Aug 5, 2016 | By Alec

Even though the 3D bioprinting revolution isn’t quite ready to help patients yet, 3D printers are already finding their way into hospital departments all over the world. In some cases, the 3D printers are even making the difference between life and death – as they did for this four-month-old Ohio baby born with its brain outside its skull. But 3D printing can also make a big difference when it comes to cosmetic surgery, as UK doctor Ken Stewart is proving. Dr. Stewart has begun using 3D scanning and 3D printing equipment to build outer ear implants for children suffering from microtia, and the results are breathtaking.

Microtia, to explain, is an unusual congenital deformity of the ear. Occurring in about one out of every 8,000–10,000 births, it leaves one or both ears completely undeveloped. For some reason it usually affects the right ear, and it occurs in different forms of severity – from unsightly ears to almost completely absent ones.

Fortunately it has been treatable for some time, but it can be a bit frightening for children to undergo treatment. Either they have to subjected to a general anesthetic, or they have to lie in an MRI machine for a lengthy period of time – something many adults are afraid of too. But this is simply necessary to capture enough data to help doctors carve an implant by hand. “Traditionally we would use a clear acetate to take a 2D tracing of the normal ear. This would be used as a template to help carve an appropriately sized and shaped opposite ear,” Dr. Stewart added.

But luckily patients in the Royal Hospital for Sick Children in Edinburgh, Scotland can now undergo a far less scary form of treatment. Instead of having to lay down in a huge MRI machine, Dr. Stewart simply uses an Artec Spider 3D scanner to accurately capture the geometry of the patient’s other, healthy ear (if he or she has one). "Starting with exterior 3D scanning was new for us and as we have busy schedules with day-to-day patients, it has taken a little time to perfect," said Dr. Stewart. "However, with the training, we can now use the solution from scanning to 3D print with relative ease. The model is then sterilized and utilized in theater to improve the accuracy of our surgical reconstruction."

“The 3D scanner and mirror image software allows us to produce a more accurate template,” Dr. Stewart added.

But the cosmetic surgeons themselves can also benefit from this innovation, because it makes their work so much easier. For the ear implants are carved from extracted rib cartilage, and require a steady hand and a good eye for detail. Nothing but the surgeon’s own judgement determines the results. Although the finished carvings were often acceptable, they are never perfect and nothing more than approximations of how the ear should look.

Thanks to 3D scanning, the Edinburgh surgeon can now easily 3D print a perfect replica of the patient’s good ear. Once sterilized, these 3D prints are taken into the operating room and act as a perfect model which the surgeon can replicate during the carving process. So far, the results have already thoroughly improved.

But it doesn’t end there. Dr. Stewart is already looking into 3D bioprinting options as well, in order to build implants made from a patient’s own cartilage. “We are working with scientists at Edinburgh University’s Centre for Regenerative Medicine and Chemistry Department with a view to tissue engineering an ear,” he explains. “Professor Bruno Peault and his team have characterized stem cells within human fat which lie next to blood vessels. We can harvest these very easily by liposuction. For a plastic surgeon that is easier than taking blood.”

Those cells could subsequently be mixed with FDA-approved polymers, and could be 3D printed to grow cartilage in the lab. In fact, Chemistry professor Mark Bradley’s team have already identified the necessary polymers, so this could definitely become a reality in the near future. “We know we can 3D print in the polymers concerned. So the Artec-derived 3D scans could potentially be mirrored [and] 3D printed with the ideal polymer,” Dr. Stewart says. It just further underlines what we’ve been suspecting for a long time: 3D printing is about to change the medical world as we know it.



Posted in 3D Printing Application



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