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Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation – A first step to create reliable customized simulators.

Valentin Favier 1, 2 Nabil Zemiti 3 Oscar Caravaca Mora 3 Gérard Subsol 2 Guillaume Captier 4 Renaud Lebrun 5 Louis Crampette 6 Michel Mondain 1 Benjamin Gilles 2 
2 ICAR - Image & Interaction
LIRMM - Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier
3 DEXTER - Robotique médicale et mécanismes parallèles
LIRMM - Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier
Abstract : Introduction Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. Methods Four 3D-printed consumer-grade materials were compared to human cadaver bone: cal- cium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We com- pared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. Results All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6–3.5 times higher than in bone. For polycarbonate, forces applied were 1.6–2.5 times higher. Polycar- bonate had a mode of fracture similar to the cadaver bone. Forces applied on materials dur- ing drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. Conclusion Polycarbonate is a good substitute of human cadaver bone for skull base surgery simula- tion. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.
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Submitted on : Tuesday, December 19, 2017 - 10:50:10 AM
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Valentin Favier, Nabil Zemiti, Oscar Caravaca Mora, Gérard Subsol, Guillaume Captier, et al.. Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation – A first step to create reliable customized simulators. . PLoS ONE, Public Library of Science, 2017, 12 (12), pp.e0189486. ⟨10.1371/journal.pone.0189486⟩. ⟨lirmm-01667197⟩

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