be a valuable tool for surgical teams. In addition, this information can augment the consultation experience for patients and their families.

Bio-Based Polymers for 3D Printing of Bioscaffolds

Three-dimensional (3D) printing technologies enable not only faster bioconstructs development but also on-demand and customized manufacturing, offering patients a personalized biomedical solution. This emerging technique has a great potential for fabricating bioscaffolds with complex architectures and geometries and specifically tailored for use in regenerative medicine. The next major innovation in this area will be the development of biocompatible and histiogenic 3D printing materials with bio-based printable polymers. This review will briefly discuss 3D printing techniques and their current limitations, with a focus on novel bio-based polymers as 3D printing feedstock for clinical medicine and tissue regeneration.

The State of Technology in Craniosynostosis

INTRODUCTION

Craniosynostosis, the premature fusion of ≥1 cranial sutures, is the leading cause of pediatric skull deformities, affecting 1 of every 2000 to 2500 live births worldwide. Technologies used for the management of craniofacial conditions, specifically in craniosynostosis, have been advancing dramatically. This article highlights the most recent technological advances in craniosynostosis surgery through a systematic review of the literature.

METHODS

A systematic electronic search was performed using the PubMed database. Search terms used were "craniosynostosis" AND "technology" OR "innovation" OR "novel.' Two independent reviewers subsequently reviewed the resultant articles based on strict inclusion and exclusion criteria. Selected manuscripts deemed novel by the senior authors were grouped by procedure categories.

RESULTS

Following review of the PubMed database, 28 of 536 articles were retained. Of the 28 articles, 20 articles consisting of 21 technologies were deemed as being novel by the senior authors. The technologies were categorized as diagnostic imaging (n = 6), surgical planning (n = 4), cranial vault evaluation (n = 4), machine learning (n = 3), ultrasound pinning (n = 3), and near-infrared spectroscopy (n = 1).

CONCLUSION

Multiple technological advances have impacted the treatment of craniosynostosis. These innovations include improvement in diagnosis and objective measurement of craniosynostosis, preoperative planning, intraoperative procedures, communication between both surgeons and patients, and surgical education.

A new operative open-wings technique to correct the frontoforehead unit in metopic synostosis

The technology adoption and creation of a multidisciplinary team have helped to overcome the complexity associated. Craniofacial surgery has thus emerged from the valuable contributions of neurosurgery, maxillofacial surgery, plastic surgery, eyes, nose, and throat as well as head and neck surgery. A patient with trigonocephaly may present a prominent "keel" forehead, accompanied by recession of the lateral orbit rims, hypotelorism, and constriction of the anterior frontal fossa when the metopic suture fuses before 6 months of age. In a period between 2007 and 2011, in the Salesi Children's Hospital, were treated for nonsyndromic variety of metopic synostosis 11 infants; their ages ranged from 6 months to 9 months, and 7 were males and 4 females. The most important aims of our new surgical technique are the achievement of symmetry as well as normal proportion and reconstruction of the frontoforehead unit but remaining in a very conservative treatment. The morphology and position of the supraorbital ridge-lateral orbital rim region are key elements of upper facial esthetics. This new "open-wings" technique for the reconfiguration of the bilateral emisupraorbital bar requires a midline incomplete osteotomy that involves only the internal cortex of the frontonasal region. Hence, both lateral orbital walls are bent inwardly and tilting forward, as in computed tomographic scan planning, with a greenstick fracture pivoting on the preserved medial frontonasal region. This open-wings conservative technique allows the avoidance of the most important complication that may result in the traditional way such as dead space in the anterior cranial fossa, infections, and blood loss but with an achievement of satisfactory craniofacial form and aesthetic result.