Author(s)
Ricardo Pulido, MD
Randall Bly
Kris Moe, Professor
Waleed Abuzeid, MD, FARS
Seth Friedman
Daniel King
Yangming Li
Blake Hannaford, PhD
Affiliation(s)
University of Washington; Seattle Children's Hospital ;
Abstract:
Background:
Advances in 3D printing have provided patient specific solutions in multiple surgical domains. These advances have been of limited application in sinus and skull base surgery.
Objective:
The objective was to develop a realistic, patient specific 3D printed model that is capable of undergoing image guided surgery and postoperative imaging.
Methods:
Computed tomography (CT) images were imported into the software system, Materialise Mimics (Leuven, Belgium), for segmentation of distinct structures. The structures were printed based on anatomic presets to delineate the soft tissue and bony components. Relevant vascularization was printed for realism. Additional bony struts were created to function as set fiducial points for calibration during image guided surgery. The model underwent a preoperative CT scan and endoscopic sinus surgery (ESS) was subsequently performed. A postoperative CT scan was then completed.
Results:
The 3D printed model had internal characteristics that were anatomically realistic, such as the location of relevant vasculature and accurate positioning of sinus ostia. Performing surgery on the printed model demonstrated similar haptic feedback as ESS in live patients. Instrument tip position could be calibrated to a registration accuracy of <2mm on the model. The postoperative CT scan adequately demonstrated the expected surgical findings.
Conclusions:
Our 3D printed model is capable of providing realistic haptic feedback during ESS, while providing anatomical realism of relevant structures with anticipated postoperative changes on CT imaging. We anticipate that this work will allow precision modeling of sinonasal and skull base pathology optimizing surgical training and planning.