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International Journal of Bioprinting 3D bioprinting in otorhinolaryngology

3D printed from a 3D model of the human nose created 3D model surgical guide ensured complete resection
using 3D scanning technology. Endoscopic sinus surgery with maximum preservation of the functional adjacent
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often improves the delivery of local drugs into the sinus soft tissues, resulting in a more aesthetic outcome and an
cavity. In one experiment, 3D-printed silicone models of improved quality of life (Figure 9A to D). The bioprinting
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patients’ nasal cavities and sinuses coated with a fluid- design technology can also be used for other soft tissue
sensitive, color-changing gel were used for intranasal cancers of the head and neck or repair surgery, such as
administration using conventional nasal spray, expiratory the reconstruction of the mouth base, tonsils, cheeks, roof
drug delivery system (EDS), and low-flow, high-volume of the mouth, and base of the tongue. The authors also
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(HVLF) methods. Specifically, the head was tilted 45° or highlighted that the technology has some limitations, and
90°, and both HVLF and EDS (relative to conventional greater accuracy and more objective evaluation methods
nasal spray) were observed to induce deep intranasal or are required to improve its overall applicability.
extra-nasal deposits in the silicone cast, highlighting the 3D bioprinting is also used in surgical reconstruction
benefits of this method. 175 of the throat. Pharyngeal fistula is a complication of
7. Application of 3D bioprinting in pharyn- laryngeal surgery that may lead to further infection and
necrosis after surgery. At present, there are numerous
gology and laryngology recommended clinical treatment methods, such as fasting,
wound packing, and surgical repair. However, some
7.1. Pharyngology patients may not recover after a long period of treatment,
Obstructive sleep apnea-hypopnea syndrome (OSA) is thereby affecting their quality of life. Macielak et al. used
caused by anatomic abnormalities of the upper airway printed sustainable fistula plugs for a patient with persistent
and decreased muscle tone, and many factors are related pharyngeal fistula after a pharyngectomy. The fistula plug
to its severity and prognosis. Ciavarella et al. printed successfully reduced the amount of saliva through the
maxillofacial models of 64 mild to severe patients fistula, alleviated the need for frequent dressing changes
and analyzed the relationship between maxillary and after surgery, and subsequently stimulated the closure
mandibular morphologies and respiratory parameters, of the fistula. Similarly, this bioprinting method has
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such as the apnea-hypopnea index (AHI) and blood been reported in the treatment of other conditions, such
oxygen saturation index (ODI). The authors found that as intestinal fistula, as well as postoperative fistula. 182,183
the deterioration of AHI and ODI was associated with Although the novel approach provides a comfortable, safe,
a significant reduction in maxillary arch length and and simple bridge, it is rarely used in the clinical setting. In
mandibular anterior width. A significant reduction in addition, the fistula plug generated using 3D bioprinting
the height and area of the palate was also associated with can be personalized to specific human tissues to improve
an increase in ODI. They reasoned that the reduction in the healing effect.
maxillary length and mandibular width may influence the
severity of OSA, resulting in a reduced tongue position 7.2. Laryngology
and a narrowing of the posterior tongue space. In other 7.2.1. Larynx
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studies, 3D bioprinting has provided substantial insights Laryngeal cancer is one of the most common malignancies
into the pathology of OSA. In patients with OSA, the requiring laryngeal and neck surgeries. Owing to the
posterior mandibular displacement, posterior airway space invasion of the tumor into the surrounding tissues, laryngeal
stenosis, tongue and soft palate enlargement, and lower cancer affects the patient’s voice (vocal cords), breathing,
hyoid bone position were confirmed by intuitive vision. 177
and swallowing. Moreover, resection oftentimes causes
Oropharyngeal carcinomas are a group of malignancies the laryngeal dysfunction. Additionally, conventional
that comprise the majority of head and neck cancers. postoperative reconstruction methods, including primary
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With the development of 3D bioprinting, researchers closure with local flaps and microvascular-free tissue, do not
can build 3D models of oropharyngeal cancer in vitro for produce satisfactory results. 184,185 A recent study reported
pathological research, as well as tissue repair and surgical the successful reconstruction of a variety of complex organs.
planning. Xu et al. established a tissue structure model for Tian et al. precisely removed and repaired the thyroid
a patient with oropharyngeal cancer using SLA, enabling cartilage using digital modeling and 3D bioprinting. In
them to develop a personalized surgical plan, delineate a the study, they indicated the scope of surgical resection by
clear and safe surgical boundary, and provide a design for digitally modeling the osteotomy lines of thyroid cartilage
the reconstruction of soft tissue defects. The intraoperative and laryngeal tumors that formed in the laryngeal tissue
judgment and postoperative pathological results were before surgery. Personalized osteotomy guide plates
consistent with the 3D bioprinting design. Likewise, the and titanium mesh were made using 3D bioprinting for

Volume 10 Issue 4 (2024) 47 doi: 10.36922/ijb.3006