Medical first in Brazil: 3D printed titanium skull successfully implanted in 23-year-old woman
While revolutionary medical applications are constantly being developed through 3D printing technology, most of these life-saving achievements are taking place in academic hospitals in China and the West. Fortunately, doctors from the Brazilian medical hospital UNICAMP (Universidade Estadual de Campinas) in Campinas show that 3D printed medical applications are also being developed elsewhere. In their academic hospital in the greater São Paolo region, they have recently completed the first ever surgery involving a 3D printed titanium implant in Brazil.
The patient in question was the 23-year-old student Jessica Cussioli, who needed a custom-made plate implant to rebuild her face. After falling from a motorcycle against a trash container, the young woman was left in a horrible situation. Bones across the right side of her head were fractured, while she had a 12 cm long hole across her skull. She was also left with aches and pains throughout her body, and was mostly lucid while waiting for surgery. ‘Dizziness, headache, malaise. Imagine you have severe headaches all day and every day.’
Fortunately, the ensuing surgery was a complete success, and just a week after the operation reporters found her optimistic in her hospital bed. ‘I want to go shopping! Finish my study at university, go on to a new life, with a new head. Everything is new,’ she said.
Soon after this horrible accident happened, Jessica’s family looked into prosthesis options for rebuilding her face. However, these were are brutally expensive, with the figures going up to R $ 130,000 (or approximately $41,500 USD). As a last resort, they therefore began looking for alternative experimental procedures, and got into contact with the Hospital de Clinicas of UNICAMP, where they were experimenting with 3D printed titanium implants.
As professor Paul Kharmandayan explained, they quickly worked to develop a virtual model of Jessica’s skull using CT scans. ‘The technique exists in other countries, but it is a breakthrough for us in Brazil because it only uses domestic resources. [3D printing technology] facilitates the reconstruction, has excellent aesthetic results and moreover, it adds value to the scientific expertise and manufacturing we have here in Brazil,’ he explained.
Before being with the surgery, the doctors did have to get the approval from the University’s board of ethics, as the titanium material isn’t yet covered by Anvisa (The National Health Surveillance Agency). After gaining that approval, they manufactured 3D printed plates both in resin and titanium. The titanium version was used to cover the hole in Jessica’s skull, while the resin version was used by doctors to prepare the surgery as best as possible.
While other implant options, including bone excerpts and acrylic resin, were also considered, the Brazilian doctors resorted to 3D printed titanium due to its high level of detail and the minute risk of rejection. ‘The polymethylmethacrylate often leads to a rejection process. This rejection may cause small or large wounds in a person, in the scalp or the face. Titanium, in turn, is a biocompatible material,’ one expert said. Researcher Luis André Biofrabris Munhoz, who also worked on the project, added that titanium is one of the most stable materials for implants. ‘It has a strong mechanical resistance and corrosion resistance when placed inside the human body, and it is a lightweight material. The patient’s recovery process is similar to when recovering from a bone fracture,’ he said.
The complex procedure she required was financed with support from the Brazilian Unified Health System (SUS), as it was strictly an experimental procedure by the University’s medical sciences department. As such, it is currently unknown when the procedure will be integrated in the medical services for the entire public.
Source: 3ders.org
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