AccScience Publishing / IJB / Online First / DOI: 10.36922/ijb.3986
Submit to IJB
Cite this article
6
Download
312
Views
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
RESEARCH ARTICLE

3D-Printing of retainer for post-otoplasty morphology preservation

Peixu Wang1 ,  Di Wang1 ,  Wenshuai Liu2 ,  Litao Jia1 ,  Bo Pan1 ,  Xiaobo Yu1 ,  Yiwen Deng1 ,  Xia Liu2 ,  Haiyue Jiang1* ,  Lin Lin1*
Show Less
1 Auricular Reconstruction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2 Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
IJB, 3986 https://doi.org/10.36922/ijb.3986
Submitted: 19 June 2024 | Accepted: 26 July 2024 | Published: 29 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Download PDF
Cite
XML
Abstract

Congenital external auricular anomalies necessitate surgical correction for normal ear appearance. Despite high success rates, recurrence is common due to the elasticity of ear cartilage. Postoperative support and stress on the anatomical structures can effectively maintain the surgical results. This study aims to develop a personalized, 3D-printed retainer for post-otoplasty support, utilizing structured light-scanning and stereolithography 3D printing to improve postoperative outcomes with greater accuracy and consistency. Retainers were designed using Rhinoceros software to fit and support the ear based on these models. BioMed Flex 80A Resin was employed for 3D printing the retainers, ensuring biocompatibility and mechanical strength. Mechanical testing was conducted to assess the cured resin’s tensile and compressive properties, as well as its stress relaxation behavior. Finite element analysis (FEA) was performed to assess stress distribution and deformation for optimal support. Clinical validation was conducted involving 20 patients wearing the retainer for 8 h daily for a week, with satisfaction measured using the C-QUEST 2.0 scale. Clinical assessments were performed with 20 post-otoplasty patients treated with either a retainer or an external stretching device. The results indicated that high-precision, biocompatible, patient-specific retainers were successfully produced. BioMed Flex 80A Resin demonstrated strong performance under strain and good stress retention. FEA indicated uniform stress distribution and effective support in critical areas, ensuring structural stability. Clinical validation reported high satisfaction rates (85%), with minor issues in comfort and weight, suggesting a need for individualized adjustments. Clinical assessments demonstrated superior performance in maintaining auricular width and helix-mastoid (H-M) distance compared to the external stretching device. The personalized 3D-printed retainer offers a promising solution for post-otoplasty support, providing consistent, effective, and biocompatible results.

