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Zahid F, Memon A, Siddiqui M, Deewani MH, Asif O, Javer A, Khan AA. Successful use of a patient specific 3D-printed biomodel as surgical guide for excision of juvenile nasopharyngeal angiofibroma extending to skull base: A case report. Surg Neurol Int 2024; 15:44. [PMID: 38468658 PMCID: PMC10927217 DOI: 10.25259/sni_743_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/02/2024] [Indexed: 03/13/2024] Open
Abstract
Background 3-Dimensional (3D) printing has proven its role in various fields. Recently, 3D printing has also been introduced in the otolaryngology domain. The nasopharynx, paranasal sinuses, and the anterior skull base have a complex anatomy. Critical structures must be delicately protected and preserved during a surgical procedure. It is, therefore, very important for the surgeon to have an excellent spatial understanding of the complex surgical field that is being traversed. Case Description Our case is of a 19-year-old male with a 2-month history of recurrent epistaxis, nasal blockage, and headache. Based on the computed tomography scan and the clinical presentation, the patient was diagnosed with juvenile nasopharyngeal angiofibroma. The patient underwent angioembolization of the tumor followed by endoscopic surgical resection. The patient remained stable postoperatively and demonstrated a good recovery in the follow-up visit with no signs of cranial deficits. This case report highlights the use of a patient-specific 3D-printed biomodel to visualize this rare tumor of the nasopharynx. The benefits of using the model in surgical planning, patient education, and resident training are reported. We found that the ability to visualize the tumor on a tangible model, viewing its actual size in relation to the adjacent anatomy and all the structures associated with it, greatly enhances the surgeon's capacity to tackle such a difficult tumor endoscopically. Conclusion Incorporating 3D-printed biomodels in surgical practice should result in improved outcomes for the patients.
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Affiliation(s)
- Fahad Zahid
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Ayesha Memon
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Moghira Siddiqui
- Department of Surgery, Section of Otolaryngology, Aga Khan University, Karachi, Pakistan
| | | | - Osama Asif
- Digital Health Resource Centre, Aga Khan University Hospital, Karachi, Pakistan
| | - Amin Javer
- Department of Surgery, St. Paul’s Sinus Centre, University of British Columbia, Vancouver, Canada
| | - Ahsan Ali Khan
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
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Santona G, Madoglio A, Mattavelli D, Rigante M, Ferrari M, Lauretti L, Mattogno P, Parrilla C, De Bonis P, Galli J, Olivi A, Fontanella MM, Fiorentino A, Serpelloni M, Doglietto F. Training models and simulators for endoscopic transsphenoidal surgery: a systematic review. Neurosurg Rev 2023; 46:248. [PMID: 37725193 PMCID: PMC10509294 DOI: 10.1007/s10143-023-02149-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023]
Abstract
Endoscopic transsphenoidal surgery is a novel surgical technique requiring specific training. Different models and simulators have been recently suggested for it, but no systematic review is available. To provide a systematic and critical literature review and up-to-date description of the training models or simulators dedicated to endoscopic transsphenoidal surgery. A search was performed on PubMed and Scopus databases for articles published until February 2023; Google was also searched to document commercially available. For each model, the following features were recorded: training performed, tumor/arachnoid reproduction, assessment and validation, and cost. Of the 1199 retrieved articles, 101 were included in the final analysis. The described models can be subdivided into 5 major categories: (1) enhanced cadaveric heads; (2) animal models; (3) training artificial solutions, with increasing complexity (from "box-trainers" to multi-material, ct-based models); (4) training simulators, based on virtual or augmented reality; (5) Pre-operative planning models and simulators. Each available training model has specific advantages and limitations. Costs are high for cadaver-based solutions and vary significantly for the other solutions. Cheaper solutions seem useful only for the first stages of training. Most models do not provide a simulation of the sellar tumor, and a realistic simulation of the suprasellar arachnoid. Most artificial models do not provide a realistic and cost-efficient simulation of the most delicate and relatively common phase of surgery, i.e., tumor removal with arachnoid preservation; current research should optimize this to train future neurosurgical generations efficiently and safely.
