In-House 3D Printing for Craniofacial Trauma: 7-Year Review.

Introduction: Complex facial trauma presents a challenge to the reconstructive surgeon, as the loss of facial buttresses makes accurate reduction of fractures more and more difficult. Accurate 3D-printed models and virtual surgical planning have become a mainstay in many other aspects of craniomaxillofacial surgery. However, turnaround times from industry produced models frequently preclude their use in the unplanned acute surgical setting.

Purpose: We seek to evaluate the use of in-house printed 3D models for facial trauma and the efficacy and safety of the procedures performed with the aid of these models.

Methods: All patients from January 2017 to August 2023 who received an in-house 3D-printed model to help treat facial fractures were analyzed. Chart review was performed to extract demographic data, fracture type, mechanism, complications, comorbidities, and operative time. Analysis was performed in Microsoft Excel.

Results: A total of 24 patients had 3D models created for facial fractures. The average age was 24.5 years. Motorized vehicles were involved in 15 cases (62.5%). The most commonly injured region was the midface (19 patients; 79.2%), and 8 patients had true panfacial fractures (33.3%). Seventeen patients (71%) had complex fractures involving multiple buttresses. For acute treatments, average time from presentation to operative treatment was 9 days. Average operative time was 268.3 minutes. Three patients (12.5%) had minor complications, including localized infection treated with antibiotics and a small wound dehiscence. Two patients (6.25%) had major complications: a draining sinus tract that required excision and a cicatricial lagophthalmos due to a laceration near the eyelid margin. Ninety-six percent of patients had satisfactory facial contour.

Conclusions: 3D printing anatomical models can be helpful in assisting surgical decision making for patients with facial fractures as well as the process of surgery itself by allowing for prebending of plates. In the acute setting, when turnaround times are short, in-house 3D printing can produce models in a timely fashion to help surgeons operate safely and efficaciously.