Jina Yom, Jose F Palacios, Allison Neuwirth, Elisa K Atamian, Todd Goldstein, Nicholas Bastidas
{"title":"“人与机器:耳廓框架的3D铣削”。","authors":"Jina Yom, Jose F Palacios, Allison Neuwirth, Elisa K Atamian, Todd Goldstein, Nicholas Bastidas","doi":"10.1177/10556656241286732","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveAutologous rib harvest with manual framework production is the current gold standard for microtia reconstruction. Recent clinical success with implantation of cadaveric costal cartilage grafts opens the possibility of point of care auricular framework production. This paper assesses the feasibility and efficiency of 3D milling of cadaveric costal cartilage for auricular framework production.DesignA Nagata/Firmin style auricular framework was manually carved en bloc out of soap and 3D scanned to design a milling toolpath on a desktop 3-axis computer numerical control (CNC) machine. An en bloc framework was then milled from cadaveric costal cartilage. Time to mill a complete framework was recorded. The dimensional/volumetric analyses were performed.Main Outcome Measure(s)The main outcome measures were total time to mill a complete auricular framework out of cadaveric cartilage and dimensional/volumetric comparisons to the model ear.ResultsTotal milling time for the cartilage framework was approximately 7 min. Finalizing steps took an extra 20 min. Total time to produce a final framework ready for implantation was approximately 27 min, compared to the traditional 1-2 h by manual carving. All dimensional comparisons were within 2 mm to the manually carved model. Volumetric analysis showed 71% similarity.ConclusionsEn bloc cadaveric costal cartilage framework milling is both feasible and efficient. 3D milling significantly reduces framework production time and allows for accurate reconstruction of the complex ear geometry, which can translate to cost savings, optimized patient safety, and potential for patient-specific reconstruction. The next step toward achieving clinical application is ensuring framework sterility.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1986-1991"},"PeriodicalIF":1.3000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"\\\"Man vs. Machine: 3D Milling of Auricular Frameworks\\\".\",\"authors\":\"Jina Yom, Jose F Palacios, Allison Neuwirth, Elisa K Atamian, Todd Goldstein, Nicholas Bastidas\",\"doi\":\"10.1177/10556656241286732\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveAutologous rib harvest with manual framework production is the current gold standard for microtia reconstruction. Recent clinical success with implantation of cadaveric costal cartilage grafts opens the possibility of point of care auricular framework production. This paper assesses the feasibility and efficiency of 3D milling of cadaveric costal cartilage for auricular framework production.DesignA Nagata/Firmin style auricular framework was manually carved en bloc out of soap and 3D scanned to design a milling toolpath on a desktop 3-axis computer numerical control (CNC) machine. An en bloc framework was then milled from cadaveric costal cartilage. Time to mill a complete framework was recorded. The dimensional/volumetric analyses were performed.Main Outcome Measure(s)The main outcome measures were total time to mill a complete auricular framework out of cadaveric cartilage and dimensional/volumetric comparisons to the model ear.ResultsTotal milling time for the cartilage framework was approximately 7 min. Finalizing steps took an extra 20 min. Total time to produce a final framework ready for implantation was approximately 27 min, compared to the traditional 1-2 h by manual carving. All dimensional comparisons were within 2 mm to the manually carved model. Volumetric analysis showed 71% similarity.ConclusionsEn bloc cadaveric costal cartilage framework milling is both feasible and efficient. 3D milling significantly reduces framework production time and allows for accurate reconstruction of the complex ear geometry, which can translate to cost savings, optimized patient safety, and potential for patient-specific reconstruction. The next step toward achieving clinical application is ensuring framework sterility.</p>\",\"PeriodicalId\":49220,\"journal\":{\"name\":\"Cleft Palate-Craniofacial Journal\",\"volume\":\" \",\"pages\":\"1986-1991\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cleft Palate-Craniofacial Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10556656241286732\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Dentistry\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cleft Palate-Craniofacial Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10556656241286732","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Dentistry","Score":null,"Total":0}
"Man vs. Machine: 3D Milling of Auricular Frameworks".
ObjectiveAutologous rib harvest with manual framework production is the current gold standard for microtia reconstruction. Recent clinical success with implantation of cadaveric costal cartilage grafts opens the possibility of point of care auricular framework production. This paper assesses the feasibility and efficiency of 3D milling of cadaveric costal cartilage for auricular framework production.DesignA Nagata/Firmin style auricular framework was manually carved en bloc out of soap and 3D scanned to design a milling toolpath on a desktop 3-axis computer numerical control (CNC) machine. An en bloc framework was then milled from cadaveric costal cartilage. Time to mill a complete framework was recorded. The dimensional/volumetric analyses were performed.Main Outcome Measure(s)The main outcome measures were total time to mill a complete auricular framework out of cadaveric cartilage and dimensional/volumetric comparisons to the model ear.ResultsTotal milling time for the cartilage framework was approximately 7 min. Finalizing steps took an extra 20 min. Total time to produce a final framework ready for implantation was approximately 27 min, compared to the traditional 1-2 h by manual carving. All dimensional comparisons were within 2 mm to the manually carved model. Volumetric analysis showed 71% similarity.ConclusionsEn bloc cadaveric costal cartilage framework milling is both feasible and efficient. 3D milling significantly reduces framework production time and allows for accurate reconstruction of the complex ear geometry, which can translate to cost savings, optimized patient safety, and potential for patient-specific reconstruction. The next step toward achieving clinical application is ensuring framework sterility.
期刊介绍:
The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.