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J Cosmet Med 2022; 6(1): 27-33

Published online June 30, 2022

https://doi.org/10.25056/JCM.2022.6.1.27

Application and limitations of facial computed tomography and three-dimensional scanner images for patient-specific three-dimensional printing of a nose mask

Jung-Gwon Nam, MD, PhD1 , Don Han Kim, PhD2 , Tae-Hoon Lee, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Rep. of Korea
2Department of Digital Contents, College of Architecture and Design, University of Ulsan, Ulsan, Rep. of Korea

Correspondence to :
Tae-Hoon Lee
E-mail: thlee@uuh.ulsan.kr

Received: May 11, 2022; Revised: May 26, 2022; Accepted: May 26, 2022

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: The applications of three-dimensional (3D) printing are expanding in personalized medicine. The image data used for 3D printing modeling include 3D scanners and medical image data such as computed tomography (CT) and/or magnetic resonance imaging data.
Objective: To compare 3D scanner images with CT 3D images for fabricating a patient-specific nasal pillow positive airway pressure (PAP) mask using 3D printing technology.
Methods: Personalized PAP masks were designed using 3D printing based on image data obtained using a low-dose facial CT scan or a 3D scanner. After converting the extracted nose shape data into a standard tessellation language file format, it was transferred to mesh-based modeling software (3-matic) to produce a PAP mask matching the shape of the nose. A questionnaire was used to evaluate the wearing sensation, degree of air leakage, and delivery ability of positive pressure for the customized and conventional nasal type masks. Each mask was rated between 0 and 4.
Results: The ultra-low-dose CT scan with a 1-mm slice distance was adequate to obtain the clear images required to produce a 3D printed nasal pillow PAP mask. The wearing sensation of the 3D printed nasal pillow PAP masks tended to be more comfortable than that of the conventional nasal masks (p=0.056). However, the least amount of air leakage was observed with the conventional nasal mask (p=0.003). The positive pressure delivery ability was slightly lower in the 3D nasal pillow mask group (p=0.054).
Conclusion: The nasal pillow type 3D printed PAP masks used in this study did not demonstrate satisfactory results to justify its use as a replacement of the conventional nasal-type mask. An ultra-low-dose CT scan was sufficient to produce a 3D printed mask.

Keywords: continuous positive airway pressure, image, three-dimensional, nasal mask, obstructive sleep apnea, stereolithography, three-dimensional printing

Fig. 1.Mask reverse engineering using mimics (3-matic) software.
  1. Chan HH, Siewerdsen JH, Vescan A, Daly MJ, Prisman E, Irish JC. 3D rapid prototyping for otolaryngology-head and neck surgery: applications in image-guidance, surgical simulation and patient-specific modeling. PLoS One 2015;10:e0136370.
    Pubmed KoreaMed CrossRef
  2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177:1006-14.
    Pubmed KoreaMed CrossRef
  3. Lin HS, Zuliani G, Amjad EH, Prasad AS, Badr MS, Pan CJ, et al. Treatment compliance in patients lost to follow-up after polysomnography. Otolaryngol Head Neck Surg 2007;136:236-40.
    Pubmed CrossRef
  4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term car-diovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-53.
    CrossRef
  5. Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, et al.; American Academy of Sleep Medi-cine. Practice parameters for the use of continuous and bi-level positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006;29:375-80.
    Pubmed CrossRef
  6. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147:887-95.
    Pubmed CrossRef
  7. VanKoevering KK, Hollister SJ, Green GE. Advances in 3-di-mensional printing in otolaryngology: a review. JAMA Oto-laryngol Head Neck Surg 2017;143:178-83.
    Pubmed CrossRef
  8. Choi JW, Kim MJ, Kang MK, Kim SC, Jeong WS, Kim DH, et al. Clinical application of a patient-specific, three-dimensional printing guide based on computer simulation for rhinoplasty. Plast Reconstr Surg 2020;145:365-74.
    Pubmed CrossRef
  9. Michael S, Sorg H, Peck CT, Koch L, Deiwick A, Chichkov B, et al. Tissue engineered skin substitutes created by laser-assist-ed bioprinting form skin-like structures in the dorsal skin fold chamber in mice. PLoS One 2013;8:e57741.
    Pubmed KoreaMed CrossRef
  10. Nguyen DG, Funk J, Robbins JB, Crogan-Grundy C, Presnell SC, Singer T, et al. Bioprinted 3D primary liver tissues allow assessment of organ-level response to clinical drug induced toxicity in vitro. PLoS One 2016;11:e0158674.
    Pubmed KoreaMed CrossRef
  11. Blaya F, Pedro PS, Silva JL, D’Amato R, Heras ES, Juanes JA. Design of an orthopedic product by using additive manufac-turing technology: the arm splint. J Med Syst 2018;42:54.
    Pubmed CrossRef
  12. Redline S, Strohl KP. Recognition and consequences of ob-structive sleep apnea hypopnea syndrome. Clin Chest Med 1998;19:1-19.
    CrossRef
  13. Strauss RS, Browner WS. Risk for obstructive sleep apnea. Ann Intern Med 2000;132:758-9.
    Pubmed CrossRef
  14. McNicholas WT, Bonsigore MR; Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mecha-nisms and research priorities. Eur Respir J 2007;29:156-78.
    Pubmed CrossRef
  15. Means MK, Edinger JD, Husain AM. CPAP compliance in sleep apnea patients with and without laboratory CPAP titra-tion. Sleep Breath 2004;8:7-14.
    Pubmed CrossRef
  16. Kim HY, Jang MS. Improving compliance for continuous pos-itive airway pressure compliance and possible influencing factors. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:7-14.
    CrossRef
  17. Teo M, Amis T, Lee S, Falland K, Lambert S, Wheatley J. Equivalence of nasal and oronasal masks during initial CPAP titration for obstructive sleep apnea syndrome. Sleep 2011;34:951-5.
    Pubmed KoreaMed CrossRef
  18. Borel JC, Tamisier R, Dias-Domingos S, Sapene M, Martin F, Stach B, et al.; Scientific Council of The Sleep Registry of the French Federation of Pneumology (OSFP). Type of mask may impact on continuous positive airway pressure adherence in apneic patients. PLoS One 2013;8:e64382.
    Pubmed KoreaMed CrossRef
  19. Ebben MR, Narizhnaya M, Segal AZ, Barone D, Krieger AC. A randomised controlled trial on the effect of mask choice on residual respiratory events with continuous positive airway pressure treatment. Sleep Med 2014;15:619-24.
    Pubmed CrossRef
  20. Bang M, Choi SH, Park J, Kang BS, Kwon WJ, Lee TH, et al. Ra-diation dose reduction in paranasal sinus CT: with feasibility of iterative reconstruction technique. Otolaryngol Head Neck Surg 2016;155:982-7.
    Pubmed CrossRef

