When a 53-year-old man called Mr. Ravi (a pseudonym) came to Bangalore’s Health Care Global (HCG) complaining of a mouth ulcer, at first that’s all the doctors found. As he had been treated for tongue cancer two years ago, however, an MRI was taken, and the results weren’t good – the tumor had returned, and it was much more extensive than anyone expected. Surgery would be required, and because the placement of the tumor made it difficult to isolate, it looked like doctors would have to remove a significant portion of the patient’s tongue.
Luckily for Mr. Ravi, surgical oncologist Dr. Vishal Rao of HCG had some experience with difficult surgeries – and with creative solutions. Dr. Rao is known for inventing an inexpensive voice box for people who have lost their ability to speak due to throat cancer; he’s also very familiar with the use of 3D printed surgical models in difficult operations. The surgical team called in Mumbai-based Anatomiz3D, a medical 3D printing company dedicated to the development of advanced 3D printed surgical guides, patient-specific implants and prosthetics.
Using the MRI scan, Anatomiz3D created a 3D model of the patient’s tongue with Materialise’s Mimics software. The software, which allows editing of MRI scan data, enabled them to digitally separate the tumor from the tongue and print them in two different colors, using a flexible material to mimic the organ’s properties.
“This is the first time globally, to the best of our knowledge, that such a procedure has been performed using flexible material differential 3D printing for soft tissues of the tongue,” said Dr. Rao.
The detailed, compound model allowed the surgeons to see the entire tumor and how it affected the tongue; they would have the printed model beside them as they operated to guide them so that they could ensure the removal of the full tumor. Once the cancer had been removed, a plastic surgery team led by Dr. Prashanth Puranik carefully reconstructed the patient’s tongue from thigh muscles, using the 3D printed model as a template for optimal cosmetic and functional results. The model would also be used in pre-surgical counseling, helping the patient himself to understand what would be happening during the surgery and recovery.
We’ve seen many, many cases of doctors using 3D printed models to aid in surgeries, but this one stands out for a few reasons. The tongue is a delicate organ that, if damaged at all, affects the patient’s ability to speak and eat. Repairing it takes a kind of precision that may not have been possible without such a detailed model that replicated the organ in both appearance and feel.
Secondly, oral cancer is an epidemic in India, according to Dr. Rao, thanks to the prevalence of chewing tobacco. Four out of every ten cancer cases diagnosed in the country are oral cancers, so improved medical treatments for mouth, tongue and throat cancers are desperately needed.
“While it’s our duty to look at preventive measures, we need to constantly innovate and help improve treatment paradigms and the quality of life,” said Dr. Rao. “We must create a benchmark for the world to follow rather than wait for the West to solve our problems.”
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