A New 3D Tool for Planning Plastic Surgery

Face plastic surgery (PS) plays a major role in today medicine. Both for reconstructive and cosmetic surgery, achieving harmony of facial features is an important, if not the major goal. Several systems have been proposed for presenting to patient and surgeon possible outcomes of the surgical procedure. In this paper, we present a new 3D system able to automatically suggest, for selected facial features as nose, chin, etc, shapes that aesthetically match the patient's face. The basic idea is suggesting shape changes aimed to approach similar but more harmonious faces. To this goal, our system compares the 3D scan of the patient with a database of scans of harmonious faces, excluding the feature to be corrected. Then, the corresponding features of the k most similar harmonious faces, as well as their average, are suitably pasted onto the patient's face, producing k+1 aesthetically effective surgery simulations. The system has been fully implemented and tested. To demonstrate the system, a 3D database of harmonious faces has been collected and a number of PS treatments have been simulated. The ratings of the outcomes of the simulations, provided by panels of human judges, show that the system and the underlying idea are effectiv

Grid simulation services for the medical community

The first part of this paper presents a selection of medical simulation applications, including image reconstruction, near real-time registration for neuro-surgery, enhanced dose distribution calculation for radio-therapy, inhaled drug delivery prediction, plastic surgery planning and cardio-vascular system simulation. The latter two topics are discussed in some detail. In the second part, we show how such services can be made available to the clinical practitioner using Grid technology. We discuss the developments and experience made during the EU project GEMSS, which provides reliable, efficient, secure and lawful medical Grid services

The Design & Verification of an Automatic Occlusion Speech Valve for Voice Rehabilitation

This work investigates the restoration of the lost functions of the upper airway in patients who have undergone total laryngectomy surgery. The primary airway functions were defined as ventilation and patency, heating and humidification of air, filtration of air, coughing, swallowing, speech, olfaction, gustation and chemo sensitisation and air resistance. Through a review of the literature, the performance of the airway functions was compared pre and post laryngectomy. It was found that all of the aforementioned functions were negatively affected by total laryngectomy which led to lower quality of life and increased risk of harm or disease compared to healthy individuals of the same age groups. There are medical devices described in the literature used for the restoration of upper airway function. For most identified functions there was a medical device and or therapeutic solution to restore them partially or fully. Research found no evidence that existing medical devices had the level of filtration they provided verified. Many devices in the literature restored one function, requiring patients to use a combination of devices, this has benefits and disbenefits, mostly relating to in use life. This work aimed to restore as many functions as possible within a singular device. A singular device was designed to restore the upper airway functions. The variability of the difference in resistance of the larynx to inhalation and exhalation identified in the literature was incorporated into the device, the phenomenon was approximately matched by employing fluid structure interaction within the device. The design featured a novel bistable diaphragm that the patient can close hands free when they want to redirect air through a speech device. This had the benefit of remaining closed during pauses in speech. Different functions of the candidate device were evaluated through a combination of tests, including tests following established methodologies and new tests and test apparatus developed as part of this work. Pneumatic test apparatus was built to produce outputs that matched laryngectomy patient spirometry data found in the literature. The first iteration of the design was tested in vitro. The design was translated into FEA, validated with the lab results and optimised. Heat and moisture exchange and filtration were fully restored. Cough, breathing resistance and speech were partially restored. It was concluded that a singular device can restore most of the upper airway functions to a level closely resembling prelaryngectomy. Additionally, it was concluded that a device must be used in conjunction with other restorative medical devices to effectively restore all lost functions to pre-laryngectomy upper airway performance

Three-Dimensional Printing and Its Applications in Otorhinolaryngology–Head and Neck Surgery

Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology–head and neck surgery, discusses future innovations, and explores the financial impact of these advances. Data Sources Articles were identified from PubMed and Ovid MEDLINE. Review Methods PubMed and Ovid Medline were queried for English articles published between 2011 and 2016, including a few articles prior to this time as relevant examples. Search terms included 3-dimensional printing, 3D printing, otolaryngology, additive manufacturing, craniofacial, reconstruction, temporal bone, airway, sinus, cost, and anatomic models. Conclusions Three-dimensional printing has been used in recent years in otolaryngology for preoperative planning, education, prostheses, grafting, and reconstruction. Emerging technologies include the printing of tissue scaffolds for the auricle and nose, more realistic training models, and personalized implantable medical devices. Implications for Practice After the up-front costs of 3D printing are accounted for, its utilization in surgical models, patient-specific implants, and custom instruments can reduce operating room time and thus decrease costs. Educational and training models provide an opportunity to better visualize anomalies, practice surgical technique, predict problems that might arise, and improve quality by reducing mistakes

Planning Plastic Surgery in 3D. An innovative approach and tool

Face plastic surgery (PS) plays a major role in today medicine. Both for reconstructive and cosmetic surgery, achieving harmony of facial features is an important, if not the major goal. Several systems have been proposed for presenting to patient and surgeon possible outcomes of the surgical procedure. In this work, we present a new 3D system able to automatically suggest, for selected facial features as nose, chin, etc., shapes that aesthetically match the patient’s face. The basic idea is suggesting shape changes aimed to approach similar but more harmonious faces. To this goal, our system compares the 3D scan of the patient with a database of scans of harmonious faces, excluding the feature to be corrected. Then, the corresponding features of the k most similar harmonious faces, as well as their average, are suitably pasted onto the patient’s face, producing k+1 aesthetically effective surgery simulations. The system has been fully implemented and tested. To demonstrate the system, a 3D database of harmonious faces has been collected and a number of PS treatments have been simulated. The ratings of the outcomes of the simulations, provided by panels of human judges, show that the system and the underlying idea are effective

Cost-effective 3D scanning and printing technologies for outer ear reconstruction: Current status

Current 3D scanning and printing technologies offer not only state-of-the-art developments in the field of medical imaging and bio-engineering, but also cost and time effective solutions for surgical reconstruction procedures. Besides tissue engineering, where living cells are used, bio-compatible polymers or synthetic resin can be applied. The combination of 3D handheld scanning devices or volumetric imaging, (open-source) image processing packages, and 3D printers form a complete workflow chain that is capable of effective rapid prototyping of outer ear replicas. This paper reviews current possibilities and latest use cases for 3D-scanning, data processing and printing of outer ear replicas with a focus on low-cost solutions for rehabilitation engineering