Patient-specific and hyper-realistic phantom for an intubation simulator with a replaceable difficult airway of a toddler using 3D printing

Ock, Junhyeok; Gwon, Eunseo; Kim, Doo-Hwan; Kim, Sung Hoon; Kim, Namkug

doi:10.1038/s41598-020-67575-5

Cited by 21 publications

(18 citation statements)

References 18 publications

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“…It is used in various applications such as patient-specific surgical guides, simulators for rehearsal surgery, patient education, and patient-specific implants 8 – 11 . Several previous studies have used 3D printing technology to fabricate a simulator with complex anatomies such as a difficult airway intubation simulator 9 , A compliant aortic simulator 12 , a gastric simulator 13 , and a thyroid cancer phantom 14 . These simulators may provide better training opportunities for the trainee and allow for in-vitro experiments.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of skin cancer resection guide using hyper-realistic in-vitro phantom fabricated by 3D printing

Ock

Lee²,

Yang

et al. 2021

Sci Rep

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Skin cancer usually occurs in the facial area relatively exposed to sunlight. Medical imaging can confirm the invasiveness and metastasis of skin cancer, which is used to establish a surgical plan. However, there is no method of directly marking this information on the patient's skin in the operating room. We evaluated a skin cancer resection guide that marks resection areas including safety margins on the patient's skin based on medical images and in-vitro phantom fabricated via 3D printing. The in-vitro phantom, which includes the skull, skin, and five different cancer locations was designed and fabricated based on a CT image of a patient. Skin cancer resection guides were designed using a CT image of an in-vitro phantom, with a safety margin, and four injection points at each cancer. The guide was used to insert 16 cc intravenous catheters into each cancer of the phantom, which was rescanned by CT. The catheter insertion point and angle were evaluated. The accuracy of the insertion points was 2.09 ± 1.06 mm and cosine similarities was 0.980 ± 0.020. In conclusion, skin cancer resection guides were fabricated to mark surgical plans on the patient's skin in the operating room. They demonstrated reasonable accuracies in actual clinical settings.

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Section: Introductionmentioning

confidence: 99%

Evaluation of skin cancer resection guide using hyper-realistic in-vitro phantom fabricated by 3D printing

Ock

Lee²,

Yang

et al. 2021

Sci Rep

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“…Although prospective validation is needed, we believe this study represents the first step toward the development of an objective parameters-based decision tool for airway management in patients with mandibular hypoplasia. In previous our study, we developed the patient-specific and hyper-realistic phantom for difficult intubation simulation using 3D printing 33 . To enrich our understanding the association between specific parameters and difficult airway in children with mandibular hypoplasia, we plan to examine the validity of the association via a manikin airway simulation model.…”

Section: Discussionmentioning

confidence: 99%

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Kim

Gwon

Ock

et al. 2021

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In children with mandibular hypoplasia, airway management is challenging. However, detailed cephalometric assessment data for this population are sparse. The aim of this study was to find risk factors for predicting difficult airways in children with mandibular hypoplasia, and compare upper airway anatomical differences using three-dimensional computed tomography (3D CT) between children with mandibular hypoplasia and demographically matched healthy controls. There were significant discrepancies in relative tongue position (P < 0.01) and anterior distance of the hyoid bone (P < 0.01) between patients with mandibular hypoplasia and healthy controls. All mandibular measures were significantly different between the two groups, except for the height of the ramus of the mandible. After adjusting for age and sex, the anterior distance of hyoid bone and inferior pogonial angle were significantly associated with a difficult airway (P = 0.01 and P = 0.02). Quantitative analysis of upper airway structures revealed significant discrepancies, including relative tongue position, hyoid distance, and mandible measures between patients with mandibular hypoplasia and healthy controls. The anterior distance of the hyoid bone and inferior pogonial angle may be risk factors for a difficult airway in patients with mandibular hypoplasia.

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“…The patient-specific facial skin was realized by a silicone casting through the mold: the selected silicone was Dragon Skin FX-Pro (Smooth-On Inc., Texas, United States) which is a bi-component silicone frequently used in literature to reproduce human skin and surgical simulation ( Francesconi et al, 2015 ; Teyssier et al, 2019 ; Ock et al, 2020 ; Ock et al, 2021 ). The silicone is available as a liquid that is separated in two components, that were mixed in ratio 1:1 by volume; then some pigments (Silc-Pig, Smooth-On Inc., Texas, United States) were added to achieve the realism of the final product ( Figure 5 ).…”

Section: Methodsmentioning

confidence: 99%

Assessment of a novel patient-specific 3D printed multi-material simulator for endoscopic sinus surgery

Molinari

Emiliani

Cercenelli

et al. 2022

Front. Bioeng. Biotechnol.

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Background: Three-dimensional (3D) printing is an emerging tool in the creation of anatomical models for surgical training. Its use in endoscopic sinus surgery (ESS) has been limited because of the difficulty in replicating the anatomical details.Aim: To describe the development of a patient-specific 3D printed multi-material simulator for use in ESS, and to validate it as a training tool among a group of residents and experts in ear-nose-throat (ENT) surgery.Methods: Advanced material jetting 3D printing technology was used to produce both soft tissues and bony structures of the simulator to increase anatomical realism and tactile feedback of the model. A total of 3 ENT residents and 9 ENT specialists were recruited to perform both non-destructive tasks and ESS steps on the model. The anatomical fidelity and the usefulness of the simulator in ESS training were evaluated through specific questionnaires.Results: The tasks were accomplished by 100% of participants and the survey showed overall high scores both for anatomy fidelity and usefulness in training. Dacryocystorhinostomy, medial antrostomy, and turbinectomy were rated as accurately replicable on the simulator by 75% of participants. Positive scores were obtained also for ethmoidectomy and DRAF procedures, while the replication of sphenoidotomy received neutral ratings by half of the participants.Conclusion: This study demonstrates that a 3D printed multi-material model of the sino-nasal anatomy can be generated with a high level of anatomical accuracy and haptic response. This technology has the potential to be useful in surgical training as an alternative or complementary tool to cadaveric dissection.

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Patient-specific and hyper-realistic phantom for an intubation simulator with a replaceable difficult airway of a toddler using 3D printing

Cited by 21 publications

References 18 publications

Evaluation of skin cancer resection guide using hyper-realistic in-vitro phantom fabricated by 3D printing

Evaluation of skin cancer resection guide using hyper-realistic in-vitro phantom fabricated by 3D printing

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Assessment of a novel patient-specific 3D printed multi-material simulator for endoscopic sinus surgery

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