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Affiliation(s)
- Giacomo Santona
- Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Alba Madoglio
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Davide Mattavelli
- Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Mario Rigante
- Otorhinolaryngology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua - Azienda Ospedaliera di Padova, Padua, Italy
| | - Liverana Lauretti
- Neurosurgery, Department of Neurosciences, Sensory Organs and Thorax, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pierpaolo Mattogno
- Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudio Parrilla
- Otorhinolaryngology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pasquale De Bonis
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
- Department of Neurosurgery, Sant' Anna University Hospital, Ferrara, Italy
| | - Jacopo Galli
- Otorhinolaryngology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Otorhinolaryngology, Department of Neurosciences, Sensory Organs and Thorax, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy
| | - Alessandro Olivi
- Neurosurgery, Department of Neurosciences, Sensory Organs and Thorax, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marco Maria Fontanella
- Neurosurgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia - ASST Spedali Civili di Brescia, Brescia, Italy
| | - Antonio Fiorentino
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Mauro Serpelloni
- Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Francesco Doglietto
- Neurosurgery, Department of Neurosciences, Sensory Organs and Thorax, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Sakellaris NI, Sakellari EI, Kanaan Y, Khalil H, Stavrakas M. Added value of 3D printing technology in the manufacturing of customised septal buttons: A scoping review of the literature. Am J Otolaryngol 2023; 44:103916. [PMID: 37196489 DOI: 10.1016/j.amjoto.2023.103916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/30/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND In recent years, Three-dimensional printing (3-DP) technology, has had several applications in many fields of medicine, including rhinology. The aim of this review is to evaluate the use of 3-DP buttons as a treatment option for nasal septal perforations (NSP). METHODS We conducted a scoping review of the literature until June 07, 2022, on the online databases PubMed, Mendeley, and Cochrane Library. All articles referred to treatment of NSP with custom made buttons created by 3-DP technology were included in this study. RESULTS A total of 197 articles were generated by the search. Six articles met the inclusion criteria. 3 of the articles referred to clinical cases or clinical series. A total of 35 patients used the 3-DP custom made button as a treatment for NSP. The retention rate of this buttons ranged from 90.5 % to 100 %. An overall decrease in NSP symptoms was also observed in the majority of patients, especially regarding the most common complaints such as nasal bleeding and crusting. CONCLUSION The manufacturing of 3-DP buttons is a complex, time consuming process that requires both special laboratory equipment and trained staff. This method has the advantage of reducing the NSP related symptoms and an improving the retention rate. This could make the 3-DP custom made button a first-choice treatment for patients with NSP. However, as a new treatment option, it needs studies with more patients to determine its superiority over conventional buttons and its long-lasting therapeutic effects.
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Affiliation(s)
| | | | - Yazan Kanaan
- ENT Department, University Hospitals Plymouth NHS Trust, United Kingdom.
| | - Hisham Khalil
- ENT Department, University Hospitals Plymouth NHS Trust, United Kingdom; Peninsula Medical School, University of Plymouth, United Kingdom
| | - Marios Stavrakas
- ENT Department, University Hospitals Plymouth NHS Trust, United Kingdom; Peninsula Medical School, University of Plymouth, United Kingdom
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Duan H, Jiang X, Li C, Chen M, Zhang B, Huang Y, Zhao Q, Mou Y. Application of a three-dimensional printed model to localize a cranial cerebrospinal fluid leak: a case report. J Int Med Res 2022; 50:3000605221078412. [PMID: 35220787 PMCID: PMC8987368 DOI: 10.1177/03000605221078412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Localization of defect sites is a major challenge for surgical repair of cerebrospinal
fluid (CSF) leaks. Here, we report a case in which we applied a 3-dimensional (3D) printed
model to accurately identify the defect sites and facilitate the successful repair of a
cranial CSF leak. A 37-year-old female patient diagnosed with recurrent nasopharyngeal
carcinoma suffered CSF rhinorrhea and severe bacterial meningitis. Lumbar drainage and
antibiotic administration failed to control the condition. In addition to high resolution
computed tomography and magnetic resonance imaging, we applied a 3D printed model of the
skull to improve the understanding of the osseous destruction at the skull base and aid in
accurately localizing the defect sites of the right middle fossa. Accordingly, a right
temporalis pedicled flap combined with an autogenous fascia lata flap was applied to cover
the defect sites. The leak stopped postoperatively, and meningitis was relieved by
enhanced antibacterial treatment. As a complement to high resolution computed tomography
and magnetic resonance imaging, a 3D printed model may improve localization of complex
defect sites and surgical planning by allowing preoperative visualization of the skull
condition.
