2025 Poster Presentations
P322: A COMPARISON OF SURGICAL OUTCOMES OF PATIENT-SPECIFIC 3D MAXILLA MODELS FOR INTRAOPERATIVE USE DURING MAXILLECTOMY
Matthew D Marquardt1; Mohammed Bilal Alsavaf, MD2; Joseph Lee, MD2; Amanda Pancake2; Kyle VanKoevering, MD2; 1The Ohio State University College of Medicine; 2The Ohio State University Wexner Medical Center Department of Otolaryngology-Head and Neck Surgery
Background: Malignancies involving the maxilla present significant challenges to surgeons during tumor resection given the proximity of critical anatomy and the often advanced stage of the tumors. The deep location of the posterior margin makes it particularly challenging to achieve complete tumor resection. 3D printing technology has the potential to assist surgeons visualize the tumor and assist with reconstruction by producing patient-specific models that can be used in the operating room. 3D printed anatomical models are rapidly gaining traction for head and neck cancers involving the mandible; however, its use for sinonasal malignancies requiring maxillectomy is new.
Methods: A matched-control retrospective chart review was conducted to assess the impact of patient-specific 3D printed tumor models on maxillectomy surgical outcomes. All patients at a large midwestern academic medical center who received a maxillectomy for squamous cell carcinoma between June 2021 and October 2023 were chart reviewed and then split into two cohorts depending whether the surgeon requested a 3D model for the procedure. Figure 1 provide an example of a patient-specific model with the tumor in purple and boney anatomy in clear. Cases were then controlled for tumor T stage. Categorical comparisons were made using a Chi-square test, and continuous variables were compared via Mann-Whitney T-tests. Statistically significant was set at p<0.05
Results: 60 patients were identified from CPT codes for maxillectomy and chart reviewed. Subjects were controlled for T4 stage, resulting in 13 patients in the 3D model group and 18 in the control group. Demographically both groups were similar in terms of gender, tobacco use, alcohol use, race, and comorbidities. The control group was older (69.2 years versus 61.4 years, P=0.034) and had a slightly higher BMI (32.7 versus 26.1 kg/m2, P=0.002). There was no statistically significant difference in main margin status or additional margins submitted (P = 0.72 and P=0.49, respectively). Both cohorts also had equivalent rates of close margins (P=0.58). Estimated blood loss and ischemia time during reconstruction was also similar (P=0.20 and P=0.57, respectively). The control group had slightly longer admission durations (6.3 ± 5.2 days) compared to the 3D model group (9.6 ± 5.4 days). No differences in recurrence rates or metastasis were observed.
Conclusion: The use of 3D-printed, patient-specific anatomical models yielded comparable surgical outcomes to a control group in this retrospective analysis. Potential bias may have negatively influenced the results for the model group since surgeons tended to request models for more complex cases involving challenging tumor anatomy. Additionally, the full benefits of these models for maxillectomy may not yet be realized as their design and application continue to be optimized with increased usage and experience. Therefore, 3D-printed anatomical models may be a useful adjunct to assist with complex ablation for these challenging tumors.
Figure 1: Example of a patient-specific model used to resect a maxillary sinus tumor