Clinical applications of three‐dimensional printing in otolaryngology–head and neck surgery: A systematic review

Abstract

Objectives Medical three‐dimensional (3D) printing, the fabrication of handheld models from medical images, has the potential to become an integral part of otolaryngology–head and neck surgery (Oto‐HNS) with broad impact across its subspecialties. We review the basic principles of this technology and provide a comprehensive summary of reported clinical applications in the field. Methods Standard bibliographic databases (MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and The Cochrane Central Registry for Randomized Trials) were searched from their inception to May 2018 for the terms: “3D printing,” “three‐dimensional printing,” “rapid prototyping,” “additive manufacturing,” “computer‐aided design,” “bioprinting,” and “biofabrication” in various combinations with the terms: “ptolaryngology,” “head and neck surgery,” and “otology.” Additional articles were identified from the references of retrieved articles. Only studies describing clinical applications of 3D printing were included. Results Of 5,532 records identified through database searching, 87 articles were included for qualitative synthesis. Widespread implementation of 3D printing in Oto‐HNS is still at its infancy. Nonetheless, it is increasingly being utilized across all subspecialties from preoperative planning to design and fabrication of patient‐specific implants and surgical guides. An emerging application considered highly valuable is its use as a teaching tool for medical education and surgical training. Conclusions As technology and training standards evolve and as healthcare moves toward personalized medicine, 3D printing is emerging as a key technology in patient care in Oto‐HNS. Treating physicians and surgeons who wish to stay abreast of these developments will benefit from a fundamental understanding of the principles and applications of this technology. Laryngoscope, 129:2045–2052, 2019

Assessment of three types of intranasal nebulization devices in three‐dimensional printed models and volunteers: a pilot study

“…In our view, computational fluid dynamic models with parameters of mucosal surfaces and the technology of 3D bioprinting, which could not only highly simulate the live mucosa but also avoid the potential ethical issue in a human study, are promising for solving the problem. [26][27][28] In addition, the small population in the drug distribution study using three sinonasal models was another limitation. Therefore, triplicate experiments were conducted to compensate for the small sample size to some degree, and the effect sizes showed that the differences we observed were significant.…”

“…Therefore, although the physiological characteristics of the mucosa and mucociliary transport could not be mimicked using 3D printed models, the initial range of the aerosol deposition reflected by the staining still offered valuable information for decision‐making in clinical work and device innovation. In our view, computational fluid dynamic models with parameters of mucosal surfaces and the technology of 3D bioprinting, which could not only highly simulate the live mucosa but also avoid the potential ethical issue in a human study, are promising for solving the problem 26‐28 . In addition, the small population in the drug distribution study using three sinonasal models was another limitation.…”

Bony contouring in head and neck microvascular reconstruction

“…An increasing number of institutions have moved to internal RP production to mitigate the cost and time required in formal VSP [32] . The 3D printer equipment costs have been estimated as minimal as $1000 USD with material costs for printing these models reaching $1 USD and 4-5 h of printing time required per application [32] . This has expanded the usage of RP in many medical centers and allowed for increasing research and educational applications in head and neck reconstruction.…”

3D Printed Fistula Plug: A Novel Bridge to Definitive Reconstruction

“…Three‐dimensional (3D) printing has become popular as we move towards personalizing medicine. Its utility expands constantly as we discover novel ways to implement this technology, even within our own field 7 . Within head and neck oncology, the reported utilization of this technology largely relates to surgical planning 7 .…”

“…Its utility expands constantly as we discover novel ways to implement this technology, even within our own field 7 . Within head and neck oncology, the reported utilization of this technology largely relates to surgical planning 7 . This case report describes a scenario in which a patient‐specific 3D printed fistula plug was used as a bridging therapy before definitive management of pharyngocutaneous fistulae.…”