There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

Generation of graspable three-dimensional objects applied for surgical planning, prosthetics and related applications using 3D printing or rapid prototyping is summarized and evaluated. Graspable 3D objects overcome the limitations of 3D visualizations which can only be displayed on flat screens. 3D objects can be produced based on CT or MRI volumetric medical images. Using dedicated post-processing algorithms, a spatial model can be extracted from image data sets and exported to machine-readable data. That spatial model data is utilized by special printers for generating the final rapid prototype model. Patient–clinician interaction, surgical training, medical research and education may require graspable 3D objects. The limitations of rapid prototyping include cost and complexity, as well as the need for specialized equipment and consumables such as photoresist resins. Medical application of rapid prototyping is feasible for specialized surgical planning and prosthetics applications and has significant potential for development of new medical applications.

3D printing based on imaging data: review of medical applications

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article.

Medical 3D Printing for the Radiologist

Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.

https://iopscience.iop.org/article/10.1088/1758-5090/aa7279/pdf

Current and emerging applications of 3D printing in medicine.

Selective laser sintering (SLS) is a solid freeform fabrication technique, developed by Carl Deckard for his master’s thesis at the University of Texas, patented in 1989. SLS manufacturing is a technique that produces physical models through a selective solidification of a variety of fine powders. SLS technology is getting a great amount of attention in the clinical field. In this paper the characteristics features of SLS and the materials that have been developed for are reviewed together with a discussion on the principles of the above-mentioned manufacturing technique. The applications of SLS in tissue engineering, and at-large in the biomedical field, are reviewed and discussed.

Selective laser sintering in biomedical engineering.

Objective The skills of ear surgery are best developed by dissecting a temporal bone. However, only a limited number of trainees can be afforded this opportunity because of the scarcity of available bones. The aim of this study was to investigate the validity of a prototype temporal bone model for surgical training and education. Material and Methods A simulated 3D model of a human temporal bone was made using a selective laser sintering method. The powder layers were laser-fused based on detailed CT data and accumulated to create a 3D structure. Conventional surgical instruments were used to dissect the model under a microscope. Results The model was as hard as real bone and surface structures were accurately reproduced. The model could be shaved using a surgical drill, burr and suction irrigator in the same way as a real bone. The malleus and incus were reproduced. The semicircular canals and the oval and round window niches were identified. Cavity structures, such as the semicircular canal, vestibule, ...

Rapid prototyping of temporal bone for surgical training and medical education.

OBJECTIVE
The skills of ear surgery are best developed by dissecting a temporal bone. However, only a limited number of trainees can be afforded this opportunity because of the scarcity of available bones. The aim of this study was to investigate the validity of a prototype temporal bone model for surgical training and education.


MATERIAL AND METHODS
A simulated 3D model of a human temporal bone was made using a selective laser sintering method. The powder layers were laser-fused based on detailed CT data and accumulated to create a 3D structure. Conventional surgical instruments were used to dissect the model under a microscope.


RESULTS
The model was as hard as real bone and surface structures were accurately reproduced. The model could be shaved using a surgical drill, burr and suction irrigator in the same way as a real bone. The malleus and incus were reproduced. The semicircular canals and the oval and round window niches were identified. Cavity structures, such as the semicircular canal, vestibule, antrum and air cells, were filled with powder which had to be removed using a pick and suction irrigator during dissection. A magnified model was useful for educating medical students.


CONCLUSION
This prototype 3D model made using selective laser sintering serves as a good educational tool for middle ear surgery.

Rapid Prototyping of Temporal Bone for Surgical Training

Purpose: This study aimed to investigate the validity of adjusting computed tomography thresholds in order to replicate a temporal bone model suitable for dissection training and education Materials and methods: A simulated three-dimensional model of a human temporal bone was prototyped using selective laser sintering The powder layers were laser-fused, based on detailed computed tomography data, and accumulated to create a three-dimensional structure The computed tomography threshold value of the stapes was modified on standard triangular language file in order to replicate the stapes The intensity value was determined to select the fluid lumen of the inner ear and the bone surface, in order to replicate the inner ear Results: The model could be shaved, using surgical instruments, in the same manner as during real surgery The stapes could be reproduced, making this model even more realistic than a previous version The inner ear was recreated, along with the surrounding bony wall and the ossicles Conclusion: This model facilitates dissection training and easy understanding of the relation between the labyrinth and the surrounding structures

Rapid-prototyped temporal bone and inner-ear models replicated by adjusting computed tomography thresholds.

OBJECTIVE To determine the subjective visual vertical (SVV) perception in patients with vestibular neuritis (VN) and sudden sensorineural hearing loss (SSHL) using the SVV test and other neuro-otological examinations, namely, the vestibular evoked myogenic potential (VEMP) and caloric tests, and to clarify which vestibular nerve function is associated with an SVV shift. PATIENTS AND METHODS We performed the SVV test in 36 VN patients and 80 SSHL patients. Thereafter, we investigated directional changes in the SVV in the VN and SSHL patients, and compared the results of the SVV test with those of the VEMP and caloric tests. RESULTS Abnormal SVV (> 2° was found at a rate of 69.4% in the VN patients and 26.3% in the SSHL patients. In all except 1 VN patient, the SVV tilted to the lesion side. The rate of abnormal SVV was significantly higher in patients with complete canal paresis (CP) than in patients with partial CP. There was no significant relationship between the rates of abnormal SVV and VEMP. In the SSHL patients, neither the SVV nor the VEMP affected the hearing outcome and patients with abnormal VEMP tended to show abnormal SVV. CONCLUSION VN patients showed a higher rate of abnormal SVV than SSHL patients. From the results, it is speculated that the superior vestibular nerve function mainly affects the SVV tilt, although the inferior vestibular nerve function may also have an effect.

Subjective visual vertical perception in patients with vestibular neuritis and sudden sensorineural hearing loss.

Rapidly Prototyped Temporal Bone Model for Otological Education

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