2D versus 3D Endoscopy: Head-to-Head Comparison in a Simulated Model of Endoscopic Endonasal Dural Suturing

2021 ◽  
Author(s):  
Ivanna Nebor ◽  
Zoe Anderson ◽  
Juan C. Mejia-Munne ◽  
Ahmed Hussein ◽  
Kora Montemagno ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Cerebrospinal Fluid Fistula ◽  
Average Deviation ◽  
Endoscopic Endonasal ◽  
Simulated Model ◽  
Novice Group ◽  
Significant Difference ◽  
Procedural Time ◽  
3D Printed ◽  
Dural Suturing

Abstract Objective Endonasal dural suturing (EDS) has been reported to decrease the incidence of cerebrospinal fluid fistula. This technique requires handling of single-shaft instrumentation in the narrow endonasal corridor. It has been proposed that three-dimensional (3D) endoscopes were associated with improved depth perception. In this study, we sought to perform a comparison of two-dimensional (2D) versus 3D endoscopy by assessing surgical proficiency in a simulated model of EDS. Materials and Methods Twenty-six participants subdivided into groups based on previous endoscopic experience were asked to pass barbed sutures through preset targets with either 2D (Storz Hopkins II) or 3D (Storz TIPCAM) endoscopes on 3D-printed simulation model. Surgical precision and procedural time were measured. All participants completed a Likert scale questionnaire. Results Novice, intermediate, and expert groups took 11.0, 8.7, and 5.7 minutes with 2D endoscopy and 10.9, 9.0, and 7.6 minutes with 3D endoscopy, respectively. The average deviation for novice, intermediate, and expert groups (mm) was 5.5, 4.4, and 4.3 with 2D and 6.6, 4.6, and 3.0 with 3D, respectively. No significant difference in procedural time or accuracy was found in 2D versus 3D endoscopy. 2D endoscopic visualization was preferred by the majority of expert/intermediate participants, while 3D endoscopic visualization by the novice group. Conclusion In this pilot study, there was no statistical difference in procedural time or accuracy when utilizing 2D versus 3D endoscopes. While it is possible that widespread familiarity with 2D endoscopic equipment has biased this study, preliminary analysis suggests that 3D endoscopy offers no definitive advantage over 2D endoscopy in this simulated model of EDS.

Primary Dural Repair via an Endoscopic Endonasal Corridor: Preliminary Development of a 3D-Printed Model for Training

2021 ◽  
Author(s):  
Ivanna Nebor ◽  
Ahmed E. Hussein ◽  
Kora Montemagno ◽  
Rebecca Fumagalli ◽  
Ikrame Labiad ◽  
...  
Keyword(s):  
Cost Model ◽  
Low Cost ◽  
Three Dimensional ◽  
Task Completion ◽  
Endoscopic Endonasal ◽  
Dural Repair ◽  
Needle Driver ◽  
Tissue Allograft ◽  
3D Printed ◽  
Dural Suturing

Abstract Objectives Endonasal suturing is an investigational method for dural repair that has been reported to decrease the incidence of cerebrospinal fluid fistula. This method requires handling of single-shaft instrumentation in the narrow endonasal corridor. In this study, we designed a low-cost, surgical model using three-dimensional (3D) printing technology to simulate dural repair through the endonasal corridor and subsequently assess the utility of the model for surgical training. Methods Using an Ultimaker 2+ printer, a 3D-printed replica of the cranial base and nasal cavity was fitted with tissue allograft to recapitulate the dural layer. Residents, fellows, and attending surgeons were asked to place two sutures using a 0-degree endoscope and single-shaft needle driver. Task completion time was recorded. Participants were asked to fill out a Likert scale questionnaire after the experiment. Results Twenty-six participants were separated into groups based on their prior endoscope experience: novice, intermediate, and expert. Twenty-one (95.5%) residents and fellows rated the model as “excellent” or “good” in enhancing their technical skills with endoscopic instrumentation. Three of four (75%) of attendings felt that the model was “excellent” or “good” in usefulness for training in dural suturing. Novice participants required an average of 11 minutes for task completion, as compared with 8.7 minutes for intermediates and 5.7 minutes for experts. Conclusion The proposed model appears to be highly effective in enhancing the endoscopic skills and recapitulating the task of dural repair. Such a low-cost model may be especially important in enhancing endoscopic facility in countries/regions with limited access to cadaveric specimens.

scholarly journals Dimensional Accuracy of Dental Models for Three-Unit Prostheses Fabricated by Various 3D Printing Technologies

