Rapid Prototyping Model Research Articles

Outcome quality assessment by surgical process compliance measures in laparoscopic surgery.

The effective and efficient assessment, management, and evolution of surgical processes are intrinsic to excellent patient care. Hence, in addition to economic interests, the quality of the outcome is of great importance. Process benchmarking examines the compliance of an intraoperative surgical process to another process that is considered as best practice. The objective of this work is to assess the relationship between the course and the outcome of surgical processes of the study. By assessing 450 skill practices on rapid prototyping models in minimally invasive surgery training, we extracted descriptions of surgical processes and examined the hypothesis that a significant relationship exists between the course of a surgical process and the quality of its outcome. The results showed a significant correlation with Person correlation coefficients >0.05 between the quality of process outcome and process compliance for simple and complex suturing tasks in the study. We conclude that high process compliance supports good quality outcomes and, therefore, excellent patient care. We also showed that a deviation from best training processes led to a decreased outcome quality. This is relevant for identifying requirements for surgical processes, for generating feedback for the surgeon with regard to human factors and for inducing changes in the workflow in order to improve the outcome quality.

Rapid prototyping model for the manufacturing by thermoforming of occlusal splints

Purpose – This paper aims to present an optimal prototyping technology for the manufacture of occlusal splints. Design/methodology/approach – To carry out this study, a comparative technique was used to analyze models obtained by different prototyping techniques. Subsequently, further tests were carried out with respect to the manufacturing of splints by means of thermoforming in a vacuum. This involved an analysis of the most important variables such as prototype material, geometric accuracy, surface finish and costs. Findings – It was found that there is a group of prototyping technologies that are suitable for the manufacture of the models used in the thermoforming of correction splints, the most appropriate technologies being based on ink jet printing (IJP-Objet), ultraviolet photo polymerization and fused deposition modelling due to the fact that they offer an optimal relationship between the cost and the quality of the model required for thermoforming. Practical implications – The application of rapid prototyping techniques in medicine makes the production of physical models from three-dimensional medical image processing and their subsequent use in different specialties possible. It also makes preoperative planning processes, the production of prostheses and the preparation of surgical templates possible, thereby offering a higher quality of diagnosis, safer surgery and cost and time savings compared to conventional manufacturing technologies. Originality/value – This paper suggests that there exists a group of prototyping technologies for the manufacture of splints that offer advantages over existing technologies. The results also suggest that, in many cases, the most expensive technology is not the most appropriate: there are other options that provide an optimal model in terms of the cost and the quality needed for thermoforming.

Rapid prototyping fracture models used in the diagnosis and classification of calcaneal fractures

Objective To explore the guiding role of rapid prototyping (RP) models in the diagnosis and classification of calcaneal fractures. Methods From January 2010 through January 2013, RP technique was used to fabricate fracture models preoperatively for 38 patients with calcaneal fracture (41 calcanei). Three patients had bilateral calcaneal fractures. There were 27 male patients (30 calcanei) and 11 female patients (11 calcanei). Their age ranged from 21 to 76 years (average, 34.4 years). Of them, 7 were injured from falling, 23 from falling from a great height and 8 from traffic incident. All patients took axial and lateral X-rays and three-dimensional CT scanning of the calcaneus. The CT data were transformed into STL files that could be read by a RP machine before RP models of calcaneal fracture with a ratio of 1: 1 were produced. Fracture classifications based on the RP models were compared with those based on conventional CT scans. Results According to CT scans, 14 cases were type Ⅱ, 16 cases type Ⅲ and 8 cases type Ⅳ by Sanders classification. The posterior joint surface was not involved in 3 cases which were classified into Essen-Lopresti type Ⅰ. According to the RP fracture models, 12 cases were classified into type Ⅱ, 15 type Ⅲand 11 type Ⅳ by Sanders'classification. The classifications determined according to RP fracture models were more severe than those determined according to CT scans. Conclusion RP fracture models can provide detailed three-dimensional information of severe calcaneal fractures which helps surgeons to visualize much more clearly the fracture in understanding the mechanism, diagnosing, making operative plan and judging the prognosis of the fracture. Key words: Calcaneus; Fracture; Models, anatomic; Rapid prototyping

