Researchers 3D Print Device to Reduce Mental Nerve Injury During Transoral Thyroidectomy

Like most, you have probably been affected by cancer more than once in your life—whether you have experienced a health issue or dealt with it through a family member or friend. You may have even lost someone to cancer as they submitted to a tragic death. Each year in the US, over 52,000 people are found to have thyroid cancer; in fact, you may be surprised to hear that it is the most common cancer for women between the ages of 20 and 34. Treatment is generally somewhat aggressive, involving surgery and radioactive iodine ablation.

In traditional methods for treating thyroid cancer, a thyroidectomy is performed through a small incision in the neck, but with an obvious scar. Now, however, researchers from National Yang-Ming University have developed a new technique that is much more cosmetically appealing; in fact, there is no scar after the procedure, as the malignant thyroid is removed through the mouth.

Development of the technique was challenging however, and as the researchers point out, this method does require a ‘keen understanding of the anatomy,’ because if not performed correctly, it can leave the patient with lower lip paresthesia. This also results in lower lip numbness, pain, and self-consciousness. Amazingly, as surgeons were learning to perform the procedure with robotic assistance, 75 percent of other maneuvers resulted in the condition.

With a new 3D printed device, surgeons can perform the procedure with less harm to the patient. This latest update to the innovative method occurred during a collaboration between the Department of Surgery and 3D Printing Center at Taipei Veterans General Hospital, Taipei, Taiwan. Their findings were outlined in ‘Printing a Three-Dimensional Patient-Specific Safety Device for Reducing the Potential Risk of Mental Nerve Injury During Transoral Thyroidectomy.’

Fitting the patients’ teeth, the 3D printed device works as a solid foundation around the teeth, while the ‘lateral margin’ acts as a marker for the location of the nerve often hit during surgery, then resulting in problems for the patient.

“The patient-specific safety device (PSSD) was a brace with an exact fit to the lower teeth and two safety markers on each side to indicate the location of the mental foramen,” stated the researchers in their paper. “For patient in whom the brace would not be applicable, a 3D mandibular model was printed as a PSSD instead. We analyzed 66 patients undergoing TOETVA at our institution from March 2017 to March 2019. The preoperative details and complication profiles were also analyzed.”

After the device was in use, none of the existing cases were afflicted.

“Through the ongoing close collaboration between surgical and design team, 3D printed patient-specific safety device is a sustainable and valuable service for patients receiving transoral endoscopic thyroidectomy,” concluded the researchers.

3D printing has played a part in not only helping doctors navigate through diagnosis, treatment, and surgery for cancerous tumors, but also in allowing patients to understand more due to the use of 3D printed models. Many doctors are able to 3D print exact replicas of tumors and then study them. This allows for better diagnosing of disease, and treatment—but also education regarding the current state and how the procedure will commence.

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[Source / Images: National Yang-Ming University]