Materials ◽  
2021 ◽  
Vol 14 (6) ◽  
pp. 1550
Author(s):  
Soo-Yeon Yoo ◽  
Seong-Kyun Kim ◽  
Seong-Joo Heo ◽  
Jai-Young Koak ◽  
Joung-Gyu Kim
Keyword(s):  
Surface Roughness ◽  
Three Dimensional ◽  
Dimensional Accuracy ◽  
3D Analysis ◽  
Digital Light Processing ◽  
Test Models ◽  
Reference File ◽  
Significant Difference ◽  
Jet Printing ◽  
3D Printed

Previous studies on accuracy of three-dimensional (3D) printed model focused on full arch measurements at few points. The aim of this study was to examine the dimensional accuracy of 3D-printed models which were teeth-prepped for three-unit fixed prostheses, especially at margin and proximal contact areas. The prepped dental model was scanned with a desktop scanner. Using this reference file, test models were fabricated by digital light processing (DLP), Multi-Jet printing (MJP), and stereo-lithography apparatus (SLA) techniques. We calculated the accuracy (trueness and precision) of 3D-printed models on 3D planes, and deviations of each measured points at buccolingual and mesiodistal planes. We also analyzed the surface roughness of resin printed models. For overall 3D analysis, MJP showed significantly higher accuracy (trueness) than DLP and SLA techniques; however, there was not any statistically significant difference on precision. For deviations on margins of molar tooth and distance to proximal contact, MJP showed significantly accurate results; however, for a premolar tooth, there was no significant difference between the groups. 3D color maps of printed models showed contraction buccolingually, and surface roughness of the models fabricated by MJP technique was observed as the lowest. The accuracy of the 3D-printed resin models by DLP, MJP, and SLA techniques showed a clinically acceptable range to use as a working model for manufacturing dental prostheses

Investigation of three-dimensional printing materials for printing aorta model replicating Type B aortic dissection

2021 ◽  
Vol 17 ◽  
Author(s):  
Chia-An Wu ◽  
Andrew Squelch ◽  
Zhonghua Sun
Keyword(s):  
3D Printing ◽  
Aortic Dissection ◽  
Three Dimensional ◽  
Ct Images ◽  
Patient Specific ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Ct Attenuation ◽  
Significant Difference ◽  
3D Printed

Aim: To determine a printing material that has both elastic property and radiology equivalence close to real aorta for simulation of endovascular stent graft repair of aortic dissection. Background: With the rapid development of three-dimensional (3D) printing technology, a patient-specific 3D printed model is able to help surgeons to make better treatment plan for Type B aortic dissection patients. However, the radiological properties of most 3D printing materials have not been well characterized. This study aims to investigate the appropriate materials for printing human aorta with mechanical and radiological properties similar to the real aortic computed tomography (CT) attenuation. Objective: Quantitative assessment of CT attenuation of different materials used in 3D printed models of aortic dissection for developing patient-specific 3D printed aorta models to simulate type B aortic dissection. Method: A 25-mm length of aorta model was segmented from a patient’s image dataset with diagnosis of type B aortic dissection. Four different elastic commercial 3D printing materials, namely Agilus A40 and A50, Visijet CE-NT A30 and A70 were selected and printed with different hardness. Totally four models were printed out and conducted CT scanned twice on a 192-slice CT scanner using the standard aortic CT angiography protocol, with and without contrast inside the lumen.Five reference points with region of interest (ROI) of 1.77 mm2 were selected at the aortic wall and intimal flap and their Hounsfield units (HU) were measured and compared with the CT attenuation of original CT images. The comparison between the patient’s aorta and models was performed through a paired-sample t-test to determine if there is any significant difference. Result: The mean CT attenuation of aortic wall of the original CT images was 80.7 HU. Analysis of images without using contrast medium showed that the material of Agilus A50 produced the mean CT attenuation of 82.6 HU, which is similar to that of original CT images. The CT attenuation measured at images acquired with other three materials was significantly lower than that of original images (p<0.05). After adding contrast medium, Visijet CE-NT A30 had an average CT attenuation of 90.6 HU, which is close to that of the original images with statistically significant difference (p>0.05). In contrast, the CT attenuation measured at images acquired with other three materials (Agilus A40, A50 and Visiject CE-NT A70) was 129 HU, 135 HU and 129.6 HU, respectively, which is significantly higher than that of original CT images (p<0.05). Conclusion: Both Visijet CE-NT and Agilus have tensile strength and elongation close to real patient’s tissue properties producing similar CT attenuation. Visijet CE-NT A30 is considered the appropriate material for printing aorta to simulate contrast-enhanced CT imaging of type B aortic dissection. Due to lack of body phantom in the experiments, further research with simulation of realistic anatomical body environment should be conducted.

scholarly journals Accuracy of Low-Cost Alternative Facial Scanners: A Prospective Cohort Study.