Rapid prototyping used in diagnosis and operation design for complex fractures of proximal humerus

Objective To explore the auxiliary role of rapid prototyping (RP) technique in diagnosis and operation design for complex fractures of proximal humerus. Methods A retrospective study was conducted to analyze the 18 patients with complex fracture of proximal humerus who had been treated by authors from January 2010 to January 2014. They were 7 men and 11 women, aged from 39 to 78 years (average, 62 years). All fractures were fresh and closed. Ten patients underwent three-dimensional CT scan and RP was used to prepare their fracture models which were used to guide their operation design (3D group). By Neer classification, 7 of them had three-part fractures and 3 four-part fractures. Another 8 patients received conventional open reduction and internal fixation (control group). By Neer classification, 6 of them had three-part fractures and 2 four-part fractures. The 2 groups were compared in terms of operation time and intraoperative bleeding. Their outcomes were assessed using Neer evaluation criteria 6 months postoperation. Results The RP fracture models of 1:1 ratio facilitated classification of the fractures and the following operation design. The 3D group incurred less operation time (1.1 hours on average) and bleeding (190 mL on average) than the control group (1.5 hours and 240 mL). All the patients were followed up for 7 to 23 months (16 months on average). Fractures healed after 3 to 5 months (4.3 months on average). Neer evaluation 6 months postoperation showed 5 excellent cases, 4 good cases and one fair case in the 3D group while 3 excellent cases, 4 good cases and one fair case in the control group. Conclusions The fracture models of 1: 1 ratio manufactured by RP technique may help surgeons to gain accurate and visualized knowledge of the fracture to be treated. Consequently their surgical plan can be more specific and more individualized with the aid of RP models. Therefore, operation time and bleeding can be reduced to improve the curative effect. Key words: Shoulder joint; Early diagnosis; Computer simulation; Rapid prototyping

Unique model evokes the supination/pronation deficits found after Mason II fractures.

A rapid prototyping model of Mason II fracture was used to investigate baseline recommendations for surgical intervention founded on kinematic forearm rotational blockage. Exact replicas of the radial heads in nine cadaveric specimens were produced and specimens were tested in a physiologic elbow simulator. After testing supination/pronation, the rotations were repeated with native replicas and with replicas modeling 3 mm depressed Mason II fractures with and without a gap of 1 mm between the body and fragment. The fragments were located circumferentially around the radial head at 10, 2 and 6 o'clock positions. There was no statistical difference between the range of motion of the native case and the native replica without fracture. After inclusion of the fracture, seven of the nine specimens showed rotational blockages. A two-way ANOVA found no statistical difference due to type of Mason II fracture (p > 0.87) or fracture location (p > 0.27). A χ-square analysis showed that presence of a kinematic deficit with a fractured radial head was significant (p < 0.03). The results support continued surgical intervention for a 3 mm depressed fracture and also establish the use of the rapid prototype as a model for kinematic investigation of fractures in a cadaveric model when ligamentous attachments are preserved.

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Key words:Rapid prototyping, radiology, computed tomography, cone beam computed tomography.

Anatomical Reproducibility of a Head Model Molded by a Three-dimensional Printer.

We prepared rapid prototyping models of heads with unruptured cerebral aneurysm based on image data of computed tomography angiography (CTA) using a three-dimensional (3D) printer. The objective of this study was to evaluate the anatomical reproducibility and accuracy of these models by comparison with the CTA images on a monitor. The subjects were 22 patients with unruptured cerebral aneurysm who underwent preoperative CTA. Reproducibility of the microsurgical anatomy of skull bone and arteries, the length and thickness of the main arteries, and the size of cerebral aneurysm were compared between the CTA image and rapid prototyping model. The microsurgical anatomy and arteries were favorably reproduced, apart from a few minute regions, in the rapid prototyping models. No significant difference was noted in the measured lengths of the main arteries between the CTA image and rapid prototyping model, but errors were noted in their thickness (p < 0.001). A significant difference was also noted in the longitudinal diameter of the cerebral aneurysm (p < 0.01). Regarding the CTA image as the gold standard, reproducibility of the microsurgical anatomy of skull bone and main arteries was favorable in the rapid prototyping models prepared using a 3D printer. It was concluded that these models are useful tools for neurosurgical simulation. The thickness of the main arteries and size of cerebral aneurysm should be comprehensively judged including other neuroimaging in consideration of errors.

