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AMS Spring 2023

Endangered Indian Hornbill Rescued with 3D Printing from Formlabs

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Formlabs‘ technology has been used in the past for medical applications, including anatomic models and COVID-19 test swabs. But recently, the 3D printing double unicorn put its printers to work to help an endangered bird with a life-threatening medical condition. Today, ZooTampa in Florida announced a successful restorative surgery for Crescent, a female Indian Hornbill diagnosed with cancer. The zoo partnered with medical experts at University of South Florida (USF), who used Formlabs technology and biocompatible resin to save Crescent from almost certain death.

Crescent, 24 hours post-op

The endangered Indian Hornbill is most recognizable for its prominent helmet-like casque, which is a hollow, bright yellow and black growth on the bird’s upper beak. According to Beauty of Birds, the casque doesn’t really serve a purpose, though males will sometimes strike each other’s casques during flight. Crescent developed a tumor on her casque, which zoo medical personnel believed was squamous cell carcinoma. This skin cancer is pretty common amongst humans, but it’s almost always fatal in hornbills, which can normally live for nearly 50 years in captivity.

3D printing has been used in the past to help other hornbills with cancerous growths on their casques, and a Form 2 3D printer was once used to create a prosthetic beak for an Abyssinian ground hornbill. This is the route that the USF Health medical experts went to save Crescent, using Formlabs 3D printers and a new biocompatible resin to get the job done.

Even though the best way to help the large bird was by entirely removing the tumor from her casque, it would be a risky procedure—Crescent’s sinuses would be exposed due to the tumor’s location. So the decision was made to design a custom, 3D printed prosthetic casque, which would allow the hornbill to live a normal life post-op. Additionally, a 3D printed surgical cutting guide was created to help with the procedure.

First, the USF Department of Radiology team turned to the Formlabs Form 3B+ to prepare for the surgery, using CT scans to 3D print a model of the hornbill’s skull, casque, and tumor in order to plan out the procedure. In addition to the model and the prosthetic casque, the team also 3D printed a cutting guide to help during the surgery.

Biomedical engineer Jonathan Ford, PhD, led the radiology team, which took into account the tumor location, skull edge, and other important anatomical features from the CT scans while modeling the pieces in rotating 3D images. They made a lot of adjustments during the process to be certain that the surgical guide and prosthetic casque would be a perfect fit for Crescent, and even took pains to align the screw holes of the surgical guide so they could be used again for the prosthetic.

“There is such a gap between human medicine and animal medicine. We take it for granted. For us to be able to help in a small way, working together and making a difference, was definitely worth it. And the ZooTampa animal care teams are amazing,” said Dr. Summer Decker, Vice Chair for Research and Innovation and director of 3D Clinical Applications at USF’s Department of Radiology.

According to Dr. Alex Fox-Alvarez, Assistant Professor of Small Animal Surgery at the University of Florida’s College of Veterinary Medicine, this surgery would have been “much more challenging” without the 3D printed guide and pre-surgical planning. Dr. Kaitlyn McNamara, D.V.M, and UF senior surgical resident, assisted Dr. Fox-Alvarez during the avian surgery.

Surgical guide

Prosthetic with acrylic

In order to work as planned, the 3D printed prosthetic casque had to be durable, lightweight, and hard, so the team needed just the right material. In the past, USF Health had used Formlabs’ medical-grade, biocompatible materials for similar applications, and asked the company for help with Crescent’s surgery. Formlabs actually donated a new material, BioMed White Resin, which is still being developed and is not yet commercially available. The biocompatible resin seems to have been the perfect choice.

Once the surgeons removed the tumor, they used dental acrylic to attach the 3D printed prosthetic casque to the top of the bird’s beak. Post-op, Crescent seems to be doing just fine, with no changes to her appetite, behavior, or vocalizations, which is great news.

Crescent, 96 hours post-op

“Formlabs’ 3D printers and BioMed materials are used to deliver precision healthcare, and clinical literature has shown improved outcomes when patient-specific prosthetics, medical devices, and surgical guides have been used with human patients,” stated Gaurav Manchanda, Director of Medical Market Development at Formlabs. “We’re thrilled that our technology was also able to bring these same benefits to Crescent, who also uncovered a unique, unexpected benefit that warmed the hearts of everyone involved.”

That “unique, unexpected benefit” happened after Crescent began preening shortly after waking up from her surgery. The hornbill’s preen gland secretion is yellow, and the birds spread it onto their longest wing weathers and beak, which gives them their bright hue. It turned out that the Formlabs BioMed White Resin is compatible with these preening oils, which are secreted from glands above the tail. So Crescent’s new 3D printed casque is now the same color as her old one!

(Images courtesy of ZooTampa)

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