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Affiliation(s)
- 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, China
| | - Xiaobing 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, China
| | - Chang Li
- 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, China
| | - Mingyuan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangzhou, China
| | - Bei Zhang
- VIP Department, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangzhou, China
| | - Yuanyuan Huang
- VIP Department, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangzhou, China
| | - Qingyu Zhao
- Intensive Care Unit, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangzhou, China
| | - Yonggao 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, China
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Choby G, Rabinowitz MR, Patel ZM, McKinney KA, Del Signore AG, Ebert CS, Thorp BD, Wang EW. Emerging concepts in endoscopic skull base surgery training. Int Forum Allergy Rhinol 2021; 11:1611-1616. [PMID: 34569168 DOI: 10.1002/alr.22895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Garret Choby
- Division of Rhinology and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mindy R Rabinowitz
- Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Zara M Patel
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Kibwei A McKinney
- Department of Otolaryngology - Head & Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Anthony G Del Signore
- Department of Otolaryngology - Head & Neck Surgery, Mount Sinai School of Medicine, New York, New York, USA
| | - Charles S Ebert
- Division of Rhinology, Allergy and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Division of Rhinology, Allergy and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eric W Wang
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Use of three-dimensional printing for the osteoplastic flap approach: A viable technique. Med J Armed Forces India 2021; 77:363-366. [PMID: 34305292 DOI: 10.1016/j.mjafi.2021.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/18/2021] [Indexed: 10/21/2022] Open
Abstract
The osteoplastic flap technique is the open and direct approach to the frontal sinus and is especially useful when disease extends laterally into the frontal sinus. One of the vital steps of surgery is delineation of the boundary of the frontal sinus. This can usually be performed either by using the classical 6-ft Caldwell view X-ray template or more recently by application of the image-guided navigation system. The present article describes an alternative technique of using 3D printing technology for preoperative creation of the onlay template to mark the limits of the frontal sinus during osteoplastic flap technique and its advantages.
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Abstract
Magnetic resonance (MR) imaging is a crucial tool for evaluation of the skull base, enabling characterization of complex anatomy by utilizing multiple image contrasts. Recent technical MR advances have greatly enhanced radiologists' capability to diagnose skull base pathology and help direct management. In this paper, we will summarize cutting-edge clinical and emerging research MR techniques for the skull base, including high-resolution, phase-contrast, diffusion, perfusion, vascular, zero echo-time, elastography, spectroscopy, chemical exchange saturation transfer, PET/MR, ultra-high-field, and 3D visualization. For each imaging technique, we provide a high-level summary of underlying technical principles accompanied by relevant literature review and clinical imaging examples.
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Affiliation(s)
- Claudia F Kirsch
- Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY
| | - Mai-Lan Ho
- Associate Professor of Radiology, Director of Research, Department of Radiology, Director, Advanced Neuroimaging Core, Chair, Asian Pacific American Network, Secretary, Association for Staff and Faculty Women, Nationwide Children's Hospital and The Ohio State University, Columbus, OH; Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY.
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Jung HJ, Lee HM. Footsteps of the Innovations in Rhinology. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2020.00332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Rhinology is the study of nose, paranasal sinus, and nasopharynx. The nose is the most prominent structure on the human face and has been a subject of study since ancient human civilization. The history of rhinology has reflected the sociocultural aspects of the times, and rhinology has achieved remarkable growth with innovative discoveries by numerous pioneers. The focus of surgical procedures of the paranasal sinus shifted from mucosal stripping to functional endoscopic surgery with advancement of technology. Furthermore, the field of rhinology is gradually expanding due to cutting-edge technologies such as image-guided surgery, three-dimensional endoscopy, and robotic surgery. Additional clinical experiences and technological developments are expected to further advance rhinology.
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Imaging of Anterior and Central Skull Base Tumors: a Review. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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10
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McCoul E. Something for Everyone in Rhinology and Allergy. Am J Rhinol Allergy 2020; 33:621-623. [PMID: 31698940 DOI: 10.1177/1945892419884133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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