Santosh Kumar Malyala

Surgical Planning in Pan Facial Trauma Using Additive ManufacturingMedical Model-A Case Study

Additive Manufacturing (AM) technology is an engineering technology which has a wide scope in medical field. Of various medical fields, craniofacial and maxillofacial surgery adapted this technology and is making use of it to overcome the shortcomings of traditional procedures. Medical application of AM or Rapid prototyping was started two decades ago and is expanding its frontiers with the advancement in technology and technical expertise by the medical professionals. AM technology is widely being used in maxillofacial surgery for hassle free planning, patient education and execution of the surgical procedure and for precision using medical models. The Current case is of pan facial trauma with multiple facial bones fracture treated by surgical planning on AM medical model to adapt the mini plates to be prior to the surgery. This paper also deals with the importance of AM medical models in complex surgeries for better outcome.

Optimization of Computer Tomography Reconstruction Parameters using Additive Manufacturing

Additive Manufacturing (AM) is one of the advanced engineering manufacturing process and the application of this process is entered into each and every industry. This process best suits for production of each part uniquely. This technology best fits for medical and dental industry, where each patient has unique anatomy. Cone Beam Computed Tomography (CBCT), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are the major input data source for the AM medical softwares. The medical data is usually stored in Digital Imaging and Communication in Medicine (DICOM) file format. In the current days the most of the CT scanners are of multi slice scanners, which help to acquire maximum data of patient anatomy with in minimum time. Once CT data acquisition is done the reconstruction of data will start. In reconstruction of CT data slice thickness, slice increment and field of view parameters plays major role. The current work is to obtain best quality of data with minimal errors by optimizing the reconstruction parameters. Considered three reconstruction parameters with three levels to conduct the experiments. The reconstruction data is analyzed using L9 orthogonal array and S/N (Signal to Noise) ratio. The paper also explains the importance of reconstruction parameters theoretically and validated by experimental analysis, also applied on few case studies. The experimental results prove that slice thickness is majorly responsible for the quality of reconstructed data. The dimensional error is reduced from 0.78 mm to 0.65 mm. The same optimal parameters are implemented in the two case studies.

Benefits of Additive Manufacturing Medical Model in Orbital Floor Reconstruction Surgery: A Case Study

Additive Manufacturing (AM) is one of the latest manufacturing processes. AM technology provides patient specific customized physical model, which is almost not achievable by any other technique. AM medical models are best suitable for pre-planning of complex medical surgeries such as reconstruction of the orbital floor which has fractured due to severe craniofacial trauma. Orbital floor is formed by a very thin bone which is often fractured during trauma. Among all the injuries of the craniofacial region, orbital fractures account for about 40 percent. The restoration of the orbit to its pre-traumatic volume and anatomy is one of the most delicate and difficult procedure. However this method which involves multiple try-ins, poses a risk of injury to the important structures within the orbit. AM provides the flexibility to bend, adapt/modify the plate prior to the surgery, which saves the intra-operative surgery time. This also avoids the revision of surgery in some cases. For the current study a patient specific preplanning medical model was made at a low cost using Fused Deposition Modeling (FDM). Placing a reconstruction plate/mesh which was pre-adapted on a model reduces operating time, risk of soft tissue trauma, and allows precise plate positioning and restoration of orbital volume. Using the FDM medical model overall surgery time is reduced by 40 minutes.

Fabrication of Patient Specific Genioplasty Surgical Template Using Investment Casting

Additive Manufacturing (AM) is one of the best techniques to fabricate customized medical models. This technique best suited for the medical industry. The surgical template design and dimensions vary from patient to patient, depending on the anatomy of the patient. AM provides flexibility to design a patient specific surgical template using the patient CT scan data. Medical processing software converts DICOM to 3D CAD data. This 3D CAD data is used to design the patient specific surgical template. This surgical template data is then converted into an STL file format to fabricate medical models using AM machines. The initial surgical template is fabricated using FDM machines, which are easily available and this template is used for pre surgical planning. After satisfactory results are obtained in the pre surgical planning, the same STL file is fabricated using a castable resin. The castable resin model is used for preparation of the mould for casting process. This mould is then used to produce the final surgical template with medical grade SS316. The cost of the final metal surgical template is reduced by 30 percent compared to production of same model fabricated using metal AM system. The major advantage of this process is that we obtain a patient specific template in traditional approved way, but at reduced cost.