2021 ◽  
Author(s):  
Alexander K. Bartella ◽  
Josefine Laser ◽  
Mohammad Kamal ◽  
Dirk Halama ◽  
Michael Neuhaus ◽  
...  
Keyword(s):  
Low Cost ◽  
Three Dimensional ◽  
Neck Surgery ◽  
Clinical Analysis ◽  
Smart Device ◽  
Data Sets ◽  
Average Deviation ◽  
Technical Improvement ◽  
Data Set ◽  
Significant Difference

Abstract Introduction: Three-dimensional facial scan images have been showing an increasingly important role in peri-therapeutic management of oral and maxillofacial and head and neck surgery cases. Face scan images can be open using optical facial scanners utilizing line-laser, stereophotography, structured light modality, or from volumetric data obtained from cone beam computed tomography (CBCT). The aim of this study is to evaluate, if two low-cost procedures for creating a three-dimensional face scan images are able to produce a sufficient data set for clinical analysis. Materials and methods: 50 healthy volunteers were included in the study. Two test objects with defined dimensions were attached to the forehead and the left cheek. Anthropometric values were first measured manually, and consecutively, face scans were performed with a smart device and manual photogrammetry and compared to the manually measured data sets.Results: Anthropometric distances on average deviated 2.17 mm from the manual measurement (smart device scanning 3.01 mm vs. photogrammetry 1.34 mm), with 7 out of 8 deviations were statistically significant. Of a total of 32 angles, 19 values showed a significant difference to the original 90° angles. The average deviation was 6.5° (smart device scanning 10.1° vs. photogrammetry 2.8°).Conclusion: Manual photogrammetry with a regular photo-camera shows higher accuracy than scanning with smart device. However, the smart device was more intuitive in handling and further technical improvement of the cameras used should be watched carefully.

scholarly journals Improving Geometric Accuracy of 3D Printed Parts Using 3D Metrology Feedback and Mesh Morphing

2020 ◽  
Vol 4 (4) ◽  
pp. 112
Author(s):  
Moustapha Jadayel ◽  
Farbod Khameneifar
Keyword(s):  
Vector Field ◽  
Three Dimensional ◽  
Measurement Data ◽  
Geometric Accuracy ◽  
Average Deviation ◽  
Mesh Model ◽  
3D Printed ◽  
3D Metrology ◽  
Deviation Vector ◽  
A Current

Additive manufacturing (AM), also known as 3D printing, has gained significant interest due to the freedom it offers in creating complex-shaped and highly customized parts with little lead time. However, a current challenge of AM is the lack of geometric accuracy of fabricated parts. To improve the geometric accuracy of 3D printed parts, this paper presents a three-dimensional geometric compensation method that allows for eliminating systematic deviations by morphing the original surface mesh model of the part by the inverse of the systematic deviations. These systematic deviations are measured by 3D scanning multiple sacrificial printed parts and computing an average deviation vector field throughout the model. We demonstrate the necessity to filter out the random deviations from the measurement data used for compensation. Case studies demonstrate that printing the compensated mesh model based on the average deviation of five sacrificial parts produces a part with deviations about three times smaller than measured on the uncompensated parts. The deviation values of this compensated part based on the average deviation vector field are less than half of the deviation values of the compensated part based on only one sacrificial part.

scholarly journals Three-Dimensional (3D) Printed Microneedles for Microencapsulated Cell Extrusion

2018 ◽  
Vol 5 (3) ◽  
pp. 59 ◽  
Author(s):  
Chantell Farias ◽  
Roman Lyman ◽  
Cecilia Hemingway ◽  
Huong Chau ◽  
Anne Mahacek ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Root Mean Square Roughness ◽  
Great Promise ◽  
Hollow Microneedle ◽  
Alginate Capsules ◽  
Significant Difference ◽  
Time In Literature ◽  
3D Printed ◽  
And Control ◽  
Cell Extrusion

