A computer-aided strategy for preoperative simulation of autologous ear reconstruction procedure
- PDF / 830,651 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 68 Downloads / 154 Views
SHORT ORIGINAL PAPER
A computer-aided strategy for preoperative simulation of autologous ear reconstruction procedure Elisa Mussi1
· Michaela Servi1 · Flavio Facchini2 · Monica Carfagni1 · Yary Volpe1
Received: 4 March 2020 / Accepted: 23 September 2020 © The Author(s) 2020
Abstract Autologous ear reconstruction is the preferred treatment in case of partial or total absence of the external ear. The surgery can be very challenging to perform and the aesthetic result highly dependent on the surgeon’s “artistic skills”. In this context a preoperative planning and simulation phase based on the patient’s specific anatomy may result crucial for the surgical outcome. In this work, starting from a case study, the elements necessary for an effective simulation are identified and a strategy for their interactive design and customization is devised with a perspective of a semi-automatization of the procedure. Keywords Autologous ear reconstruction · Microtia · Preoperative planning · Reverse engineering · Additive manufacturing
1 Introduction Microtia is a congenital malformation characterized by the absence or deformation of the outer ear in terms of size, orientation, shape and position. Three alternative treatments are used in clinical practice to address this physical malformation [1]: (1) external silicone prosthesis, (2) Medpor implants, (3) reconstruction with autologous cartilage tissue extracted from the ribcage. The prosthetic approach is a non-permanent solution, while the alloplastic approach requires the insertion of a foreign body and is therefore more subjected to rejection. In this context, the third technique, autologous ear reconstruction (AER), represents the preferred clinical treatment for restoring the anatomy of the ear as it is a definitive solu-
B
Elisa Mussi [email protected] Michaela Servi [email protected] Flavio Facchini [email protected] Monica Carfagni [email protected] Yary Volpe [email protected]
1
Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139 Florence, Italy
2
Meyer Children’s Hospital, Viale Pieraccini 24, 50139 Florence, Italy
tion with high degree of integration. This surgery requires the realization of a 3D framework of the ear (Fig. 1b), obtained by carving and sculpting harvested patient’s costal cartilages, before the final implantation into a subcutaneous pocket in the auricular region. According to the technique proposed in [2], the auricular elements to be reconstructed are helix, antihelix, tragus-antitragus (Fig. 1a) plus a support base. Due to the complexity of the surgical technique and of the 3D geometry to be reproduced, this procedure represents a real challenge for plastic surgeons. The main difficulties are: (i) study of the anatomy of the patient’s healthy ear (HE) to evaluate its volume and size; (ii) isolation of the anatomical elements of the ear involved in the surgery; (iii) optimization of the individual elements removal phase from the costal cartilage; (iv) sculpting and carving of the
Data Loading...
