Transparency film or x-ray film were used to trace a model ear (the patient's good ear or a parent's ear if the child had microtia on both sides). The templates were sterilized and used in the operating room to assist in carving the rib cartilage. However, ears are 3-dimensional structures. These two dimensional templates were not a great representation of the beautiful nooks and crannies that we all recognize as a normal ear.

3D printing, allows us to print a sterilizable model to take to the operating room. Prior to the surgery, the patient has either a CT scan (which is obtained to assess for candidacy for aural atresia repair) or a 3D optical scan (which can be performed in the clinic). The data from these images is used to create a custom computer construct of the ear. This model is designed with a guide that connects to the side of the nose, to allow for proper angle and positioning of the reconstructed ear. Once the design is complete, it is sent to a 3D printer which creates the structure that you see using a laser that cures resin. Once sterilized, Dr. Jabbour uses these models in the operating room to be able to match the sculpted ear as closely as possible to this model.

While 3D guides are helpful to see the ear in three dimensions, cutting guides are also needed that are two dimensional. These are custom designed by Dr. Jabbour for each patient and printed by the UPMC 3D print lab. The holes allow room for securing the cutting guides to the rib during the initial tracing and carving.

The custom 3D printed cutting guides provide a a great start to creating a cartilage sculpture that is of the correct size and shape. The cartilage that is shown outside of the cutting guide will be used to create other portions of the finished cartilage sculpture.

3D printing allows Dr. Jabbour to ensure that the cartilage that is carved is a great match to the goal, ensuring more symmetric results.