New face for a girl thanks of 3D printing

http://www.cbc.ca/news/health/3d-printing-helps-give-girl-a-new-face-1.3014957

Violet Pietrok, playing with her father Matt, was born two years ago with a Tessier cleft, a rare deformity in which the bones that form the face have not fused properly. Thanks to 3D printing of models of her skull, Violet has begun a series of surgeries to correct the problem.

3D printing helps give girl a new face

Doctors practise on an exact image of face before repairing deformity.

The great thing about medical school cadavers is that they can’t die.

If a surgeon in training makes a mistake, there’s always next time. It is the last environment where medical errors have no consequences.

But 3D printing is changing that, giving even experienced operating room teams valuable practice on a model that looks and feels like the real thing. It has life-saving and life-altering implications.

Violet Pietrok was born two years ago with a rare deformity called a Tessier cleft. The bones that normally join to form the fetal face had not fused properly.

  • Watch David Common’s full story on The National Sunday April 5 at 9 p.m.

As a result, Violet’s eyes were set so far apart, her vision was more like a bird’s than a human’s. She also had no cartilage in her nose.

But the corrective operation is extraordinarily complex. So Violet’s family turned to one of the world’s leading reconstructive surgeons, Dr. John Meara, at Boston Children’s Hospital.

Violet Pietrok

He warned them of the danger of making sophisticated cuts through the skull, very close to the optic nerve. “They might be very close to the brain,” Meara explained in an interview. “So the ability to make these cuts on the model first and see the trajectory of a sawblade or where that cut would come through in relationship to the eye is absolutely critical.”

To get that model, the simulation team at Boston Children’s took multiple MRIs of Violet’s skull and replicated it on a 3D printer.

It took more than a day to print, but the model is exact. Even the density of the bone is precise.

 “We were actually able to do the procedure before going into the operating room,” Meara said.

“So we made the cuts in the model, made the bony movements that we would be making in Violet’s case and we identified some issues that we modified prior to going into the operating room, which saves time and means that you’re not making some of these critical decisions in the operating room.”

During the surgery earlier this year, Meara kept a model of Violet’s skull close by and referred to it as he went through the complicated steps of the operation. This successful surgery was just the first of several that will be needed to remake Violet’s face.

Other hospitals are interested

Boston’s success has prompted a lot of calls from hospitals around the world looking to set up their own 3D printing simulations to Dr. PeterWeinstock, who runs the Boston program.

He equates medicine with sports teams. Any team worth its salt, he says, practises before the game.

“We looked at that and thought, why is health care not doing that?  If you can see the patient before you see the patient, if you can do the operation before you do the operation, you have the opportunity to tailor your approach, to tailor your team to the specific environment and event. Think about that opportunity.”

Weinstock’s printer now runs 24/7 preparing for procedures at Boston Children’s — well worth the $400,000 investment.

The models are game-changing — giving a whole new meaning to personalized medicine. With each new print, the models are getting more sophisticated. Soon, the replicated veins and arteries will bleed as they would in real-life.

Boston Children’s has also found better recovery times. Patients of surgeons who’ve practised on the models typically leave hospital sooner and get back on their feet more easily.

Weinstock’s simulation program really took off a few years ago with Surgical Sam, the world’s first operable infant mannequin.

A model of an individual

But Weinstock wanted not just a model of generic human but one of a specific person.

That’s also what Adam Stedman needed. Adam was born witharteriovenous malformation or AVM, a tangled mess of arteries and veins in the brain that restricts blood flow and prompts progressively worse seizures that can cause brain damage.

He could have had a stroke at any moment, or a hemorrhage, his mother Amy tearily explained. But surgically tackling the web of tubes inside Adam’s brain was also potentially deadly, or it could leave him blind.

The 3D printer re-created Adam’s brain — including the AVM — something his surgeon could hold, manipulate, examine, re-examine and ultimately, practice on.

The surgery was a success — taking only a third of the expected time because the entire operating room team had done it before just hours earlier on the practice model.

When Adam came out of the OR, he smiled and his mother broke down. “He just has a blind spot,” she said in an interview in her Connecticut home. To her, that’s a big improvement.

“I honestly think that the 3D printing has the majority to do with that, as far as where they knew, where to cut and where not to.”

cbc.ca

by David Common, CBC News | Apr 04, 2015 5:00 AM ET

Advertisements

3D printing helped with facial defect

3D Printing Has Another Positive Impact on a Child’s Life

http://goo.gl/3GZNgy

Check out this excellent story about a little girl named Violet born with a rare defect, a Tessier facial cleft, that left a fissure in her skull, and how 3D-printing is helping doctors take on these kinds of complicated surgeries. The piece is in today’s The New York Times and written by health reporter and CommonHealth contributor Karen Weintraub, who offers a little background:

Violet Pietrok was born nearly two years ago without a nose. Her eyes were set so far apart that her mom compared her vision to a bird of prey’s. There was a gap in the skull behind her forehead.

There was no question she would need drastic surgery to lead a normal life. But few surgeons have seen patients with problems as complex as Violet’s. Her parents, Alicia Taylor and Matt Pietrok, who live near Salem, Oregon, brought her to Boston Children’s Hospital, to Dr. John Meara, who had operated before on kids with Tessier facial clefts.

As part of Children’s Pediatric Simulator Program, Meara was able to get several 3D printed models made of Violet’s skull. By handling and slicing up the models, he got a better sense of what had gone wrong and how best to fix it.

Such 3D-printing is becoming more commonplace in complex surgeries, allowing doctors views and knowledge they can’t get on their screens.

From the Times story:

Such 3-D-printed models are transforming medical care, giving surgeons new perspectives and opportunities to practice, and patients and their families a deeper understanding of complex procedures. Hospitals are also printing training tools and personalized surgical equipment. Someday, doctors hope to print replacement body parts.

“There’s no doubt that 3-D printing is going to be disruptive medicine,” said Dr. Frank J. Rybicki, chief of medical imaging at the Ottawa Hospital and chairman and professor of radiology at the University of Ottawa. He is the former director of the applied imaging science lab at Brigham and Women’s Hospital, a few blocks from Boston Children’s.

“It makes procedures shorter, it improves your accuracy,” said Dr. Rybicki, who has used 3-D printing in his work with face transplants. “When bioprinting actually hits, it will change everything.”

For now, the printer extrudes a layer of liquid plastic instead of ink. It adds a second layer, and then another, and a skull or rib cage — or whatever the surgeon dials up — slowly emerges.

The same process can also print layers of human cells. So far, researchers have also printed blood vessels, simple organs and bits of bone.

COMMONHEALTH.WBUR.ORG
by Rachel Zimmerman |