Search

This study investigated the determination of detailed microstructure modeling of the trochlea of the superior oblique muscle (SOM) using micro-computed tomography (micro-CT) and modeling of a potential prototype for a trochlea implant using three-dimensional (3D) printing. We dissected 15 intact orbits of 15 embalmed cadavers. The trochleae of the SOM were detached from the periosteum. The specimens were stained by immersion in a 15% Lugol's solution. Images were reconstructed using conventional scanner software. Measurement points were determined for the middle cross section. Points P1 and P2 were selected where the SOM adjoined the curvature of the inner trochlea. They defined the inner contact points of the SOM in the inner part of the trochlea curvature. On the back of the trochlea, points P3 and P4 were selected at the uppermost and lowest points in the inner parts of the straight trochlea, respectively. Origin O was defined on the arcuate line of P 1 P 2 ^ to generate the smallest-diameter circle consisting of P1, O, and P2. We then measured the angle from O P 1 ¯ t o O P 2 ¯ , and from O P 3 ¯ t o O P 4 ¯. We also measured the distances O P 1 ¯ , O P 2 ¯ , O P 3 ¯ , a n d O P 4 ¯ for the design of a potential trochlea implant prototype using 3D-printing and micro-CT-based modeling. The distances O P 1 ¯ , O P 2 ¯ , O P 3 ¯ , a n d O P 4 ¯ were 2.2 ± 0.7, 1.4 ± 0.5, 2.7 ± 0.9, and 2.5 ± 0.4 mm (mean ± SD), respectively. The angles from O P 1 ¯ t o O P 2 ¯ , from O P 2 ¯ t o O P 4 , - and from O P 3 ¯ t o O P 4 ¯ were 100.7 ± 14.4, 66.3 ± 18.0, and 98.9 ± 24.9 degrees, respectively. The present investigation demonstrates that the high-resolution CT is a powerful imaging technique for defining the true 3D geometry of a specimen and can potentially be used to create a 3D-printed trochlea implant. [ABSTRACT FROM AUTHOR]

Purpose: Extrinsic trauma to the orbit may cause a blowout or orbital fracture, which often requires surgery for reconstruction of the orbit and repositioning of the eyeball with an implant. Post-operative complications, however, are high with the most frequent cause of complications being a mismatch of the position and shape of the implant and fracture. These mismatches may be reduced by computed tomography (CT) based modeling and three-dimensional (3D) printed guide. Therefore, the aim of this study is to propose and evaluate a patient-specific guide to shape an orbital implant using 3D printing. Design/methodology/approach: Using CT images of a patient, an orbital fracture can be modeled to design an implant guide for positioning and shaping of the surface and boundaries of the implant. The guide was manufactured using UV curable plastic at 0.032 mm resolution by a 3D printer. The accuracy of this method was evaluated by micro-CT scanning of the surgical guides and shaping implants. Findings: The length and depth of the 3D model, press-compressed and decompressed implants were compared. The mean differences in length were 0.67 ± 0.38 mm, 0.63 ± 0.28 mm and 0.10 ± 0.10 mm, and the mean differences in depth were 0.64 ± 0.37 mm, 1.22 ± 0.56 mm and 0.57 ± 0.23 mm, respectively. Statistical evaluation was performed with a Bland-Altman plot. Originality/value: This study suggests a patient-specific guide to shape an orbital implant using 3D printing and evaluate the guiding accuracy of the implant versus the planned model. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to systemically evaluate morphological printing errors between computer-aided design (CAD) and reference models fabricated using two different three-dimensional printing (3DP) technologies with hard and soft materials. Design/methodology/approach: The reference models were designed to ensure simpler and more accurate measurements than those obtained from actual kidney simulators. Three reference models, i.e. cube, dumbbell and simplified kidney, were manufactured using photopolymer jetting (PolyJet) with soft and hard materials and multi-jet printing (MJP) with hard materials. Each reference model was repeatably measured five times using digital calipers for each length. These values were compared with those obtained using CAD. Findings: The results demonstrate that the cube models with the hard material of MJP and hard and soft materials of PolyJet were smaller (p = 0.022, 0.015 and 0.057, respectively). The dumbbell model with the hard material of MJP was smaller (p = 0.029) and that with the soft material of PolyJet was larger (p = 0.020). However, the dumbbell with the hard material of PolyJet generated low errors (p = 0.065). Finally, the simplified kidney models with the hard material of MJP and soft materials of PolyJet were smaller (p = 0.093 and 0.021) and that with the hard material of PolyJet was opposite to the former models (p = 0.043). Originality/value: This study, to the best of authors' knowledge, is the first to determine the accuracy between CAD and reference models fabricated using two different 3DP technologies with multi-materials. Thus, it serves references for surgical applications as simulators and guides that require accuracy. [ABSTRACT FROM AUTHOR]

Background: ERCP training models are very different in terms of anatomical differences, ethical issues, storage problems, realistic tactile sensation, durability and portability. There is no easy way to select an optimized model for ERCP training. If the ERCP training model could be made as a soft silicone model using 3D printing technique, it would have numerous advantages over the models presented so far. The purpose of this study was to develop an optimized ERCP training model using a 3D printing technique and to try to find ways for implementing various practical techniques.Methods: All organ parts of this model were fabricated using silicone molding techniques with 3D printing. Especially, various anatomy of the ampulla of Vater and common bile duct (CBD) were creatively designed for different diagnostic and therapeutic procedures. In order to manufacture each of the designed organ parts with silicone, a negative part had to be newly designed to produce the molder. The negative molders were 3D printed and then injection molding was applied to obtain organ parts in silicone material. The eight different types of ampulla and CBD were repeatedly utilized and replaced to the main system as a module-type.Results: ERCP training silicone model using 3D technique was semi-permanently used to repeat various ERCP procedures. All ERCP procedures using this model could be observed by real-time fluoroscopic examination as well as endoscopic examination simultaneously. Using different ampulla and CBD modules, basic biliary cannulation, difficult cannulation, stone extraction, mechanical lithotripsy, metal stent insertion, plastic stent insertion, and balloon dilation were successfully and repeatedly achieved. Endoscopic sphincterotomy was also performed on a specialized ampulla using a Vienna sausage. After repeat procedures and trainings, all parts of organs including the ampulla and CBD modules were not markedly damaged or deformed.Conclusions: We made a specialized ERCP training silicon model with 3D printing technique. This model is durable, relatively cheap and easy to make, and thus allows the users to perform various specialized ERCP techniques, which increases its chances of being a good ERCP training model. [ABSTRACT FROM AUTHOR]