Article

Original Article

J Cosmet Med 2022; 6(1): 27-33

Published online June 30, 2022 https://doi.org/10.25056/JCM.2022.6.1.27

Copyright © Korean Society of Korean Cosmetic Surgery.

Application and limitations of facial computed tomography and three-dimensional scanner images for patient-specific three-dimensional printing of a nose mask

Jung-Gwon Nam, MD, PhD1 , Don Han Kim, PhD2 , Tae-Hoon Lee, MD, PhD1

1Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Rep. of Korea
2Department of Digital Contents, College of Architecture and Design, University of Ulsan, Ulsan, Rep. of Korea

Correspondence to:Tae-Hoon Lee
E-mail: thlee@uuh.ulsan.kr

Received: May 11, 2022; Revised: May 26, 2022; Accepted: May 26, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The applications of three-dimensional (3D) printing are expanding in personalized medicine. The image data used for 3D printing modeling include 3D scanners and medical image data such as computed tomography (CT) and/or magnetic resonance imaging data.
Objective: To compare 3D scanner images with CT 3D images for fabricating a patient-specific nasal pillow positive airway pressure (PAP) mask using 3D printing technology.
Methods: Personalized PAP masks were designed using 3D printing based on image data obtained using a low-dose facial CT scan or a 3D scanner. After converting the extracted nose shape data into a standard tessellation language file format, it was transferred to mesh-based modeling software (3-matic) to produce a PAP mask matching the shape of the nose. A questionnaire was used to evaluate the wearing sensation, degree of air leakage, and delivery ability of positive pressure for the customized and conventional nasal type masks. Each mask was rated between 0 and 4.
Results: The ultra-low-dose CT scan with a 1-mm slice distance was adequate to obtain the clear images required to produce a 3D printed nasal pillow PAP mask. The wearing sensation of the 3D printed nasal pillow PAP masks tended to be more comfortable than that of the conventional nasal masks (p=0.056). However, the least amount of air leakage was observed with the conventional nasal mask (p=0.003). The positive pressure delivery ability was slightly lower in the 3D nasal pillow mask group (p=0.054).
Conclusion: The nasal pillow type 3D printed PAP masks used in this study did not demonstrate satisfactory results to justify its use as a replacement of the conventional nasal-type mask. An ultra-low-dose CT scan was sufficient to produce a 3D printed mask.

Keywords: continuous positive airway pressure, image, three-dimensional, nasal mask, obstructive sleep apnea, stereolithography, three-dimensional printing

Fig 1.

