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International Journal of Bioprinting 3D bioprinting in otorhinolaryngology

causes of hearing loss. After mastoid radical surgery, data enables researchers to create complex 3D models,
doctors can implant an artificial auditory ossicular chain prostheses, and implants (e.g., temporal bone, auricle
to mediate hearing recovery. However, the use of artificial prostheses, and mandibular implants) that can be
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ossicles in clinical practice is often limited because subsequently used in preoperative planning to improve
customized ossicles cannot be readily developed for each the success rate of surgeries. 15-19 Notably, 3D-bioprinted
patient. Many researchers have established models to ear models with personalized characteristics that mimic
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study the construction of the middle ear and attempted the (healthy) ear of patients with microtia are considered
to customize artificial ossicles. Tissue engineering is the most prominent example of 3D bioprinting and
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considered the most promising strategy for tissue and have been widely used in clinical practice. Furthermore,
organ repair because it offers the possibility of individual 3D-bioprinted personalized grafts for tissue and organ
customization. Furthermore, the anatomy of the tissues repair have recently garnered significant attention for
and organs involved in otorhinolaryngology is complex their precise restoration of anatomical structures to their
and delicate. Consequently, there are often difficulties and natural form and high transplantation success rate without
high-risk situations in this field, such as surgical failure rejection of the respective allogeneic transplantation.
20
that often causes irreversible pain to the patient. However, Despite the successful application of 3D bioprinting in
preoperative planning can effectively reduce such risks. At human patients, 3D bioprinting for transplantation remains
present, preoperative planning often combines computed mostly in the experimental stage with animal models.
tomography (CT), magnetic resonance imaging (MRI), Herein, this comprehensive review provides a
and/or other imaging data with the doctor’s subjective comprehensive guide for non-specialists on 3D bioprinting
evaluation to optimize surgical procedures. This would in otorhinolaryngology and the latest progress in related
also indicate that errors in three-dimensional (3D) fields. This review discusses the common 3D bioprinting
visualization may ultimately lead to mistakes during the techniques and bioinks, their performance in the field
medical procedure. of otorhinolaryngology, and the applications of 3D

3D bioprinting is an additive manufacturing process that bioprinting in rhinology, nasopharynx, pharyngology, and
involves multi-disciplinary integration. Based on layer-by- head and neck surgery.
layer manufacturing and available imaging data (e.g., from
MRI or CT), 3D models of complex structures in the human 2. Current 3D bioprinting techniques
body can be accurately established using computer-aided Various 3D bioprinting techniques can be used to generate
software and biological agents (e.g., living cells, biological 3D structures. The commonly used 3D bioprinting
materials, drugs, growth factors, and genes). Compared techniques in otorhinolaryngology are extrusion-based
5-7
with conventional manufacturing techniques in tissue bioprinting, droplet-based bioprinting, and laser-based
engineering (e.g., compression molding, molten casting, bioprinting (Figure 1). 21,22 In this section, the different
and electrospinning), 3D bioprinting can rapidly and techniques used in otorhinolaryngology are discussed
accurately transform computer-aided designs into complex in detail.
3D objects without the use of conventional manufacturing
tools, such as molds and models. Furthermore, 3D 2.1. Extrusion-based 3D bioprinting
8,9
bioprinting can also facilitate the manufacture of on- Extrusion-based 3D bioprinting can be divided into
demand medical products, highlighting its economic, pneumatic, piston, and spiral bioprinting. These techniques
efficiency, and precision advantages over conventional predominantly use compressed air, a piston, or spiral
manufacturing technologies. 10,11 3D printing has been used rotation, respectively, to push the bioink from a nozzle onto a
to construct medical models since it was first reported substrate. 23,24 Otorhinolaryngology-related 3D bioprinting
by Hull et al., who described the first light-curing mold often involves high-viscosity materials. Extrusion-based
printing device in 1984. It has now been used to create bioprinting can generate different degrees of pressure
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miniature laboratories on microchips for in vitro testing (dependent on the power source), which is conducive to
and develop new diagnostics, drugs, and therapeutics. 12-14 the bioprinting of high-viscosity materials. Consequently,
Currently, 3D bioprinting is widely used in the medical bioinks with a wider viscosity range can be printed, even
field and has been integrated with other technologies for from cell spheres. 25-28 Extrusion-based 3D bioprinting is
diverse applications, including the development of models economical, easy to operate, and delivers rapid results,
used in contemporary medicine. driving its commoditization. However, the undeniable
In recent years, the application of 3D bioprinting disadvantage of extrusion-based 3D bioprinting is that
has improved the diagnosis and treatment of it exposes cells to greater stress than other bioprinting
otorhinolaryngologic diseases. The patients’ imaging techniques during the bioprinting process, resulting in cell

Volume 10 Issue 4 (2024) 29 doi: 10.36922/ijb.3006