3D printed temporal bones for preoperative simulation and planning

Authors

William Rienas, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States of America; Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America.
Richard Hubbell, Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, 2160S. First Ave, Maywood, IL 60153, United States of America. Electronic address: richard.hubbell@lumc.edu.
Joonas Toivonen, Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, FI-20014 Turun Yliopisto, Finland. Electronic address: joonas.toivonen@utu.fi.
Mariah Geritano, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America. Electronic address: Mariah.Latshaw@childrens.harvard.edu.
Andrew Hall, University Hospital for Wales, Heath Park Way, Cardiff CF14 4XW, United Kingdom.
Sanjay Prabhu, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America. Electronic address: Sanjay.Prabhu@childrens.harvard.edu.
Caroline Robson, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America. Electronic address: Caroline.Robson@childrens.harvard.edu.
Peter Weinstock, Immersive Design Systems, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America; Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America. Electronic address: Peter.Weinstock@childrens.harvard.edu.
Dennis S. Poe, Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America. Electronic address: dennis.poe@childrens.harvard.edu.

Document Type

Journal Article

Publication Date

1-1-2024

Journal

American journal of otolaryngology

Volume

45

Issue

4

DOI

10.1016/j.amjoto.2024.104340

Keywords

3D model; Cholesteatoma; Cochlear implant; Temporal bone

Abstract

OBJECTIVE: Demonstrate the utility of 3D printed temporal bone models in individual patient preoperative planning and simulation. METHODS: 3D models of the temporal bone were made from 5 pediatric and adult patients at a tertiary academic hospital with challenging surgical anatomy planned for cochlear implantation or exteriorization of cholesteatoma with complex labyrinthine fistula. The 3D models were created from CT scan used for preoperative planning, simulation and intraoperative reference. The utility of models was assessed for ease of segmentation and production and impact on surgery in regard to reducing intraoperative time and costs, improving safety and efficacy. RESULTS: Three patients received cochlear implants, two exteriorization of advanced cholesteatoma with fistulas (1 internal auditory canal/cochlea, 1 all three semicircular canals). Surgical planning and intraoperative referencing to the simulations by the attending surgeon and trainees significantly altered original surgical plans. In a case of X-linked hereditary deafness, optimal angles and rotation maneuvers for cochlear implant insertion reduced operating time by 93 min compared to the previous contralateral side surgery. Two cochlear implant cases planned for subtotal petrosectomy approach due to aberrant anatomy were successfully approached through routine mastoidectomy. The cholesteatoma cases were successfully exteriorized without necessitating partial labyrinthectomy or labyrinthine injury. There were no complications. CONCLUSION: 3D printed models for simulation training, surgical planning and use intraoperatively in temporal bone surgery demonstrated significant benefits in designing approaches, development of patient-specific techniques, avoidance of potential or actual complications encountered in previous or current surgery, and reduced surgical time and costs.

APA Citation

Rienas, William; Hubbell, Richard; Toivonen, Joonas; Geritano, Mariah; Hall, Andrew; Prabhu, Sanjay; Robson, Caroline; Weinstock, Peter; and Poe, Dennis S., "3D printed temporal bones for preoperative simulation and planning" (2024). GW Authored Works. Paper 5389.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5389

Department

School of Medicine and Health Sciences Student Works