The Use of a Three-Dimensional Printed Model for Surgical Excision of a Vascular Lesion in the Head and Neck

Facial vascular lesions are considered a great therapeutic challenge due to the considerable variability of clinical presentations. Surgical removal requires precise planning and advanced visualization to understand the three-dimensional anatomical relationships better. The aim of the study was to evaluate the feasibility of three-dimensional printed models, based on computed tomography angiography (CTA), in planning and guiding surgical excision of vascular lesions. A patient with a suspected vascular malformation in the face was recruited for participation in this feasibility study. Two personalized three-dimensional models were printed based off 2 separate CTA examinations. These constructs were used in preoperative planning and navigating surgical excision. The three-dimensional constructs identified the vicinity of the lesion and highlighted significant anatomical structures including the infraorbital nerve and vessels supplying the area of vascular anomaly. On postoperative follow-up the patient reported no recurrence of swelling and no sensory deficits. A personalized three-dimensional printed model of a facial vascular lesion was developed based on CTA images and used in preoperative planning and navigating surgical excision. It was most useful in establishing dangerous areas during the dissection process, including critical anatomical structures such as the infraorbital nerve. Combining conventional imaging techniques with three-dimensional printing may lead to improved diagnosis of vascular malformations and should be considered a useful adjunct to surgical management.