Jun 21, 2016 | By Benedict
Surgeons at Boston Children’s Hospital have used 3D printing to assist complex brain surgery on an infant suffering from severe encephalocele. 3D printed models of the deformed skull, through which parts of the patient’s brain were growing, were used during surgical planning.
When parents-to-be Sierra and Dustin Yoder were told that Bentley, their unborn baby, was suffering from a rare condition called encephalocele, otherwise known as cranium bifidum, they naturally feared the worst. When conducting a routine ultrasound, doctors discovered that parts of Bentley’s brain were protruding through gaps in his skull, and the diagnosis was grim: Bentley was unlikely to survive long after birth, and even if he did, his brain would not function properly.
Sierra and Dustin, both from Sugarcreek, Ohio, swallowed the news, but were determined to meet their son before saying goodbye, and refused to terminate the pregnancy. The child was born on his due date, October 31, 2015, and—to everyone’s surprise—appeared to have normal brain function, in spite of the large sac protruding from the back of his head. Months later and Bentley was still in ship shape, developing normally and crying when hungry. The exuberant youngster was defying all expectations.
At four months old, Bentley was taken to the Cleveland Clinic by his parents, where a surgeon concluded that Bentley was indeed using his brain from outside of his head, but that it would be an almighty task to return it to the cranium. Ever the optimists, Sierra and Dustin approached Dr. John Meera at Boston Children’s Hospital, whose team of surgeons examined Bentley. They found that the parts of his brain protruding through his skull were responsible for cognitive functions such as motor control, problem-solving, and vision, and could therefore not be removed. They could, however, potentially be reinserted into the skull.
Because of the complexity of the operation, the Boston Children’s Hospital surgeons needed an extra helping hand in their surgical planning—help that came from 3D printing. By 3D printing a model of Bentley’s skull using visual data from brain scans, surgeons were able to practice the procedure on a plastic replica of the patient’s head before going into the operating room, giving them some much-needed extra preparation. The 3D printed skull was used to determine how much of the 100 cubic centimeters of externalized brain could be returned to the cranium.
The six-hour surgery began on May 24, at a stage where Bentley’s skull was just about strong enough to withstand surgery, but before the encephalocele began to pose a greater risk of rupture. The surgeons first drained cerebrospinal fluid from Bentley’s brain, before making further cuts into the cranium, enabling them to move parts of the patient’s brain back into his head. Leftover bone was used to close the gap. Although the surgery went well, Bentley returned for a pair of follow-up procedures, first to add a shunt and then to drain further fluid from his brain.
Now seven months old, Bentley appears healthy, although doctors are still unsure how his future will pan out. Given the adversity their son has already overcome, Sierra and Dustin remain hopeful about his chances, but refuse to get ahead of themselves: “We just have to take it step by step,” Sierra told the Washington Post.
A month ago, a similarly complex operation was performed in China, where a young patient was suffering from a rare condition called narrow cranial disease. As with Bentley’s operation, a 3D printed skull model was used to assist surgeons, giving one-year-old Chen Chen a greater chance of survival. With additive manufacturing being used to assist such delicate procedures all over the world, the medical 3D printing revolution is evidently in full swing.
Posted in 3D Printing Application
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We do, indeed, live in a time of miracles.
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