Keywords
3D Printing
Biocompatible resin
Congenital auricular anomalies
Otoplasty complications
Post-surgery support
Funding
This work was supported by the Chinese Academy of Medical Science Innovation Fund for Medical Sciences (2021-I2M-052), Beijing Municipal Science & Technology Commission (No. Z221100007422084), Young Scientists Fund of the National Natural Science Foundation of China (Grant No. 8230092675), and Beijing Natural Science Foundation (No.7244400).
Conflict of interest
The authors declare no conflicts of interests.
References
  1. Zhuang Q, Wei N, Zhou Q, et al. Efficacy and timing of neonatal ear correction molding. Aesthetic Plast Surg. 2020;44(3):872-878. doi: 10.1007/s00266-019-01596-y
  2. Lin J, Sclafani AP. Otoplasty for congenital auricular malformations. Facial Plast Surg Clin North Am. 2018;26(1):31-40. doi: 10.1016/j.fsc.2017.09.003
  3. Joukhadar N, McKee D, Caouette-Laberge L, Bezuhly M. Management of congenital auricular anomalies. Plast Reconstr Surg. 2020;146(2):205e-216e. doi: 10.1097/PRS.0000000000006997
  4. Handler EB, Song T, Shih C. Complications of otoplasty. Facial Plast Surg Clin North Am. 2013;21(4):653-662. doi: 10.1016/j.fsc.2013.08.001
  5. Basat SO, Askeroglu U, Aksan T, et al. New otoplasty approach: a laterally based postauricular dermal flap as an addition to Mustarde and Furnas to prevent suture extrusion and recurrence. Aesthetic Plast Surg. 2014;38(1):83-89. doi: 10.1007/s00266-013-0269-z
  6. Chen L, Li C, He A, et al. Long-term effectiveness of ear molding and factors affecting outcomes. Plast Reconstr Surg. 2024;153(4):905-913. doi: 10.1097/PRS.0000000000010678
  7. Zhang JL, Li CL, Fu YY, Zhang TY. Newborn ear defomities and their treatment efficiency with earwell infant ear correction system in China. Int J Pediatr Otorhinolaryngol. 2019;124:129-133. doi: 10.1016/j.ijporl.2019.06.001
  8. Sayadi JJ, Arora JS, Chattopadhyay A, Hopkins E, Quiter A, Khosla RK. A retrospective review of outcomes and complications after infant ear molding at a single institution. Plast Reconstr Surg Glob Open. 2023;11(8):e5133. doi: 10.1097/GOX.0000000000005133
  9. Xu H, Ding S, Yang H, et al. The treatment effect of non-surgical ear molding correction in children with mild cryptotia deformity. Laryngoscope. 2023;133(9):2122-2128. doi: 10.1002/lary.30491
  10. Aygit AC. Molding the ears after anterior scoring and concha repositioning: a combined approach for protruding ear correction. Aesthetic Plast Surg. 2003;27(1):77-81. doi: 10.1007/s00266-002-0095-1
  11. Triacca A, Pitzanti G, Mathew E, Conti B, Dorati R, Lamprou DA. Stereolithography 3D printed implants: a preliminary investigation as potential local drug delivery systems to the ear. Int J Pharm. 2022;616:121529. doi: 10.1016/j.ijpharm.2022.121529
  12. Ng WL, An J, Chua CK. Process, material, and regulatory considerations for 3D printed medical devices and tissue constructs. Engineering. 2024;36:146-166. doi: 10.1016/j.eng.2024.01.028
  13. Vidakis N, Petousis M, Michailidis N, et al. High-performance medical-grade resin radically reinforced with cellulose nanofibers for 3D printing. J Mech Behav Biomed Mater. 2022;134:105408. doi: 10.1016/j.jmbbm.2022.105408
  14. Ambrosio D, Gabrion X, Malécot P, Amiot F, Thibaud S. Influence of manufacturing parameters on the mechanical properties of projection stereolithography–manufactured specimens. Int J Adv Manuf Technol. 2020;106(1):265-277. doi: 10.1007/s00170-019-04415-5
  15. Aravind Shanmugasundaram S, Razmi J, Mian MJ, Ladani L. Mechanical anisotropy and surface roughness in additively manufactured parts fabricated by stereolithography (SLA) using statistical analysis. Materials. 2020;13(11):2496. doi: 10.3390/ma13112496
  16. Zhang S, Bhagia S, Li M, Meng X, Ragauskas AJ. Wood-reinforced composites by stereolithography with the stress whitening behavior. Materials & Design. 2021;206:109773. doi: 10.1016/j.matdes.2021.109773
  17. Keßler A, Dosch M, Reymus M, Folwaczny M. Influence of 3D-printing method, resin material, and sterilization on the accuracy of virtually designed surgical implant guides. J Prosthet Dent. 2022;128(2):196-204. doi: 10.1016/j.prosdent.2020.08.038
  18. Cai M, Shen S, Li H, Zhang X, Ma Y. Study of contact characteristics between a respirator and a headform. J Occup Environ Hyg. 2016;13(3):D50-60. doi: 10.1080/15459624.2015.1116699
  19. Tse KM, Tan LB, Lee SJ, Lim SP, Lee HP. Investigation of the relationship between facial injuries and traumatic brain injuries using a realistic subject-specific finite element head model. Accid Anal Prev. 2015;79:13-32. doi: 10.1016/j.aap.2015.03.012
