The use of 3D printing in shared decision making for a juvenile aggressive ossifying fibroma in a pediatric patient.

Juvenile aggressive ossifying fibromas (JAOF) are rare, typically benign pediatric tumors that are locally aggressive and have high recurrence rates. A 7-year old male presented with a palatal mass and a 3D printed model was created and used as a visual aide to highlight the importance of management in terms of functional, cosmetic, and disease-free outcomes with the family. The patient ultimately underwent successful enucleation with final pathology consistent with JAOF. To our knowledge, this is the first description of the use of 3D printing to help in the shared decision-making process for the treatment of this aggressive tumor.

A 3-dimensional bioprinted tracheal segment implant pilot study: Rabbit tracheal resection with graft implantation.

OBJECTIVES: Surgical reconstruction of tracheal disease has expanded to include bioengineering and three dimensional (3D) printing. This pilot study investigates the viability of introducing a living functional tracheal replacement graft in a rabbit animal model. METHODS: Seven New Zealand White rabbits were enrolled and six completed participation (one intraoperative mortality). Tracheal replacement grafts were created by impregnating 3D printed biodegradable polycaprolactone (PCL) tracheal scaffolds with rabbit tracheal hyaline chondrocytes. 2 cm of native trachea was resected and the tracheal replacement graft implanted. Subjects were divided into two equal groups (n = 3) that differed in their time of harvest following implantation (three or six weeks). Tracheal specimens were analyzed with intraluminal telescopic visualization and histopathology. RESULTS: The two groups did not significantly differ in histopathology or intraluminal diameter. All sections wherein the implant telescoped over native trachea (anastomotic ends) contained adequate hyaline cartilage formation (i.e. chondrocytes within lacuna, surrounding extracellular matrix, and strong Safranin O staining). Furthermore, the PCL scaffold was surrounded by a thin layer of fibrous tissue. All areas without membranous coverage contained inadequate or immature cartilage formation with inflammation. The average intraluminal stenosis was 83.4% (range 34.2-95%). CONCLUSIONS: We report normal cartilage growth in a tracheal replacement graft when chondrocytes are separated from the tracheal lumen by an intervening membrane. When no such membrane exists there is a propensity for inflammation and stenosis. These findings are important for future construction and implantation of tracheal replacement grafts. LEVEL OF EVIDENCE: Not applicable: this is an in vivo animal trial.

Three dimensional printing: A review on the utility within medicine and otolaryngology.

Three dimensional (3D) printing is a novel technique that has evolved over the past 35 years and has the potential to revolutionize the field of medicine with its inherent advantages of customizability and the ability to create complex shapes with precision. It has been used extensively within the fields of orthopedics, dentistry, and craniofacial reconstruction with wide ranging utility including, medical modeling, surgical planning and the production of custom plates, screws and surgical guides. Furthermore, it has been used for similar means in the field of Otorhinolaryngology and also has potential to revolutionize the treatment of airway malacia. In fact, 3D printed external tracheal splints have already been studied in several pediatric patients with very promising results. The emerging field of 3D bioprinting, which integrates tissue engineering with 3D printing, may produce a paradigm shift with the potential introduction of customized functional biologic replacements.

Feasibility of Bioprinting with a Modified Desktop 3D Printer.

Numerous studies have shown the capabilities of three-dimensional (3D) printing for use in the medical industry. At the time of this publication, basic home desktop 3D printer kits can cost as little as $300, whereas medical-specific 3D bioprinters can cost more than $300,000. The purpose of this study is to show how a commercially available desktop 3D printer could be modified to bioprint an engineered poly-l-lactic acid scaffold containing viable chondrocytes in a bioink. Our bioprinter was used to create a living 3D functional tissue-engineered cartilage scaffold. In this article, we detail the design, production, and calibration of this bioprinter. In addition, the bioprinted cells were tested for viability, proliferation, biochemistry, and gene expression; these tests showed that the cells survived the printing process, were able to continue dividing, and produce the extracellular matrix expected of chondrocytes.