Bergamo 3D Rhinoplasty Software: Select, Store, and Share Surgical Maneuvers in a Three-Dimensional Nasal Model

Overview

Rhinoplasty varies so much between patients that surgeons use worksheets to record exactly which steps were performed and how they interacted. The Gunter Rhinoplasty Diagrams have been the standard since 1989 and no newer software had replaced them. The authors built a three-dimensional nasal framework model and an interface for selecting and recording surgical manoeuvres on it.

Sections of note

• A new standard three-dimensional nasal framework model was built in STL format.
• All basic components were modified to simulate how sutures, grafts and common manoeuvres interact.
• 669 three-dimensional figures were created, 99 built-in units and 285 unilateral units, selectable from 230 options.
• The software has a database section holding patient information and documents, and a surgery section grouping selection lists across 10 surgical areas.
• Eighty percent of the options change the shape of the three-dimensional model.
• Results can be exported to desktop software and as a physical three-dimensional printed model. The stated main limitation is customisation of the original model and manoeuvres, given the technology available in 2014.

What it means for a patient

• The tool records what was done in an operation in a form another surgeon can read, which matters if a revision is needed years later.
• It is designed for surgeon documentation, teaching and case discussion, not for showing a patient what their nose will look like.
• Because the model is a standard nasal framework rather than the patient's own anatomy, it does not predict an individual result.
• No patient outcomes, accuracy testing or comparison against paper worksheets is reported in the abstract.

Why this paper matters

Rhinoplasty operative notes are notoriously hard to interpret afterwards, which complicates revision surgery and makes results difficult to compare between surgeons. A structured three-dimensional record addresses that directly. Whether it improves documentation quality or surgical outcomes is not tested here.

Terms

• Worksheet: a diagram used to record which surgical steps were performed.
• Gunter Rhinoplasty Diagrams: the standard hand-drawn rhinoplasty recording system introduced in 1989.
• STL format: a standard file type for describing three-dimensional shapes.
• Surgical manoeuvre: a specific step performed during an operation.
• Unilateral: applied to one side only.
• Three-dimensional printing: producing a physical model from a digital shape file.