3D printing has increasing applications in rhinology, for instance to create patient-specific preoperative models for procedure planning, including designing a template for reconstruction planning following tumour resection, patient consultation and customised prostheses. The authors focused their review on the role of 3D printing in improving treatment of large or irregular septal perforations. A virtual 3D image of the perforated septum and its surrounding tissue is first obtained using a high-resolution CT scan and subsequently printed. The prosthetics department then creates a prosthesis based on the printed 3D template. The creation of the prosthesis is similar to the technique used to create custom dental (whitening) trays. The entire process of creating a custom prosthesis typically takes about a week to complete. The indication for custom prosthesis is for large perforations (> 1.5cm) and those that are difficult to close surgically. The authors found patients who had previous unsuccessful results with commercially available septal buttons also reported improved outcomes with a custom prosthesis. Placement of the prosthesis could be performed under local anaesthetic although the authors advocate general anaesthesia if the prosthesis is much larger than the nares opening or if further procedures are needed such as adhesiolysis. In their review, the authors found that the retention rate for 3D sized patients was much better compared to other patients as they found it more comfortable. It appears there is a role for 3D prosthesis although this should be reserved for more complex or revision cases. Its availability is also limited to units where 3D printers are available.

The emerging role of 3-dimensional printing in rhinology.
Stokken JK, Pallanch J.
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Wai Sum Cho

Queens Medical Centre, Nottingham, UK.

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