Utility of 3D printed temporal bones in pre-surgical planning for complex BoneBridge cases

Abstract

With the advent of single-sided hearing loss increasingly being treated with cochlear implantation, bone conduction implants are reserved for cases of conductive and mixed hearing loss with greater complexity. The BoneBridge (BB, MED-EL, Innsbruck, Austria) is an active fully implantable device with no attenuation of sound energy through soft tissue. However, the floating mass transducer (FMT) part of the device is very bulky, which limits insertion in complicated ears. In this study, 3D printed temporal bones of patients were used to study its utility in preoperative planning on complicated cases. Computed tomography (CT) scans of 16 ears were used to 3D print their temporal bones. Three otologists graded the use of routine preoperative planning provided by MED-EL and that of operating on the 3D printed bone of the patient. Data were collated to assess the advantage and disadvantage of the technology. There was a statistically significant benefit in using 3D printed temporal bones to plan surgery for difficult cases of BoneBridge surgery compared to the current standard. Surgeons preferred to have the printed bones in theatre to plan their drill sites and make the transition of the planning to the patient's operation more precise. 3D printing is an innovative use of technology in the use of preoperative planning for complex ear surgery. Surgical planning can be done on the patient's own anatomy which may help to decrease operating time, reduce cost, increase surgical precision and thus reduce complications.

Utility of vestibular testing and new technologies in a complex cholesteatoma

“…The use of these tools in pre-surgical planning has also been reported by the authors [11]. Customized surgical instruments can be designed, developed and 3D printed for a particular patient using 3D software and also 3D printed.…”

Progressive 3D Printing Technology and Its Application in Medical Materials

“…Personalized devices manufactured preoperationally are benefited for the efficiency and accuracy (Konta et al, 2017). For medical education and surgical planning, 3D anatomical models are printed subtly with microscopic anatomy structures (Mukherjee et al, 2017;Ganguli et al, 2018). Tissue and organ printing is an emerging field that mainly focused on regenerative medicine and tissue engineering by both academy and industry (Murphy and Atala, 2014).…”

What would you like to print? Students' opinions on the use of 3D printing technology in medicine

“…The use of 3D printing in medicine was a natural consequence of its development [6][7][8][9]. In surgery, 3D printing allows for a better understanding of the operating field on which the surgeon will work during a complicated operation, as well as the creation of tools tailored individually to the patient's anatomical conditions and personalized implants [4,[10][11][12][13][14][15][16][17][18][19][20]. Sometimes the problem of the availability of equipment necessary to treat patients is related to its price.…”

“…The examples of use of 3D printing in medicine are in use currently preoperative, personalized models that serve as an aid in the preparation for complicated surgeries, for example within the spine, as well as craniofacial or heart surgeries. This allows for a better preparation of the operator for possible difficulties that may occur during the procedure, which shortens its duration, reduces the risk of medical errors and accelerates patient's convalescence [8,19,20,25].…”