Cell-hydrogel based therapies offer great promise for wound healing. The specific aim of this study was to assess the viability of human hepatocellular carcinoma (HepG2) cells immobilized in atomized alginate capsules (3.5% (w/v) alginate, d = 225 µm ± 24.5 µm) post-extrusion through a three-dimensional (3D) printed methacrylate-based custom hollow microneedle assembly (circular array of 13 conical frusta) fabricated using stereolithography. With a jetting reliability of 80%, the solvent-sterilized device with a root mean square roughness of 158 nm at the extrusion nozzle tip (d = 325 μm) was operated at a flowrate of 12 mL/min. There was no significant difference between the viability of the sheared and control samples for extrusion times of 2 h (p = 0.14, α = 0.05) and 24 h (p = 0.5, α = 0.05) post-atomization. Factoring the increase in extrusion yield from 21.2% to 56.4% attributed to hydrogel bioerosion quantifiable by a loss in resilience from 5470 (J/m3) to 3250 (J/m3), there was no significant difference in percentage relative payload (p = 0.2628, α = 0.05) when extrusion occurred 24 h (12.2 ± 4.9%) when compared to 2 h (9.9 ± 2.8%) post-atomization. Results from this paper highlight the feasibility of encapsulated cell extrusion, specifically protection from shear, through a hollow microneedle assembly reported for the first time in literature.

scholarly journals Biomechanical Evaluation and Strength Test of 3D-Printed Foot Orthoses

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Kuang-Wei Lin ◽  
Chia-Jung Hu ◽  
Wen-Wen Yang ◽  
Li-Wei Chou ◽  
Shun-Hwa Wei ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Motion Capture ◽  
Reaction Force ◽  
Three Dimensional ◽  
Compressive Load ◽  
Foot Orthoses ◽  
Significant Difference ◽  
Optical Motion ◽  
3D Printed ◽  
Optical Motion Capture

Foot orthoses (FOs) are commonly used as interventions for individuals with flatfoot. Advances in technologies such as three-dimensional (3D) scanning and 3D printing have facilitated the fabrication of custom FOs. However, few studies have been conducted on the mechanical properties and biomechanical effects of 3D-printed FOs. The purposes of this study were to evaluate the mechanical properties of 3D-printed FOs and determine their biomechanical effects in individuals with flexible flatfoot. During mechanical testing, a total of 18 FO samples with three orientations (0°, 45°, and 90°) were fabricated and tested. The maximum compressive load and stiffness were calculated. During a motion capture experiment, 12 individuals with flatfoot were enrolled, and the 3D-printed FOs were used as interventions. Kinematic and kinetic data were collected during walking by using an optical motion capture system. A one-way analysis of variance was performed to compare the mechanical parameters among the three build orientations. A paired t-test was conducted to compare the biomechanical variables under two conditions: walking in standard shoes (Shoe) and walking in shoes embedded with FOs (Shoe+FO). The results indicated that the 45° build orientation produced the strongest FOs. In addition, the maximum ankle evertor and external rotator moments under the Shoe+FO condition were significantly reduced by 35% and 16%, respectively, but the maximum ankle plantar flexor moments increased by 3%, compared with the Shoe condition. No significant difference in ground reaction force was observed between the two conditions. This study demonstrated that 3D-printed FOs could alter the ankle joint moments during gait.

scholarly journals Three-dimensional printed polylactic acid scaffold integrated with BMP-2 laden hydrogel for precise bone regeneration

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Misun Cha ◽  
Yuan-Zhe Jin ◽  
Jin Wook Park ◽  
Kyung Mee Lee ◽  
Shi Huan Han ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Polylactic Acid ◽  
Three Dimensional ◽  
Burst Release ◽  
Defect Model ◽  
Ectopic Ossification ◽  
Significant Difference ◽  
3D Printed

Abstract Background Critical bone defects remain challenges for clinicians, which cannot heal spontaneously and require medical intervention. Following the development of three-dimensional (3D) printing technology is widely used in bone tissue engineering for its outstanding customizability. The 3D printed scaffolds were usually accompanied with growth factors, such as bone morphometric protein 2 (BMP-2), whose effects have been widely investigated on bone regeneration. We previously fabricated and investigated the effect of a polylactic acid (PLA) cage/Biogel scaffold as a carrier of BMP-2. In this study, we furtherly investigated the effect of another shape of PLA cage/Biogel scaffold as a carrier of BMP-2 in a rat calvaria defect model and an ectopic ossification (EO) model. Method The PLA scaffold was printed with a basic commercial 3D printer, and the PLA scaffold was combined with gelatin and alginate-based Biogel and BMP-2 to induce bone regeneration. The experimental groups were divided into PLA scaffold, PLA scaffold with Biogel, PLA scaffold filled with BMP-2, and PLA scaffold with Biogel and BMP-2 and were tested both in vitro and in vivo. One-way ANOVA with Bonferroni post-hoc analysis was used to determine whether statistically significant difference exists between groups. Result The in vitro results showed the cage/Biogel scaffold released BMP-2 with an initial burst release and followed by a sustained slow-release pattern. The released BMP-2 maintained its osteoinductivity for at least 14 days. The in vivo results showed the cage/Biogel/BMP-2 group had the highest bone regeneration in the rat calvarial defect model and EO model. Especially, the bone regenerated more regularly in the EO model at the implanted sites, which indicated the cage/Biogel had an outstanding ability to control the shape of regenerated bone. Conclusion In conclusion, the 3D printed PLA cage/Biogel scaffold system was proved to be a proper carrier for BMP-2 that induced significant bone regeneration and induced bone formation following the designed shape.

