Fabrication of 3D-Printed Implant for Two-Stage Ear Reconstruction Surgery and Its Clinical Application

Abstract

Purpose Ear reconstruction is one of the most difficult areas in the field of reconstructive surgery. Due to limitations of the current practice, a novel method of auricular reconstruction is needed. Major advancements in three-dimensional (3D) printing technique have rendered the process of ear reconstruction more favorable. Herein, we present our experience in designing and clinically using 3D implants in both 1st and 2nd stage ear reconstruction surgery. Materials and Methods After obtaining 3D CT data from each patient, a 3D geometric ear model was created using mirroring and segmentation processes. The 3D-printed implant design resembles but does not exactly match the normal ear shape, and can be inserted in harmony with the currently used surgical technique. The 2nd stage implant was designed to minimize dead space and support the posterior ear helix. The 3D implants were finally fabricated with a 3D printing system and used in ear reconstruction surgery in our institute. Results The 3D implants were manufactured for application to the currently used two-stage technique while maintaining the shape of the patient’s normal ear. The implants were successfully used for ear reconstruction surgery in microtia patients. A few months later, the 2nd stage implant was used in the 2nd stage operation. Conclusion The authors were able to design, fabricate, and apply patient-specific 3D-printed ear implants for 1st and 2nd stage ear reconstruction surgeries. This design, combined with 3D bioprinting technique, may be a future alternative for ear reconstruction.

One-Year Results of Ear Reconstruction with 3D Printed Implants

“…The modeling algorithm followed the previously reported method by the authors. 15 16 The images of contralateral, unaffected ear were obtained by segmentation procedure to isolate them from other surrounding structures. Then, 3D-reconstructed image of the unaffected ear was mirrored to be suitable for design of the implant.…”

3D printing tissue-engineered scaffolds for auricular reconstruction

“…When combined with 3D printing technology, this model can produce high-fidelity anatomical scaffolds with complex geometries. These scaffolds can be used for preoperative modeling to guide surgery or to create personalized external ear prostheses [ [103] , [104] , [105] ]. Scholars have replicated 3D-printed ear molds to sculpt rib cartilage [ 106 ], and create ear scaffolds with personalized features.…”

The Creation of an Average 3D Model of the Human Cartilaginous Nasal Septum and Its Biomimetic Applications

“…Recreating defects with 3DP often requires a standard model on which to base the structure. For example, patients with microtia have had prosthetics created by 3D-modeling and subsequently mirroring the unaffected ear [19][20][21]. However, since the septum has no anatomic counterpart that can be mirrored, patient-specific imaging in conjunction with a mean septal model would allow for anatomically consistent grafts.…”