Aug. 19, 2025
Head and neck tumors pose significant challenges for resection because of the complex anatomy surrounding them. Virtual surgical planning is critical for those operations. Mayo Clinic takes preoperative planning further by printing 3D models and cutting guides in-house.
"If you have a tumor in a highly sensitive location, it can obscure the anatomy seen on imaging," says Samip Patel, M.D., a head and neck surgeon at Mayo Clinic in Jacksonville, Florida. "As surgeons, familiarizing ourselves with a patient's unique anatomy and tumor helps us preserve the neurovascular structure and functioning organs in that constricted space. Even a small tumor requires precise surgical planning to achieve a radical resection."
Mayo Clinic combines surgery, biomedical engineering and radiology in one place to create 3D printed models and guides to improve surgical planning in head and neck surgeries.
Benefits of in-house 3D printing for head and neck surgeons and patients
Having a 3D printing lab embedded in the practice enables preoperative printing to happen quickly, often within days of a patient's assessment and imaging. The radiology team collaborates with the in-house engineering team to ensure the imaging is appropriate and to segment out the tumors compared with the native anatomy. The engineering team, which has multiple printers with various production capacities, can create a 3D model of any part of the head and neck.
"It's incredibly helpful to have the tumor in hand, especially with skull base tumors," says Dr. Patel. "Without a 3D model, you can't always visualize the tumor completely until you've made the incisions and begun the operation."
Bringing 3D printing in-house offers advantages to both surgeons and patients, including:
- Improved surgical precision and ability to achieve clear margins.
- Lower cost compared with custom planning and printing performed by third-party manufacturing.
- Reduced operative time, which also decreases the cost and risk of complications.
"Having this capability in-house enables us to implement this type of surgical planning on a daily basis with every patient, if needed," explains Dr. Patel. "It's cost-effective and quicker, which are critical advantages. It also allows surgeons to approach a complex surgery with full confidence."
Printing a more precise approach for jaw reconstruction surgery
Jaw reconstruction is often necessary to restore function and aesthetics after head and neck cancer surgery. Mapping out a comprehensive reconstruction is vital for precise implant placement, bone grafting and resection.
3D printed cutting guides outline the exact angles and measurements needed to make accurate cuts. Patient-specific cutting guides and surgical planning can save up to two hours in the operating room, reducing the time under anesthesia. Printing those cutting guides in-house saves time and money.
"We've used commercial companies in the past to create custom cutting guides, and they do a great job," says Dr. Patel. "But it can be costly, and having in-house engineers enables us to jump on the preoperative planning quickly."
Jaw reconstruction is based on the patient's unique anatomy, with the new jaw built to the patient's exact structure and measurements. Using 3D modeling reduces long-term complications and the risk of plate breaks, bone fractures and nonunion. 3D printed models also help surgeons achieve perfect bone-to-bone contact when the jaw is reconstructed using bone from another area of the body.
"For jaw reconstruction, we may use either the scapula or fibula from the patient," says Dr. Patel. "We use imaging of the patient's bone to create a model of the new jaw." Using that model, surgeons work with a third-party or commercial manufacturer to create a custom titanium plate that precisely fits the patient's anatomy and fixates the jaw.
"The next step would be creating those titanium implants ourselves, which would further decrease the cost," says Dr. Patel. Until then, Dr. Patel and his team are reviewing the accuracy outcomes of the last 100 head and neck surgeries performed using in-house 3D printing as part of their virtual surgical planning. "Research on virtual surgical planning for mandible reconstruction shows that it decreases operative time and produces more-accurate outcomes. However, our group looks forward to publishing the outcomes we've achieved here at Mayo Clinic by printing our models and guides on-site."
Study results were published in the American Journal of Otolaryngology in 2024.
For more information
Speed OE, et al. Virtual surgical planning for mandibular reconstruction in an abbreviated admission pathway. American Journal of Otolaryngology. 2024;45:104141.
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