Medicine meets engineering in the lab of David A. Zopf, M.D., M.S., where new ears and noses are created utilizing computer-aided design (CAD) and 3D printing. Dr. Zopf’s research captures not only the marriage of medicine and engineering, but medicine and art as well. “Even Vincent Van Gogh had difficulty with the ear in his artwork,” Dr. Zopf observes. “Creating auricular and nasal scaffolds that have precise anatomic fidelity and supportive structure are just as important as building a house with a solid foundation in place.”
For Dr. Zopf, his research marks a creative return to the department where he once worked as an otolaryngology head-and-neck surgery resident. As a resident, Dr. Zopf trained under Glenn E. Green, M.D., a pediatric otolaryngologist in the department, and Scott Hollister, Ph.D., professor of biomedical engineering and associate professor of surgery at the University of Michigan. Drs. Green and Hollister are considered leaders in the medical applications of 3D printing. It was under their mentorship that Dr. Zopf began his research into how 3D printing can be used to catalyze auricular and nasal reconstruction. Today Dr. Zopf works alongside Drs. Green and Hollister and their teams, who are studying other medical applications for 3D printing, including tracheal reconstruction and custom-printed CPAP masks.
While practicing in the oldest medical specialty in the United States, Dr. Zopf is at the forefront of an innovative technology that could offer unparalleled results for his patients. He hopes that these advances in tissue-engineered ears and noses will one day improve his patients’ quality of life beyond mere aesthetics. The 3D scaffolds for the ear and nose have the potential to improve anatomic function as well as social impact, particularly in improving psycho-social development for children who have suffered a congenital or traumatic deformation. Additional populations who could benefit include armed service members and law enforcement officials who incur facial blast injuries.
Due to the complex three-dimensional nature of the ear and nose, the ability to effectively capture both their unique appearance and function is no small feat. Patients needing auricular or nasal reconstruction often suffer from congenital malformations. These include microtia (a condition where the external ear is undeveloped), an acquired traumatic deformation of the ear or nose or oncologic resection. These patients currently face limited options for surgical reconstruction, but with Dr. Zopf’s research, these 3D scaffolds could have the potential to become synonymous with auricular and nasal reconstruction.
The unique design of these scaffolds is credited to biodegradable polymer with many intricately-designed fine pores that are reabsorbed by the body. The scaffolds are created using an image-based hierarchical design method with a 3D printing process. Dr. Zopf would like to see the scaffolding available for patients as soon as possible pending preliminary clinical trials required by the FDA.
Advancement in this field of biomedical research is particularly important due to its unique ability to conform to the needs of each individual patient. The gold standard available to patients seeking auricular reconstruction is to use the patient’s rib cartilage and then carve this into the shape of an ear. Dr. Zopf has received extensive specialty training in this procedure. Such a technically challenging procedure has many inherent hurdles, including the need for a highly-trained surgeon who can carve auricular cartilage frameworks, the variability with the framework appearance, the need for multiple surgical procedures and morbidity related to the rib donor site. Scaffolds created by auricular CAD and 3D printing will eliminate the technically demanding process and variability, as well as eliminate the need for the donor site. This will allow for more rapid manufacturing while simultaneously improving the patient-specific anatomy. “With the current options available,” says Dr. Zopf, “there is a clear need for what we have to offer.”
This collaboration across departments and specialties exemplifies just one way that UMHS continually strives to become the national leader in health care, biomedical innovation and education. The novel and exciting nature of this technology has the potential to dramatically increase patients’ quality of life and outcomes. There remains a need and potential for more strong collaboration between engineering and medicine in this research. Dr. Zopf adds, “Because of the breadth and depth of [our] expertise, our scaffolds are being designed with clinical implementation in mind.”