FDM Prototype Experimental Research of Processing Parameter Optimization to Achieve Higher Tensile Stress

Fused Deposition Modeling (FDM) is one of most common ways of rapidly producing a part. Heated material (most commonly – plastic) is used to extrude it through a nozzle and deposit on a surface layer by layer until the part is fully produced. FDM has become one of the most popular in rapid production area due to its low cost, available materials and versatility.Due to fact that part is made layer by layer and each additional layer is deposited on top of a layer that is already a little below material melting point, part maintains different mechanical properties in various directions. These varying mechanical properties affect the part usability in practical applications. Critical point is tensile strength.The objective of this paper is to research optimal processing parameters for FDM prototyping to improve tensile strength. Several rapid prototype models (tensile test samples) with various geometry of longitudinal reinforcement channels were built. As reinforcing material, the epoxy resin was used, because it has higher tensile strength when solid and allows filling channels with various geometry. All made samples were tested for tensile strength. Experiment was carried out to confirm the effectiveness of this approach. From the results, it is found how different amount of epoxy resin affects part tensile strength.

The application of three-dimensional printing techniques in the fi eld of oral and maxillofacial surgery.

Recent advancements in science and technology have resulted in important changes in the medical field. Three-dimensional (3D) printing is a good example of such developments and has already achieved a considerable level of technical development in many industrial fields. Use of this innovative manufacturing technique is gradually expanding in the medical field. In clinics, application of 3D printing can be largely divided into diagnostic or treatment purposes. Meanwhile, research in the basic sciences is also advancing, allowing 3D printing of tissue or organs via cell bioprintings. This technology could potentially change the paradigm of the medical community1. Because of its usefulness, various applications of 3D printing should be considered in the area of oral and maxillofacial surgery. In fact, the field of oral and maxillofacial surgery has sought to apply a simple rudimentary form of 3D printing technique for a long time. Use of 3D-printed rapid prototyped models before oral cancer surgery or orthognathic surgery for treatment planning and simulation has been established to assure more precise and safe surgeries2. Moreover, surgical stents are fabricated using computed tomography (CT) images in the field of dental implantology3. It is necessary to move forward and adopt this technology in the fabrication of complex forms of molds in order to provide individualized medical services. For example, easier production of customized and reconstruction plates and morphologic reconstruction of bony defect areas are possible uses of 3D printing in fracture surgery or reconstructive surgery. The 3D printing technique can also be utilized in other areas of oral and maxillofacial surgery. For example, it would be very helpful to be able to design and fabricate a customized non-absorbable barrier of titanium mesh. In addition, 3D printing could be used in other fields of dentistry. For example, individual occlusion could be accurately determined and treated with a unique splint fabricated using 3D printing. It would be beneficial for patients if splints could be fabricated without the need for cast impressions. Orthodontic appliances also could be manufactured with 3D printing. Considering a wide variety of morphologies of the tooth surfaces, appliances with customized surfaces would be helpful4. Of course, there are still problems with 3D printing that need to be solved, such as the high cost; that this technology is not yet cost-effective. However, though it is difficult to justify the use of 3D printing on general surgery patients, the use of 3D printing might be much more appropriate for patients with special needs. For example, it is possible to greatly reduce the operation time if highly customized devices are prepared in advance, since it would exempt the time-consuming process of bending or modifying the appliance during the surgery. This would ultimately benefit the patient. Increased precision of the technique will also result in a wider range of applications for 3D printing. In addition, increased resolution in medical imaging such as CT will allow greater use of 3D printing5. Material science and engineering are also important areas in which 3D printing will be useful. Materials that are relatively easy to modify, such as polymers or plastics, are already at a high level of technological development, though materials such as metals, alloys, or other composites are still under development6. Many countries are increasing their national policies that support the developing 3D technology. In order to respond to the demands and remain competitive, oral and maxillofacial surgeons should have an interest in 3D printing and understand its various applications. Though it is important to have the source technology, its utilization in a variety of fields should not be overlooked. In target business models such as jewelry/accessory and interior, customized device/healthcare structure, early participation of the potential customer is also being encouraged. Moreover, since complex mold forms can be more readily manufactured using 3D printing, mass production is a future goal in applicable fields. In conclusion, the role of 3D printing in oral and maxillofacial surgery should be a focus of interest since the technique could offer endless developmental possibilities.

