Scientists have started using computed tomography (CT) and 3-D printing technology to help them in face transplantation surgeries.
Physicians at Brigham and Women's Hospital in Boston performed the country's first full-face transplantation in 2011 and have subsequently completed four additional face transplants. The procedure is performed on patients who have lost some or all of their face as a result of injury or disease.
In the study, a research team led by Frank J. Rybicki, M.D., and Amir Imanzadeh, M.D., research fellow, assessed the clinical impact of using 3-D printed models of the recipient's head in the planning of face transplantation surgery.
Each of the transplant recipients underwent preoperative CT with 3-D visualization. To build each life-size skull model, the CT images of the transplant recipient's head were segmented and processed using customized software, creating specialized data files that were input into a 3-D printer.
Although the entire transplant procedure lasts as long as 25 hours, the actual vascular connections from the donor face to the recipient typically takes approximately one hour, during which time the patient's blood flow must be stopped.
Dr. Rybicki said that if there were absent or missing bony structures needed for reconstruction, they could make modifications based on the 3-D printed model prior to the actual transplantation, instead of taking the time to do alterations during ischemia time. The 3-D model was important for making the transplant cosmetically appealing.
The researchers said they also used the models in the operating room to increase the surgeons' understanding of the anatomy of the recipient's face during the procedure.
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Senior surgeons and radiologists involved in the five face transplantations agreed that the 3-D printed models provided superior pre-operative data and allowed complex anatomy and bony defects to be better appreciated, reducing total procedure time.
Based on the results of this study, 3-D printing has now routinely been used for surgical planning for face transplantation procedures at Brigham and Women's Hospital, and 3-D printed models may be implemented in other complex surgeries.
The study was presented at the annual meeting of the Radiological Society of North America (RSNA).