Using 3D printed sinonasal models to visualize and optimize personalized sinonasal sinus irrigation strategies

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Abstract
Topical sinus irrigations (neti-pot, squeeze bottles) play a critical role in the management of sinonasal disease. However, due to intricate nasal anatomy, penetration of topical irrigations to targeted sinus regions may be highly variable, and difficult to objectively predict. Variables, including head positions, injection angles, flow rates, etc. may vary significantly depending on the individual's anatomy. The purpose of this study was to propose a novel idea: using a 3D printed model of sinonasal cavities to visualize and develop a patient-specific irrigation strategy. As a proof of concept, 3D replicas of one patient's sinonasal cavities pre- and post-surgery were printed with a Form2 SLA 3D printer based on their CT scans. The setup included rubber/silicon seals attached to the model's nostrils to create a watertight seal with the irrigation device and food color dye added for better visualization of irrigation results. Irrigations were performed on the 3D models with various head positions, injection angles, and flow rates, and were successful to determine the optimal strategy to targeted sinuses. Significant differences were observed between different targeted sinuses and between pre and post-surgery models. With more affordable 3D printing, this technology may potentially improve patient care and patient education, allowing clinicians and patients to develop a personalized irrigation strategy and have visual confirmation.

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