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Preoperative definition and new concept design of 3D printed buttress model to seal skull base after endoscopic endonasal surgery

Ida Papallo (Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy and Department of Industrial Engineering, Fraunhofer JL IDEAS, University of Naples Federico II, Naples, Italy)
Domenico Solari (Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy)
Ilaria Onofrio (Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy)
Lorenzo Ugga (Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy)
Renato Cuocolo (Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Salerno, Italy and Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy)
Massimo Martorelli (Department of Industrial Engineering, Fraunhofer JL IDEAS, University of Naples Federico II, Naples, Italy)
Teresa Russo (Institute of Polymers Composites and Biomaterials National Research Council, Naples, Italy)
Ilaria Bove (Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy)
Luigi Maria Cavallo (Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy)
Antonio Gloria (Department of Industrial Engineering, Fraunhofer JL IDEAS, University of Naples Federico II, Naples, Italy)

Rapid Prototyping Journal

ISSN: 1355-2546

Article publication date: 28 August 2024

Issue publication date: 24 October 2024

58

Abstract

Purpose

This study aims to integrate design methods and additive manufacturing with the use of a thermoplastic elastomer certified for medical use and reverse engineering towards a new concept of a customized buttress model with optimized features for the reconstruction of the osteo-dural opening after endoscopic endonasal transtuberculum-transplanum approach.

Design/methodology/approach

Additive manufacturing allows making of cost-effective and useable devices with tailored properties for biomedical applications. The endoscopic endonasal approach to the suprasellar area enables the management of different intradural tumours, and the craniectomy at the skull base is generally wide and irregular. Defining an optimal strategy for osteodural defect closure at the preoperative stage represents a significant challenge.

Findings

Using the results obtained from a computed tomography analysis, skull base defects were designed to plan the surgical approach. Several concepts of customized buttress models were first built up, initially focusing on thin, flexible edges characterized by different thicknesses. Finite element analyses and design optimization allowed us to achieve the optimal design solution with improved compliance/flexibility for easy intranasal manoeuvrability, maintaining an adequate mechanical stability. As the thickness of the edges decreased, an increase of strain energy values was found (i.e. 1.2 mJ – Model A, 1.7 mJ – Model B, 2.3 mJ – Model C, 4.3 mJ – Model D). However, a further optimization (Model E) led to a significant increase of the compliance (strain energy of 14.1 mJ).

Originality/value

The results obtained from clinical evaluations demonstrated the feasibility of the proposed technical solutions, improving surgery effectiveness.

Keywords

Acknowledgements

Erratum: It has come to the attention of the publisher that the article “Preoperative definition and new concept design of 3D printed buttress model to seal skull base after endoscopic endonasal surgery” by Papallo, I., Solari, D., Onofrio, I., Ugga, L., Cuocolo, R., Martorelli, M., Russo, T., Bove, I., Cavallo, L.M. and Gloria, A., published in Rapid Prototyping Journal, Vol. ahead-of-print, No. ahead-of-print, https://doi.org/10.1108/RPJ-08-2023-0280, contained an error in the title. “Preoperative definition and new concept design of 3D printed buttress model to sealskull base after endoscopic endonasal surgery” and has been corrected to “Preoperative definition and new concept design of 3D printed buttress model to sealskull base after endoscopic endonasal surgery”. The publisher sincerely apologises for this error and for any confusion caused.

Citation

Papallo, I., Solari, D., Onofrio, I., Ugga, L., Cuocolo, R., Martorelli, M., Russo, T., Bove, I., Cavallo, L.M. and Gloria, A. (2024), "Preoperative definition and new concept design of 3D printed buttress model to seal skull base after endoscopic endonasal surgery", Rapid Prototyping Journal, Vol. 30 No. 9, pp. 1956-1973. https://doi.org/10.1108/RPJ-08-2023-0280

Publisher

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Emerald Publishing Limited

Copyright © 2024, Emerald Publishing Limited

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