  20. Chafi MS, Karami G, Ziejewski M. Biomechanical assessment of brain dynamic responses due to blast pressure waves. Ann Biomed Eng. 2010;38(2):490-504. doi: 10.1007/s10439-009-9813-z
  21. Lu P, Liao Z, Zeng Q, et al. Customized three-dimensional-printed orthopedic close contact casts for the treatment of stable ankle fractures: finite element analysis and a pilot study. ACS Omega. 2021;6(4):3418-3426. doi: 10.1021/acsomega.0c06031
  22. Chan SC, Chan AP. The validity and applicability of the Chinese version of the Quebec user evaluation of satisfaction with assistive technology for people with spinal cord injury. Assist Technol. 2006;18(1):25-33. doi: 10.1080/10400435.2006.10131904
  23. Wang D, Jiang H, Yang Q, et al. Non-surgical correction of cryptotia and the analysis of treatment time and other influence factors. Int J Pediatr Otorhinolaryngol. 2020;129:109771. doi: 10.1016/j.ijporl.2019.109771
  24. Palmara G, Frascella F, Roppolo I, Chiappone A, Chiado A. Functional 3D printing: approaches and bioapplications. Biosens Bioelectron. 2021;175:112849. doi: 10.1016/j.bios.2020.112849
  25. Wang S, Zhao S, Yu J, Gu Z, Zhang Y. Advances in translational 3D printing for cartilage, bone, and osteochondral tissue engineering. Small. 2022;18(36):e2201869. doi: 10.1002/smll.202201869
  26. He L, Liu X, Khatter NJ, Yu X, Washington KM, Shu M. Treatment of progressive hemifacial atrophy by cartilage graft and free adipofascial flap combined with three-dimensional planning. Plast Reconstr Surg. 2024;153(3): 679-688. doi: 10.1097/PRS.0000000000010585
  27. Schwam ZG, Chang MT, Barnes MA, Paskhover B. Applications of 3-dimensional printing in facial plastic surgery. J Oral Maxillofac Surg. 2016;74(3):427-428. doi: 10.1016/j.joms.2015.10.016
  28. Li H, Fan W, Zhu X. Three-dimensional printing: the potential technology widely used in medical fields. J Biomed Mater Res A. 2020;108(11):2217-2229. doi: 10.1002/jbm.a.36979
  29. Pfaff MJ, Steinbacher DM. Plastic surgery applications using three-dimensional planning and computer-assisted design and manufacturing. Plast Reconstr Surg. 2016;137(3):603e-616e. doi: 10.1097/01.prs.0000479970.22181.53
  30. Bernhard JC, Isotani S, Matsugasumi T, et al. Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol. 2016;34(3):337-345. doi: 10.1007/s00345-015-1632-2
  31. Andolfi C, Plana A, Kania P, Banerjee PP, Small S. Usefulness of three-dimensional modeling in surgical planning, resident training, and patient education. J Laparoendosc Adv Surg Tech A. 2017;27(5):512-515. doi: 10.1089/lap.2016.0421
  32. Mishra A, Srivastava V. Biomaterials and 3D printing techniques used in the medical field. J Med Eng Technol. 2021;45(4):290-302. doi: 10.1080/03091902.2021.1893845
  33. Zhu W, Ma X, Gou M, Mei D, Zhang K, Chen S. 3D printing of functional biomaterials for tissue engineering. Curr Opin Biotechnol. 2016;40:103-112. doi: 10.1016/j.copbio.2016.03.014
  34. Wang Z, Yang Y. Application of 3D printing in implantable medical devices. Biomed Res Int. 2021;2021:6653967. doi: 10.1155/2021/6653967
  35. Rohrich RJ, Mohan R. Male rhinoplasty: update. Plast Reconstr Surg. 2020;145(4):744e-753e. doi: 10.1097/PRS.0000000000006835
  36. Boustany AN, Grover R, Alnaeem H, Seyidova N, Rohrich RJ, Lin SJ. Cosmetic rhinoplasty. Plast Reconstr Surg. 2023;151(2):315e-329e. doi: 10.1097/PRS.0000000000009874
  37. Hidalgo DA, Spector JA. Breast augmentation. Plast Reconstr Surg. 2014;133(4):567e-583e. doi: 10.1097/PRS.0000000000000033
  38. Xia Z, Xie J, Zhang W, Wang X, Zheng Y, Zeng A. Subfascial mini muscle-release dual plane technique: a modified procedure for breast augmentation. Plast Reconstr Surg. 2024. doi: 10.1097/PRS.0000000000011284
  39. Roby BB, Woods T, Chinnadurai S. Update on congenital ear molding. Curr Opin Otolaryngol Head Neck Surg. 2023;31(4):215-218. doi: 10.1097/MOO.0000000000000895
  40. Zou K, Fan Y, Jiang L, et al. Ear mold for congenital ear malformation: a randomized controlled trial. Medicine (Baltimore). 2020;99(30):e21313. doi: 10.1097/MD.0000000000021313
  41. Wang X, Liu J, Zhang Y, et al. Advances in precision microfabrication through digital light processing: system development, material and applications. Virtual Phys Prototyp. 2023;18(1):e2248101. doi: 10.1080/17452759.2023.2248101

 

 

 

 

 

 

 

 

Share
Back to top
International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept