Üç boyutlu yazıcının kraniyosinostoz cerrahisine katkıları

Öz

Amaç: Kraniosinostoz ameliyatında ameliyat süresinin kısaltılması ve kan kaybının en aza indirilmesi esastır. Günümüzde üç boyutlu yazıcıların ve biyoyazıcıların kullanımı artıyor ve bu makale bu teknolojinin kraniyosinostoz cerrahisindeki etkisini araştırmayı amaçlıyor. Gereç ve yöntem: Açık kraniyosinostoz ameliyatı geçiren hastaların dosyaları incelendi. 3D baskılı preoperatif modellemenin yapılmadığı grup Grup 1 (5 hasta), 3D baskılı preoperatif modellemenin yapıldığı grup ise Grup 2 (12 hasta) olarak belirlendi. Tüm olguların dosyaları retrospektif olarak incelendi ve eritrosit replasman ihtiyaçları, operasyon süreleri ve demografik bilgileri dikkate alınarak karşılaştırıldı. Bulgular: 1. grupta yaş ortalaması 13,70 ay, 2. grupta ise yaş ortalaması 9,1 ay oldu. Ortalama ES replasman hacmi birinci grupta 190 mL iken, ikinci grupta 142 mL idi. Ameliyat öncesi 3D baskılı modelleme yapılan olgularda eritrosit replasman ihtiyacının daha az olduğu görüldü. Ayrıca ortalama ameliyat süresi 1. grupta 3,3 saat iken 2. grupta 2,4 saatti. Ortalama takip süresi birinci grupta 2,37 yıl, ikinci grupta ise 2,05 yıldı. Hiçbir olgumuzda komplikasyon gelişmedi. Sonuç: Bu çalışma, üç boyutlu yazıcı kullanılarak yapılan ameliyat öncesi modellemenin ameliyat süresini kısalttığını ve daha az kan nakli gerektirdiğini göstermektedir.

Anahtar Kelimeler

• Kraniosinostoz
• pediatri
• cerrahi

Contributions of the three-dimensional printer to craniosynostosis surgerys

Öz

Purpose: In craniosynostosis surgery, it is essential to reduce the duration of the operation and minimize blood loss. Currently, the use of three-dimensional printers and bioprinters is on the rise, and this article aims to investigate the impact of this technology on craniosynostosis surgery. Materials and methods: The files of patients who underwent open craniosynostosis surgery were examined. The group without 3D-printed preoperative modeling was designated as Group 1 (5 patients), and the group with 3D-printed preoperative modeling was designated as Group 2 (12 patients). The files of all cases were retrospectively reviewed and compared, focusing on their erythrocyte replacement needs, operation durations, and demographic information. Results: The average age in the 1st group was 13.70 months, and the average age in the 2nd group was 9.1 months. While the average volume of ES replacement was 190 mL in the first group, it was 142 mL in the second group. The need for erythrocyte replacement was found to be less in cases with 3D-printed preoperative modeling. Additionally, while the mean operation duration was 3.3 hours in the 1st group, it was 2.4 hours in the 2nd group. The average follow-up period was 2.37 years in the second group. No complications developed in any of our cases. Conclusion: This study demonstrates that preoperative modeling using a three-dimensional printer reduces the duration of surgery and requires fewer blood transfusions.

Anahtar Kelimeler

• Craniosynostosis
• pediatrics
• surgery

Kaynakça

1. 1. Slater BJ, Lenton KA, Kwan MD, Gupta DM, Wan DC, Longaker MT. Cranial sutures: a brief review. Plast Reconstr Surg. 2008;121(4):170e-178e. doi: 10.1097/01.prs.0000304441.99483.97
2. 2. Albuz B, Coskun ME, Egemen E. Endoscopy-Assisted Craniosynostosis Surgery Versus Cranial Vault Remodeling for Non-Syndromic Craniosynostosis: Experience of a Single Center. Turk Neurosurg. 2024;34(1):102-112. doi:10.5137/1019-5149.JTN.43011-22.2
3. 3. Hoey ET, Shahid M, Watkin RW. Computed tomography and magnetic resonance imaging evaluation of pericardial disease. Quant Imaging Med Surg. 2016;6(3):274-284. doi:10.21037/qims.2016.01.03
4. 4. Kodama H. Automatic method for fabricating a three‐dimensional plastic model with photo‐hardening polymer. Rev Sci Instrum. 1981; 52:1770-1773. doi:10.1063/1.1136492
5. 5. Anderl H, Zur Nedden D, Mühlbauer W, et al. CT-guided stereolithography as a new tool in craniofacial surgery. Br J Plast Surg. 1994;47(1):60-64. doi:10.1016/0007-1226(94)90121-x
6. 6. Ventola CL. Medical Applications for 3D Printing: Current and Projected Uses. P T. 2014;39(10):704-711.
7. 7. Blohm JE, Salinas PA, Avila MJ, Barber SR, Weinand ME, Dumont TM. Three-Dimensional Printing in Neurosurgery Residency Training: A Systematic Review of the Literature. World Neurosurg. 2022; 161:111-122. doi: 10.1016/j.wneu.2021.10.069
8. 8. Bowen L, Benech R, Shafi A, et al. Custom-Made Three-Dimensional Models for Craniosynostosis. J Craniofac Surg. 2020;31(1):292-293. doi:10.1097/SCS.0000000000005927

9. 9. Elbanoby TM, Elbatawy AM, Aly GM, Sharafuddin MA, Abdelfattah UA. 3D printing-guided surgery in the treatment of unicoronal craniosynostosis and orbital dysmorphology. Oral Maxillofac Surg. 2020;24(4):423-429. doi:10.1007/s10006-020-00863-6
10. 10. Emmez H, Küçüködük I, Börcek AO, et al. Effectiveness of skull models and surgical simulation: comparison of outcome between different surgical techniques in patients with isolated brachycephaly. Childs Nerv Syst. 2009;25(12):1605-1612. doi:10.1007/s00381-009-0939-y
11. 11. Jiménez Ormabera B, Díez Valle R, Zaratiegui Fernández J, Llorente Ortega M, Unamuno Iñurritegui X, Tejada Solís S. 3D printing in neurosurgery: a specific model for patients with craniosynostosis [Impresión 3D en neurocirugía: modelo específico para pacientes con craneosinostosis]. Neurocirugia (English Edition). 2017;28(6):260-265. doi: 10.1016/j.neucir.2017.05.001
12. 12. Alshomer F, AlFaqeeh F, Alariefy M, Altweijri I, Alhumsi T. Low-Cost Desktop-Based Three-Dimensional-Printed Patient-Specific Craniofacial Models in Surgical Counseling, Consent Taking, and Education of Parents of Craniosynostosis Patients: A Comparison with Conventional Visual Explanation Modalities. J Craniofac Surg. 2019;30(6):1652-1656. doi:10.1097/SCS.0000000000005401
13. 13. Coelho G, Rabelo NN, Adani LB, et al. The Craniosynostosis Puzzle: New Simulation Model for Neurosurgical Training. World Neurosurg. 2020;138: e299-e304. doi: 10.1016/j.wneu.2020.02.098
14. 14. Ghizoni E, de Souza JPSAS, Raposo-Amaral CE, et al. 3D-Printed Craniosynostosis Model: New Simulation Surgical Tool. World Neurosurg. 2018; 109:356-361. doi: 10.1016/j.wneu.2017.10.025