Personalized 3D Printed Surgical Tool for Guiding the Chisel during Hump Reduction in Rhinoplasty

Herrero Antón de Vez H, Herrero Jover J, Silva-Vergara C.

PubMed 29616168 Publisher (DOI)Free full text (PMC)

What this paper says

The authors describe a six-step workflow for designing and 3D printing a patient-specific guide that directs the chisel during hump removal, allowing a single-step bone cut instead of the usual multistep one.

Overview

Removing a dorsal hump normally requires the surgeon to judge how much bone to take. This paper introduces a printed guide, designed from the patient's own CT scan and the preoperative plan, that physically constrains the chisel so the planned amount is removed.

Sections of note

Step 1: obtain a digital 3D model of the patient's anatomy from computed tomography images.
Step 2: carry out preoperative surgical planning on that model.
Step 3: design the guide, accounting for nasal measurements and resection objectives.
Step 4: print the guide and sterilize it. Step 5: perform the surgery. Step 6: analyze the outcomes.
The guide allowed a 1-step osteotomy instead of the usual multistep osteotomy, and removal of exactly the planned amount of dorsum.
Operating time was considerably shorter than with conventional osteotomy, and the authors describe the technique as easier, reducing the learning curve from years to minutes once the guide is printed.
Patient understanding of the procedure improved after being shown the 3D model.
The authors state the study design does not allow them to quantify predictability, and that future studies are needed to show an accuracy benefit.

What it means for a patient

The amount of bone removed is decided on a scan before surgery rather than judged during it.
The same model doubles as an explanation tool during the consultation.
The authors themselves state their design cannot quantify predictability, so the accuracy claim is not established.
Limits: no patient count, no measurements, no comparison group, and no follow-up reported in the abstract.

Why this paper matters

Transferring a preoperative plan reliably into the operating room is a persistent gap in rhinoplasty, and printed guides are established in jaw and joint surgery. This applies the idea to hump reduction. It stops short of demonstrating that the guide improves accuracy.

Terms

Surgical guide: A custom-printed template that physically directs an instrument during surgery.
Dorsal hump: The bump of bone and cartilage on the bridge of the nose.
Osteotomy: A controlled surgical cut through bone.
Computed tomography: An X-ray scan producing cross-sectional images used to build 3D models.
Resection: Surgical removal of tissue.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

The authors aimed to present an introduction of patient-specific model in rhinoplasty by introducing a 3D printed surgical guide designed and adapted in an individualized manner for guiding dorsal hump reduction. To introduce the tool, we have designed a six step workflow. First, we obtain a digital 3D model of patient anatomy using computed tomography (CT) images. Second, we conduct a surgical preoperative planning of the rhinoplasty on the mentioned model. Third step consists of designing the guide, while taking into account nasal anthropometries and resection objectives. Fourth step is printing the guide and sterilizing it. Fifth step is performing the surgery. The last step is analyzing the main outcomes of the surgery. Our surgical guide allowed us to perform only 1 step osteotomy instead of the usual multistep osteotomy and remove exactly the amount of dorsum that we decided to remove during the preoperative planning. The duration of intervention was considerably shorter than conventional osteotomy. Using the guide was technically easier than the conventional method and reduced the learning curve from years to minutes (once the guide is printed). Moreover, the patient understanding of the procedure was significantly better after showing the 3D model of the surgery. The surgical guide allows a surgeon to transfer with extreme simplicity the presurgical planning to the surgical field. We have to point out that the design of the study does not allow us to quantify predictability, so future studies are needed to demonstrate an accuracy benefit over the former techniques.

Abstract as indexed by PubMed; the article is open access (PubMed Central).