Computerised rapid prototyping of human foot using computed tomography

Rapid prototyping (RP) is an additive manufacturing process where the prototype is built layer by layer according to the three-dimensional (3D) contours data of the model. The human foot is considered to be a complex load bearing member and to study it, a realistic representation is needed. The stress distribution in the foot depends on geometry and structure of the foot. The purpose of this paper is to describe the building of 3D prototype of the human foot from CT scan data and hence, to assist in pre-surgical planning of foot. The digital CT scan data of the human foot were acquired and processed in MIMICS s/w and 3D computational model of the foot was developed. The RP model of the foot was then built using polymeric ABS material in fused depositional modelling (FDM)-1650 RP system. The built prototype depicts the true geometry of the human foot. The study helps in understanding the foot and ankle joint anatomy. The prototype is useful for preoperative surgical planning, surgical simulation and is also useful for production of customised implants.

3D SCANNING INSPECTION OF THE COMPOSITE STRUCTURES

Wide range of different visual measurement techniques, which are used nowadays, shows the need of the development of geometry description possibilities. New applications of advanced materials require measurement methods, which can be used in the areas of reverse engineering, FEA modelling validation, rapid prototyping and analysis of structure deformations. Light and laser-based techniques such as photogrammetry, laser triangulation, Moire and optical coherence tomography allow for analysing geometry of the specimens. Widely used optical methods take into account the global and local coordinate translation, sensitivity, resolution, and measurement uncertainty. They are used in the respect to research trends such as direct shape measurement from surfaces, system calibration and optimization methods. In this paper, composite specimens’ geometries with artificial delamination inside and structures without delamination are analysed. Rectangular, curved and cylindrical shapes are investigated by 3D scanning technique. The measured composite structures are manufactured with autoclave and vacuum bag methods. Results presented in this paper, shows geometries different between composites manufactured by using these methods. Inspection process was executed in two steps. First, virtual models of the composite specimens are used to determine main geometry dimensions. Second, their curvatures and GD&T are determined. Additional, the thickness change connected with delamination is revealed. Used method gives an opportunity of observing specimens curving radius and manufacturing defects. Presented results shows that use of additional aluminum plate in vacuum bag method allowed to get specimens with high level of flatness and parallelism in the case of rectangular structures and cylindricity in case of the curved shells. Presented methodology of the inspection is simply, give multidimensional results and its application are not limited to laboratory conditions.

3D Printed Titanium Implant for the Skull Reconstruction: A Preliminary Case Study

The skull defect can be made after the trauma, oncologic problems or neurosurgery. The skull reconstruction has been the challenging issue in craniofacial fields for a long time. So far the skull reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for skull reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile various types of allogenic and alloplastic materials have been also used. However, skull reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original skull anatomy as possible using the 3D printed titanium implant, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we fabricated Titanium implant to reconstruct three-dimensional orbital structure in advance, using the 3D printer. This prefabricated Titanium-implant was then inserted onto the defected skull and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.

Development of rapid tooling by rapid prototyping technology and electroless nickel plating for low-volume production of plastic parts

A rapid tooling approach is presented in this article to build an injection mould for low-volume production of plastic parts. This is an indirect tooling method using a rapid prototype model as a casting pattern. A layer of nickel–phosphorous alloy is plated on the casting pattern before it is cast in the aluminium-filled epoxy resin to form a cavity insert. After the removal of the casting pattern, the nickel–phosphorous alloy layer left on the wall of epoxy cavity insert acts as a protective layer to improve the tool life. The insert is installed in a mouldbase for injection moulding experiment. Three plastic parts are tried on the moulds built by this rapid tooling approach. This research has shown that manufacturing an indirect rapid tooling using electroless nickel plating for low-volume production of plastic injection mouldings is feasible for the rapid prototyping models. The cavity insert can be fabricated using commonly available low-cost materials within 48 h. More importantly, the tool life is longer under normal plastic processing conditions and quality mouldings are obtained.