Figure 1.Mask reverse engineering using mimics (3-matic) software.
Journal of Cosmetic Medicine 2022; 6: 27-33https://doi.org/10.25056/JCM.2022.6.1.27

References

  1. Chan HH, Siewerdsen JH, Vescan A, Daly MJ, Prisman E, Irish JC. 3D rapid prototyping for otolaryngology-head and neck surgery: applications in image-guidance, surgical simulation and patient-specific modeling. PLoS One 2015;10:e0136370.
    Pubmed KoreaMed CrossRef
  2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177:1006-14.
    Pubmed KoreaMed CrossRef
  3. Lin HS, Zuliani G, Amjad EH, Prasad AS, Badr MS, Pan CJ, et al. Treatment compliance in patients lost to follow-up after polysomnography. Otolaryngol Head Neck Surg 2007;136:236-40.
    Pubmed CrossRef
  4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term car-diovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-53.
    CrossRef
  5. Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, et al.; American Academy of Sleep Medi-cine. Practice parameters for the use of continuous and bi-level positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006;29:375-80.
    Pubmed CrossRef
  6. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147:887-95.
    Pubmed CrossRef
  7. VanKoevering KK, Hollister SJ, Green GE. Advances in 3-di-mensional printing in otolaryngology: a review. JAMA Oto-laryngol Head Neck Surg 2017;143:178-83.
    Pubmed CrossRef
  8. Choi JW, Kim MJ, Kang MK, Kim SC, Jeong WS, Kim DH, et al. Clinical application of a patient-specific, three-dimensional printing guide based on computer simulation for rhinoplasty. Plast Reconstr Surg 2020;145:365-74.
    Pubmed CrossRef
  9. Michael S, Sorg H, Peck CT, Koch L, Deiwick A, Chichkov B, et al. Tissue engineered skin substitutes created by laser-assist-ed bioprinting form skin-like structures in the dorsal skin fold chamber in mice. PLoS One 2013;8:e57741.
    Pubmed KoreaMed CrossRef
  10. Nguyen DG, Funk J, Robbins JB, Crogan-Grundy C, Presnell SC, Singer T, et al. Bioprinted 3D primary liver tissues allow assessment of organ-level response to clinical drug induced toxicity in vitro. PLoS One 2016;11:e0158674.
    Pubmed KoreaMed CrossRef
  11. Blaya F, Pedro PS, Silva JL, D’Amato R, Heras ES, Juanes JA. Design of an orthopedic product by using additive manufac-turing technology: the arm splint. J Med Syst 2018;42:54.
    Pubmed CrossRef
  12. Redline S, Strohl KP. Recognition and consequences of ob-structive sleep apnea hypopnea syndrome. Clin Chest Med 1998;19:1-19.
    CrossRef
  13. Strauss RS, Browner WS. Risk for obstructive sleep apnea. Ann Intern Med 2000;132:758-9.
    Pubmed CrossRef
  14. McNicholas WT, Bonsigore MR; Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mecha-nisms and research priorities. Eur Respir J 2007;29:156-78.
    Pubmed CrossRef
  15. Means MK, Edinger JD, Husain AM. CPAP compliance in sleep apnea patients with and without laboratory CPAP titra-tion. Sleep Breath 2004;8:7-14.
    Pubmed CrossRef
  16. Kim HY, Jang MS. Improving compliance for continuous pos-itive airway pressure compliance and possible influencing factors. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:7-14.
    CrossRef
  17. Teo M, Amis T, Lee S, Falland K, Lambert S, Wheatley J. Equivalence of nasal and oronasal masks during initial CPAP titration for obstructive sleep apnea syndrome. Sleep 2011;34:951-5.
    Pubmed KoreaMed CrossRef
  18. Borel JC, Tamisier R, Dias-Domingos S, Sapene M, Martin F, Stach B, et al.; Scientific Council of The Sleep Registry of the French Federation of Pneumology (OSFP). Type of mask may impact on continuous positive airway pressure adherence in apneic patients. PLoS One 2013;8:e64382.
    Pubmed KoreaMed CrossRef
  19. Ebben MR, Narizhnaya M, Segal AZ, Barone D, Krieger AC. A randomised controlled trial on the effect of mask choice on residual respiratory events with continuous positive airway pressure treatment. Sleep Med 2014;15:619-24.
    Pubmed CrossRef
  20. Bang M, Choi SH, Park J, Kang BS, Kwon WJ, Lee TH, et al. Ra-diation dose reduction in paranasal sinus CT: with feasibility of iterative reconstruction technique. Otolaryngol Head Neck Surg 2016;155:982-7.
    Pubmed CrossRef

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