Additive Manufacturing for Personalized Skull Base Reconstruction in Endoscopic Transclival Surgery: A Proof-of-Concept Study

Mattavelli, Davide; Fiorentino, Antonio; Tengattini, Francesco; Colpani, Alessandro; Agnelli, Silvia; Buffoli, Barbara; Ravanelli, Marco; Ferrari, Marco; Schreiber, Alberto; Rampinelli, Vittorio; Taboni, Stefano; Verzeletti, Vincenzo; Deganello, Alberto; Rodella, Luigi Fabrizio; Maroldi, Roberto; Ceretti, Elisabetta; Sartore, Luciana; Piazza, Cesare; Fontanella, Marco Maria; Nicolai, Piero; Doglietto, Francesco

doi:10.1016/j.wneu.2021.08.080

Cited by 7 publications

(3 citation statements)

References 62 publications

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“…In our tests, the navigation system set-up was optimal in all cases (systematic error always < 1 mm); accordingly, the scaffold was always easily plugged into the defect and its surface perfectly faced the bony boundaries without any need for drilling to adjust the shape. This finding is in accordance with a preclinical study from our group on the use of 3D-printed scaffolds to reconstruct complex clival defects and highlight the necessity of a meticulous setting of the navigation system in a hypothetical clinical scenario [ 25 ].…”

Section: Discussionsupporting

confidence: 89%

Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study

Mattavelli,

Verzeletti,

Deganello

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose To investigate the potential reconstruction of complex maxillofacial defects using computer-aided design 3D-printed polymeric scaffolds by defining the production process, simulating the surgical procedure, and explore the feasibility and reproducibility of the whole algorithm. Methods This a preclinical study to investigate feasibility, reproducibility and efficacy of the reconstruction algorithm proposed. It encompassed 3 phases: (1) scaffold production (CAD and 3D-printing in polylactic acid); (2) surgical simulation on cadaver heads (navigation-guided osteotomies and scaffold fixation); (3) assessment of reconstruction (bone and occlusal morphological conformance, symmetry, and mechanical stress tests). Results Six cadaver heads were dissected. Six types of defects (3 mandibular and 3 maxillary) with different degree of complexity were tested. In all case the reconstruction algorithm could be successfully completed. Bone morphological conformance was optimal while the occlusal one was slightly higher. Mechanical stress tests were good (mean value, 318.6 and 286.4 N for maxillary and mandibular defects, respectively). Conclusions Our reconstructive algorithm was feasible and reproducible in a preclinical setting. Functional and aesthetic outcomes were satisfactory independently of the complexity of the defect.

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Section: Discussionsupporting

confidence: 89%

Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study

Mattavelli,

Verzeletti,

Deganello

et al. 2024

Eur Arch Otorhinolaryngol

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“…Segmentation is performed with dedicated software starting from a radiological study (usually a CT scan) up to the creation of an .stl file that is then modified according to the needs of the different 3D printers. The above process leads to the formation of extremely accurate scaffolds with discrepancies from the virtual render of less than 1 mm [37].…”

Section: Scaffold Optionsmentioning

confidence: 99%

Tracheal Tissue Engineering: Principles and State of the Art

Mammana,

Bonis,

Verzeletti

et al. 2024

Bioengineering

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Patients affected by long-segment tracheal defects or stenoses represent an unsolved surgical issue, since they cannot be treated with the conventional surgery of tracheal resection and consequent anastomosis. Hence, different strategies for tracheal replacement have been proposed (synthetic materials, aortic allografts, transplantation, autologous tissue composites, and tissue engineering), each with advantages and drawbacks. Tracheal tissue engineering, on the other hand, aims at recreating a fully functional tracheal substitute, without the need for the patient to receive lifelong immunosuppression or endotracheal stents. Tissue engineering approaches involve the use of a scaffold, stem cells, and humoral signals. This paper reviews the main aspects of tracheal TE, starting from the choice of the scaffold to the type of stem cells that can be used to seed the scaffold, the methods for their culture and expansion, the issue of graft revascularization at the moment of in vivo implantation, and experimental models of tracheal research. Moreover, a critical insight on the state of the art of tracheal tissue engineering is also presented.

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“…In recent years, many universities and teaching hospitals have been equipped with dissection laboratories, not only for learning anatomy but also for the surgical training of young residents with different surgical backgrounds, such as general surgery, orthopedic surgery, plastic surgery, head and neck surgery, and neurosurgery [2][3][4][5][6][7]. Meanwhile, several papers have been published on this topic, emphasizing how dissection optimizes learning topographical anatomy and improves resident's surgical confidence through a wide range of procedures [8,9].…”

Section: Introductionmentioning

confidence: 99%

Step-by-Step Dissection of the Mediastinum: A Training Protocol

Verzeletti,

Cannone,

Hirtler

et al. 2023

Surgeries

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The understanding of mediastinal anatomy represents a real challenge because of the vital structures inside it and due to its complex relationships with surrounding anatomical regions. Human anatomical specimens are always used both for the teaching of anatomy and the training of young surgeons, thus providing a deep understanding of the most complex anatomical regions and allowing less experienced surgeons to become familiar with surgical instruments and their use on actual human tissues. Despite the spread of these learning practices, there are no principles of dissection to follow for a young physician interested in the anatomy of the mediastinum. Therefore, the main objective of this study is to define a reliable and reproducible protocol for the dissection of the mediastinum. A stratigraphic anatomical dissection on three embalmed human specimens was performed. All steps were documented by high-quality photographs, taken with a professional digital reflex camera, and subsequently edited. A step-by-step anatomical dissection guide was created, detailing every phase, guiding the dissection of the mediastinal anatomy, and leading to the correct identification of its main anatomical structures. We present a step-by-step dissection guide to the mediastinal anatomy with point-by-point explanations and dedicated images, providing an additional tool for the comprehension of this complex anatomical area.

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Additive Manufacturing for Personalized Skull Base Reconstruction in Endoscopic Transclival Surgery: A Proof-of-Concept Study

Cited by 7 publications

References 62 publications

Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study

Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study

Tracheal Tissue Engineering: Principles and State of the Art

Step-by-Step Dissection of the Mediastinum: A Training Protocol

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