A national pediatric otolaryngology fellowship virtual dissection course using 3D printed simulators.

Objective: Our objective was to create and evaluate a novel virtual platform dissection course to complement pediatric otolaryngology fellowship training in the setting of the COVID-19 pandemic.

Methods: A four-station, four-simulator virtual course was delivered to pediatric otolaryngology fellows virtually using teleconferencing software. The four stations consisted of microtia ear carving, airway graft carving, cleft lip repair, and cleft palate repair.

Starting a medical 3D printing lab for otolaryngology-head and neck surgery collaboration.

Objective: To evaluate the different strategies for developing and maintaining a 3-dimensional (3D) printing lab.

Methods: We evaluated two printing labs and compared their structure, integration, and production.

Results: While one lab was initiated by a clinician and the other by a technical expert, both labs followed a similar series of steps to develop their lab.

Evaluating Directional Dependency of Selective Laser Sintered Patient Specific Biodegradable Devices to Improve Predictive Modeling and Design Verification.

Additive manufacturing, or 3D printing, of the bioresorbable polymer [Formula: see text]-polycaprolactone (PCL) is an emerging tissue engineering solution addressing patient specific anatomies. Predictively modeling the mechanical behavior of 3D printed parts comprised of PCL improves the ability to develop patient specific devices that meet design requirements while reducing the testing of extraneous design variants and development time for emergency devices. Predicting mechanical behavior of 3D-printed devices is limited by the variability of effective material moduli that are determined in part by the 3D printing manufacturing process.

Advanced Therapies for Severe Tracheobronchomalacia: A Review of the Use of 3D-Printed, Patient-Specific, Externally Implanted, Bioresorbable Airway Splints.

Tracheobronchomalacia is a condition of dynamic collapse of the trachea and mainstem bronchi. The clinical significance of tracheobronchomalacia depends on its severity. Mild cases may be medically managed with limited symptomology, while severe cases require advanced therapies, lengthy hospital stays, and carry significant morbidity and mortality.

Addressing the Pandemic Training Deficiency: Filling the Void with Simulation in Facial Reconstruction.

Objective/hypothesis: To assess the use of a three-dimensional (3D) printed, multilayer facial flap model for use in trainee education as an alternative method of teaching surgical techniques of facial reconstruction.

Study Design: Cohort study.

Methods: A 3D printed facial flap simulator was designed from a computed tomography scan and manufactured out of silicone for low-cost, high-fidelity simulation.

Delivery system can vary ventilatory parameters across multiple patients from a single source of mechanical ventilation.

Background: Current limitations in the supply of ventilators during the Covid19 pandemic have limited respiratory support for patients with respiratory failure. Split ventilation allows a single ventilator to be used for more than one patient but is not practicable due to requirements for matched patient settings, risks of cross-contamination, harmful interference between patients and the inability to individualize ventilator support parameters. We hypothesized that a system could be developed to circumvent these limitations.

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study Design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

A 3D-printed Lateral Skull Base Implant for Repair of Tegmen Defects: A Case Series.

Objective: To determine the feasibility of a patient-specific, three-dimensionally (3D)-printed reconstruction plate for repair of lateral skull base defects.

Study Design: Prospective case series and cadaveric study.

Setting: A university-based, tertiary care hospital.

Innovations in Airway Surgery.

The management of pediatric airway stenosis has evolved considerably over time. At the outset, dilation was the mainstay of management. In the 1900s, open surgery in the form of cricoid expansion procedures or resection procedures was the primary treatment with subsequent development of the slide tracheoplasty.

Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection.

The worst complication of cricotracheal resection (CTR) is anastomotic dehiscence, and to limit it, postoperative management at Michigan Medicine included the use of a modified Minerva cervical-thoracic orthosis (MMCTO). To date, there has been no analysis of the risks and benefits of the brace's use following CTR. We analyze this with our retrospective study.

Computer-Aided Design, 3-D-Printed Manufacturing, and Expert Validation of a High-fidelity Facial Flap Surgical Simulator.

Importance: Facial flap procedures may be difficult for surgical trainees to conceptualize and challenging for supervising surgeons to allow entrustment early in training. Simulation outside of the operating room may accelerate and enhance the surgical education experience.

Objective: To design and manufacture a 3-dimensional (3-D)-printed, multilayer, anatomically accurate facial flap model for use in surgical education.

3D-printed, externally-implanted, bioresorbable airway splints for severe tracheobronchomalacia.

Objectives/hypothesis: To report the clinical safety and efficacy of three-dimensional (3D)-printed, patient-specific, bioresorbable airway splints in a cohort of critically ill children with severe tracheobronchomalacia.

Study Design: Case series.

Methods: From 2012 to 2018, 15 subjects received 29 splints on their trachea, right and/or left mainstem bronchi.

Development and Multidisciplinary Preliminary Validation of a 3-Dimensional-Printed Pediatric Airway Model for Emergency Airway Front-of-Neck Access Procedures.

Background: Pediatric-specific difficult airway guidelines include algorithms for 3 scenarios: unanticipated difficult tracheal intubation, difficult mask ventilation, and cannot intubate/cannot ventilate. While rare, these instances may require front-of-neck access (FONA) to secure an airway until a definitive airway can be established. The aim of this study was to develop a pediatric FONA simulator evaluated by both anesthesiology and otolaryngology providers, promoting multidisciplinary airway management.

Secondary lymphoid organ fibroblastic reticular cells mediate trans-infection of HIV-1 via CD44-hyaluronan interactions.

Fibroblastic reticular cells (FRCs) are stromal cells in secondary lymphoid organs, the major sites for HIV-1 infection of CD4 T cells. Although FRCs regulate T cell survival, proliferation, and migration, whether they play any role in HIV-1 spread has not been studied. Here, we show that FRCs enhance HIV-1 spread via trans-infection in which FRCs capture HIV-1 and facilitate infection of T cells that come into contact with FRCs.

Co-culture of adipose-derived stem cells and chondrocytes on three-dimensionally printed bioscaffolds for craniofacial cartilage engineering.

Objectives/hypothesis: Reconstruction of craniofacial cartilagenous defects are among the most challenging surgical procedures in facial plastic surgery. Bioengineered craniofacial cartilage holds immense potential to surpass current reconstructive options, but limitations to clinical translation exist. We endeavored to determine the viability of utilizing adipose-derived stem cell-chondrocyte co-culture and three-dimensional (3D) printing to produce 3D bioscaffolds for cartilage tissue engineering.

PLZF-expressing CD4 T cells show the characteristics of terminally differentiated effector memory CD4 T cells in humans.

We show the presence of lymphoid tissue-resident PLZF CD45RA RO CD4 T cells in humans. They express HLA-DR, granzyme B, and perforin and are low on CCR7 like terminally differentiated effector memory (Temra) cells and are likely generated from effector T cells (Te) or from central (Tcm) or effector (Tem) memory T (Tcm) cells during immune responses. Tn, Naïve T cells.

Computer-Aided Design and 3-Dimensional Printing for Costal Cartilage Simulation of Airway Graft Carving.

Autologous cartilage grafting during open airway reconstruction is a complex skill instrumental to the success of the operation. Most trainees lack adequate opportunities to develop proficiency in this skill. We hypothesized that 3-dimensional (3D) printing and computer-aided design can be used to create a high-fidelity simulator for developing skills carving costal cartilage grafts for airway reconstruction.