scholarly journals Comparison of 3D-Printed Dental Implants with Threaded Implants for Osseointegration: An Experimental Pilot Study

Materials ◽  
2020 ◽  
Vol 13 (21) ◽  
pp. 4815
Author(s):  
Ling Li ◽  
Jungwon Lee ◽  
Heithem Ben Amara ◽  
Jun-Beom Lee ◽  
Ki-Sun Lee ◽  
...  
Keyword(s):  
Dental Implants ◽  
Three Dimensional ◽  
Primary Stability ◽  
Titanium Implants ◽  
Implant Stability ◽  
Implant Surgery ◽  
Post Surgery ◽  
Significant Difference ◽  
3D Printed ◽  
Stability Measurements

This study aimed to compare bone healing and implant stability for three types of dental implants: a threaded implant, a three-dimensional (3D)-printed implant without spikes, and a 3D-printed implant with spikes. In four beagle dogs, left and right mandibular premolars (2nd, 3rd, and 4th) and 1st molars were removed. Twelve weeks later, three types of titanium implants (threaded implant, 3D-printed implant without spikes, and 3D-printed implant with spikes) were randomly inserted into the edentulous ridges of each dog. Implant stability measurements and radiographic recordings were taken every two weeks following implant placement. Twelve weeks after implant surgery, the dogs were sacrificed and bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) were compared between groups. At implant surgery, the primary stability was lower for the 3D-printed implant with spikes (74.05 ± 5.61) than for the threaded implant (83.71 ± 2.90) (p = 0.005). Afterwards, no significant difference in implants’ stability was observed between groups up to post-surgery week 12. Histomorphometrical analysis did not reveal a significant difference between the three implants for BIC (p = 0.101) or BAFO (p = 0.288). Within the limits of this study, 3D-printed implants without spikes and threaded implants showed comparable implant stability measurements, BIC, and BAFO.

Evaluation of the 3-Dimensional Endoscope in Transsphenoidal Surgery

2013 ◽  
Vol 73 (suppl_1) ◽  
pp. ons74-ons79 ◽  
Author(s):  
Garni Barkhoudarian ◽  
Alicia Del Carmen Becerra Romero ◽  
Edward R. Laws
Keyword(s):  
Skull Base ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Anterior Skull Base ◽  
High Definition ◽  
Endoscopic Endonasal ◽  
Endoscopic Techniques ◽  
Bony Landmarks ◽  
Significant Difference ◽  
Invaluable Tool

Abstract BACKGROUND: Three-dimensional (3-D) endoscopy is a recent addition to augment the transsphenoidal surgical approach for anterior skull-base and parasellar lesions. We describe our experience implementing this technology into regular surgical practice. OBJECTIVE: Retrospective review of clinical factors and outcomes. METHODS: All patients were analyzed who had endoscopic endonasal parasellar operations since the introduction of the 3-D endoscope to our practice. Over an 18-month period, 160 operations were performed using solely endoscopic techniques. Sixty-five of these were with the Visionsense VSII 3-D endoscope and 95 utilized 2-dimensional (2-D) high-definition (HD) Storz endoscopes. Intraoperative and postoperative findings were analyzed in a retrospective fashion. RESULTS: Comparing both groups, there was no significant difference in total or surgical operating room times comparing the 2-D HD and 3-D endoscopes (239 minutes vs 229 minutes, P = .47). Within disease-specific comparison, pituitary adenoma resection was significantly shorter utilizing the 3-D endoscope (surgical time 174 minutes vs 147 minutes, P = .03). These findings were independent of resident or fellow experience. There was no significant difference in the rate of complication, reoperation, tumor resection, or intraoperative cerebrospinal fluid leaks. Subjectively, the 3-D endoscope offered increased agility with 3-D techniques such as exposing the sphenoid rostrum, drilling sphenoidal septations, and identifying bony landmarks and suprasellar structures. CONCLUSION: The 3-D endoscope is a useful alternative to the 2-D HD endoscope for transnasal anterior skull-base surgery. Preliminary results suggest it is more efficient surgically and has a shorter learning curve. As 3-D technology and resolution improve, it should serve to be an invaluable tool for neuroendoscopy.

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