Cost Analysis for In-house versus Industry-printed Skull Models for Acute Midfacial Fractures

Background: Industry-printed (IP) 3-dimensional (3D) models are commonly used for secondary midfacial reconstructive cases but not for acute cases due to their high cost and long turnaround time. We have begun using in-house (IH) printed models for complex unilateral midface trauma. We hypothesized that IH models would decrease cost and turnaround time, compared with IP models. Methods: We retrospectively examined cost and turnaround time data from midface trauma cases performed in 2017-2019 using 3D models (total, n = 15; IH, n = 10; IP, n = 5). Data for IH models were obtained through itemized cost reports from our Biomedical Engineering Department, where the models were printed. Data associated with IP models were obtained through itemized cost reports from our industry vendor. Perioperative data were collected from electronic medical records. Results: The average cost for IH models ($236.38 +/- 26.17) was significantly less (P< 0.001) than that for IP models ($1677.82 +/- 488.43). Minimal possible time from planning to model delivery was determined. IH models could be produced in as little as 4.65 hours, whereas the IP models required a minimum of 5 days (120 hours) from order placement. There were no significant differences in average operating room time (P= 0.34), surgical complications, or subjective outcomes, but there was a significant difference in estimated blood loss (P= 0.04). Conclusion: Utilization of IH 3D skull models is a creative and practical adjunct to complex unilateral midfacial trauma that also reduces cost and turnaround time compared with IP 3D models.