目的:带肋骨移植的环状软骨后裂开是一种优雅地矫正小儿声门后狭窄和声门下狭窄的手术。目前,该程序需要收获肋软骨,为优化留出空间。随着三维打印技术的使用,我们的目的是设计一种装置,该装置可以消除在该手术中收获肋软骨的需要.
方法:优化,利用计算机辅助设计软件和三维打印技术设计了新型聚己内酯支架。在三个猪动物受试者中植入该装置的情况下进行初步概念验证研究。通过术后临床过程对装置进行评估,内窥镜检查,验尸后,和组织学评估。
结果:创建了一系列大小可变的支架。在猪模型研究中,支架显示出结构完整性,并成功扩展了环状软骨。术后内窥镜检查和临床检查未显示植入物不稳定或失败的迹象。大体和组织学检查显示,成功的支架粘膜化和软骨向内生长六周。
结论:这项猪动物试验研究证明了计算机辅助设计的早期成功,3D打印,生物可吸收PCL后移植支架。支架消除了对肋软骨收获的需要,并且具有优异的手术可用性。脚手架按照设计运行,提供概念证明和进一步评估的理由,以扩大这一小型试点研究与更大的动物研究和持续的设计改进。
OBJECTIVE: The posterior cricoid split with rib graft is a procedure that elegantly corrects pediatric posterior glottic stenosis and subglottic stenosis. Currently, the procedure requires harvesting of rib cartilage which leaves room for optimization. With use of three dimensional printing technology, our objective was to design a device that would negate the need for costal cartilage harvesting in this procedure.
METHODS: An optimized, novel polycaprolactone scaffold was designed using computer aided design software and three dimensional printing. A pilot proof of concept study was conducted with implantation of the device in three porcine animal subjects. Device was evaluated by post-procedural clinical course, endoscopic exams, post-mortem exam, and histological evaluation.
RESULTS: A series of variably sized scaffolds were created. The scaffolds showed structural integrity and successfully expanded the cricoid cartilage in the porcine model study. Post-operative endoscopy and clinical exams demonstrated no signs of implant instability or failure. Gross and histologic exams showed successful mucosalization over the scaffold and cartilage ingrowth by six weeks.
CONCLUSIONS: This porcine animal pilot study demonstrated early success of a computer-aided designed, 3D printed, bioresorbable PCL posterior graft scaffold. The scaffolds eliminate the need for costal cartilage harvesting and had excellent surgical usability. The scaffolds functioned as designed, offering proof of concept and grounds for further evaluation to expand on this small pilot study with larger animal studies and continued design refinement.