Mandibular reconstruction using plates prebent to fit rapid prototyping 3-dimensional printing models ameliorates contour deformity.

BackgroundRecently, medical rapid prototyping (MRP) models, fabricated with computer-aided design and computer-aided manufacture (CAD/CAM) techniques, have been applied to reconstructive surgery in the treatment of head and neck cancers. Here, we tested the use of preoperatively manufactured reconstruction plates, which were produced using MRP models. The clinical efficacy and esthetic outcome of using these products in mandibular reconstruction was evaluated.MethodsA series of 28 patients with malignant oral tumors underwent unilateral segmental resection of the mandible and simultaneous mandibular reconstruction. Twelve patients were treated with prebent reconstruction plates that were molded to MRP mandibular models designed with CAD/CAM techniques and fabricated on a combined powder bed and inkjet head three-dimensional printer. The remaining 16 patients were treated using conventional reconstruction methods. The surgical and esthetic outcomes of the two groups were compared by imaging analysis using post-operative panoramic tomography.ResultsThe mandibular symmetry in patients receiving the MRP-model-based prebent plates was significantly better than that in patients receiving conventional reconstructive surgery.ConclusionsPatients with head and neck cancer undergoing reconstructive surgery using a prebent reconstruction plate fabricated according to an MRP mandibular model showed improved mandibular contour compared to patients undergoing conventional mandibular reconstruction. Thus, use of this new technology for mandibular reconstruction results in an improved esthetic outcome with the potential for improved quality of life for patients.

Additive manufacturing in prosthesis development – a case study

Purpose – The purpose of this paper was development of patient-specific femoral prosthesis using rapid prototyping (RP), a part of additive manufacturing (AM) technology, and comparison of its merits or demerits over CNC machining route. Design/methodology/approach – The customized femoral prosthesis was developed through computed tomography (CT)-3D CAD-RP-rapid tooling (RT)-investment casting (IC) route using a stereolithography apparatus (SLA-250) RP machine. A similar prosthesis was also developed through conventional CT-CAD-CAM-CNC, using RP models to check the fit before machining. The dimensional accuracy, surface finish, cost and time involvement were compared between these two routes. Findings – In both the routes, RP had an important role in checking the fit. Through the conventional machining route, higher-dimensional accuracies and surface finish were achieved. On the contrary, RP route involved lesser time and cost, with rougher surface finish on the prosthesis surface and less internal shrinkage porosity. The rougher surface finish of the prosthesis is favourable for bone ingrowths after implantation and porosity reduce the effective stiffness of the prosthesis, leading to reduced stress shielding effect after implantation. Research limitations/implications – As there is no AM machine for direct fabrication of metallic component like laser engineered net shaping and electron beam melting in our Institute, the metallic prosthesis was developed through RP-RT-IC route using the SLA-250 machine. Practical implications – The patient-specific prosthesis always provides better fit and favourable stress distribution, leading to longer life of the prosthesis. The described RP route can be followed to develop the customized prosthesis at lower price within the shortest time. Originality/value – The described methodology of customized prosthesis development through the AM route and its advantages are applicable for development of any metallic prostheses.

Rapid prototyping of power electronics converters for photovoltaic system application using Xilinx System Generator

The aim of this study is to develop a research platform for rapid prototyping of the power electronics converters for solar photovoltaic (PV) system applications. This study describes the field-programmable gate array (FPGA)-based hardware-in-the-loop (HIL) simulation of voltage source inverter (VSI) used for PV system power conversion. The PV system and inverter models are realised in simulation as part of the HIL to test the real-time functionality of the FPGA controller. The generation of switching control signals for the VSI and its interface with the PV system is developed through the Xilinx System Generator (XSG) domain. The XSG automatically generates the VHSIC hardware description language (VHDL) code using hardware description language co-simulation for generation of gating signal for modulation of the VSI. To validate the proposed approach, the sinusoidal pulse-width modulation using bipolar and unipolar switching schemes and current control method have been tested for the PV supported VSI. The proposed approach of the rapid prototype model has been designed and implemented in the laboratory through XSG and MATLAB/SIMULINK interface. Performance comparison between the software simulation and real-time HIL simulation has been demonstrated.

