3D Printing a Key Technology in Head and Neck Surgery Care

What are the basic principles and clinical applications of medical three-dimensional (3D) printing in otolaryngology–head and neck surgery (Oto-HNS) and its subspecialties?

BOTTOM LINE
As technology and training standards evolve and as healthcare moves toward personalized medicine, 3D printing is emerging as a key technology in patient care in Oto-HNS.

Background: In Oto-HNS, 3D printing is being increasingly used to fabricate life-size training models, tissue scaffolds, and patient-specific implants and surgical guides. This technology has the potential to hold a key role in the field of Oto-HNS with broad impact across its sub-specialties. To date, no comprehensive systematic review of the standard bibliographic literature exists.

Study design: Literature review of 87 articles (710 patients) on Oto-HNS 3D printing.

Setting: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and The Cochrane Central Registry for Randomized Trials from inception to May 2018.

Synopsis: The most common diseases utilizing 3D printing were microtia and squamous cell carcinoma, orbital wall/floor trauma, ameloblastoma, and osteoradionecrosis. The most common procedures were mandibular resection and reconstruction, auricular and orbital reconstruction, maxillary resection and reconstruction, and mandibular open reduction and internal fixation. The most widely used 3D printing application is in preoperative planning, customizing surgical templates and equipment for more precise approaches. In bony defect reconstruction, 3D-printed temporal bone models have been beneficial in repairing tegmen tympani defects, and 3D-printed templates are used in septal prosthesis sizing. Advanced imaging, preoperative planning, and implant fabrication are used in all aspects of pediatric Oto-HNS, being recently utilized in perinatal management of complex airway anomalies in a newborn. 3D laser surface scanning and rapid prototyping have been utilized to develop translucent templates to accurately recreate nasal tip and dorsum with rib and ear cartilage dimensions. 3D-printed models are routinely used to prebend titanium mesh for orbital reconstruction following orbital wall/floor trauma. These models are important teaching aids in all levels of medical and residency training.

Limitations included only 6% of the total studies being randomized controlled trials.

Citation: Hong CJ, Giannopoulos AA, Hong BY, et al. Clinical applications of three-dimensional printing in otolaryngology–head and neck surgery: a systematic review. Laryngoscope. 2019;129:2045–2052.