Application of Computer-Aided Design and Customized Implants in the Reconstruction of Pyriform Aperture Defects Secondary to Unilateral Cleft Lip and Palate.

Purpose: To design and develop customized implants with the rapid prototyping (RP) technique in order to reconstruct the defected pyriform aperture. Methods: A 3-dimensional digital model was reconstructed with the software proplan CMF based on the computed tomography data of the patient's skeleton. Then an individualized implant was designed by computer-aided design (CAD) and prepared with the RP technique. A total of 5 patients (3 males and 2 females) with unilateral secondary nasal deformities received the customized implants in this study. Results: All the implants closely matched the surface of the defects. During the 12- to 24-month follow-up period, all the patients reported satisfactory outcomes except for 1 patient where exposure of the implant was observed and had to be removed 3 months after the surgery. Conclusion: With high precision and matching degree, individualized implants designed by CAD and prepared with the RP technique can be used to overcome the limitations of ready-made materials and improve the accuracy of the surgical procedure in reconstructing the defected pyriform aperture. (C) 2017 by Mutaz B. Habal, MD.

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