3-D Model Reconstruction and Mold Flow Simulation for an Existing Shaped Part

This study presents a 3-D model reconstruction method using a multiple coordinate measurement machine that includes a touch-trigger probe and image detection. Control points of the feature curves of an existing shaped part and geometric data of engineering features are first measured, and then the 3-D model is reconstructed in forward design procedure by the common CAD software ‘Pro/E’. This study also develops finite element models based on the 3-D model built to conduct mold flow simulations by the simulating system ‘Moldflow’. A joystick with two cases was adopted as the illustrated case. Final, actual rapid prototyping (RP) models were fabricated for model examination.

Topological optimization of internal patterns and support in additive manufacturing

Rapid prototyping (RP) and more generally Additive Manufacturing (AM) enable the manufacture of complex geometries, which are very difficult to build with classical production. There are numerous technologies that are using different kind of material. For each of these, there are at least two materials: the production material and the support one. Support material is, in most cases, cleaned and becomes a manufacturing residue. Improve the material volume and the global mass of the product is an essential aim surrounding the integration of simulation in additive manufacturing process. Moreover the layer-by-layer technology of additive manufacturing allows the design of innovative objects and the use of topological optimization in this context can create a very interesting combination. The purpose of our paper is to present a methodology and a tool, which allow the use of topological optimization for the preparation of model for RP and AM.

Accuracy of three-dimensional, paper-based models generated using a low-cost, three-dimensional printer

Our study aimed to determine the accuracy of a low-cost, paper-based 3D printer by comparing a dry human mandible to its corresponding three-dimensional (3D) model using a 3D measuring arm.One dry human mandible and its corresponding printed model were evaluated. The model was produced using DICOM data from cone beam computed tomography. The data were imported into Maxilim software, wherein automatic segmentation was performed, and the STL file was saved. These data were subsequently analysed, repaired, cut and prepared for printing with netfabb software. These prepared data were used to create a paper-based model of a mandible with an MCor Matrix 300 printer.Seventy-six anatomical landmarks were chosen and measured 20 times on the mandible and the model using a MicroScribe G2X 3D measuring arm. The distances between all the selected landmarks were measured and compared. Only landmarks with a point inaccuracy less than 30% were used in further analyses.The mean absolute difference for the selected 2016 measurements was 0.36 ± 0.29 mm. The mean relative difference was 1.87 ± 3.14%; however, the measurement length significantly influenced the relative difference.The accuracy of the 3D model printed using the paper-based, low-cost 3D Matrix 300 printer was acceptable. The average error was no greater than that measured with other types of 3D printers. The mean relative difference should not be considered the best way to compare studies. The point inaccuracy methodology proposed in this study may be helpful in future studies concerned with evaluating the accuracy of 3D rapid prototyping models.

Application of 3D Simulation Surgery to Orbital Wall Fracture : A preliminary Case Study

The orbit has a very special anatomical structure. The complex anatomical structure should be restored when we encounter the patient with orbital wall fracture. Unless these specific anatomy were reconstructed well, the patient should suffer from various complications such enophthalmos, diplopia or orbital deformity. In addition, because the patient has a his own specific orbital shape, individualized approach will be necessary. The aim of this trial is to try to restore the original orbit anatomy as possible based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. In order to restore the missing skipped images between the cuts of CT data because of the thinness of the orbital walls, we manipulated the DICOM data for imaging the original orbital contour using the preoperatively manufactured mirror-image of the RP model. And we fabricated Titanium-Medpor to reconstruct three-dimensional orbital structure intraoperatively. This prefabricated Titanium-Medpor was then inserted onto the defected orbital wall and fixed. Three dimensional approach based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.