3D打印术前设计和内镜辅助在颧骨颧弓骨折复位固定术中的应用

doi:10.19438/j.cjoms.2018.01.009

中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (1): 44-47.doi: 10.19438/j.cjoms.2018.01.009

3D打印术前设计和内镜辅助在颧骨颧弓骨折复位固定术中的应用

徐冰冰¹, 李雅南², 来庆国², 唐晓朋², 慈江波², 薛润琦², 邹斌³, 邢宏宇³

1.山东大学口腔医学院,山东济南 250012;
2.山东大学第二医院口腔颌面外科,山东济南 250033;
3.山东大学机械工程学院,山东济南 250061

收稿日期:2017-05-12 修回日期:2017-10-01 出版日期:2018-01-20 发布日期:2018-02-11
通讯作者: 来庆国,E-mail: laiqingguo@sdu.edu.cn
作者简介:徐冰冰（1982-）,男,在读硕士研究生,E-mail: 254166750@qq.com
基金资助:
山东省科技发展计划(2014GSF118145); 山东省优秀中青; 年科学家科研奖励基金(BS2013YY050); 济南市高校院所自主创新计划(26010205081417); 山东省重点研发计划（2017GSF218097）; 山东大学基本科研业务费专项资金（2017JC046）

Application of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch

XU Bing-bing¹, LI Ya-nan², LAI Qing-guo², TANG Xiao-peng², CI Jiang-bo², XUE Run-qi², ZOU Bin³, XING Hong-yu³

1.School of Stomatology,Shandong University. Jinan 250012;
2.Department of Oral and Maxillofacial Surgery, The Second Hospital of Shandong University. Jinan 250033;
3.School of Mechanical Engineering, Shandong University. Jinan 250061, Shandong Province, China

Received:2017-05-12 Revised:2017-10-01 Online:2018-01-20 Published:2018-02-11

摘要/Abstract

摘要： 目的: 探讨3D打印术前设计和内镜技术应用于颧骨颧弓骨折复位固定手术的可行性及效果。方法: 选择4例B型颧骨颧弓骨折患者,均伴发颧弓骨折,面部凹陷明显伴开口受限。术前行CT扫描后将数据转化为STL格式,3D打印骨折模型和镜像模型,在模型上完成手术设计和钛板预弯制。手术采用耳屏前小切口和颧弓表面隧道手术入路,内镜辅助下完成颧弓骨折的复位及坚固内固定。结果: 所有患者术后面部恢复对称性,面部凹陷消失,开口度正常,面部瘢痕不明显,无感染和神经损伤等并发症。结论: 术前3D模型手术设计降低了内镜辅助下行颧弓骨折复位固定术的难度,提高了手术精准度,避免了头皮冠状切口,创伤小,美容效果好。

关键词: 3D打印, 内镜, 颧骨颧弓骨折, 微创手术

Abstract: PURPOSE: To evaluate the feasibility and effect of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch. METHODS: Four patients diagnosed as B type fractures of zygoma and zygomatic arch with limited mouth opening and facial depression were included. After CT scanning data were tranformed into STL type, the fracture model and mirror-imaged model were printed. Preoperative design and premolding of titanium plates were completed on the models. Through a small preauricular incision and tunnel on the zygomatic arch, reduction and fixation of fractures of zygoma and zygomatic arch were performed under endoscope. RESUITS: All patients achieved symmetrical face and normal mouth opening. Facial scar was not obvious and there was no complication such as infection and nerve damages. CONCLUSIONS: 3D printing design reduces the difficulty of endoscopic surgery in reduction and fixation of fractures of zygoma and zygomatic arch and improves the precision of operation. This method avoided coronal incision and achieved cosmetic results with minimal invasion.

Key words: 3D printing, Endoscope, Fractures of zygoma and zygomatic arch, Minimally invasive surgery

中图分类号:

R782.2

徐冰冰, 李雅南, 来庆国, 唐晓朋, 慈江波, 薛润琦, 邹斌, 邢宏宇. 3D打印术前设计和内镜辅助在颧骨颧弓骨折复位固定术中的应用[J]. 中国口腔颌面外科杂志, 2018, 16(1): 44-47.

XU Bing-bing, LI Ya-nan, LAI Qing-guo, TANG Xiao-peng, CI Jiang-bo, XUE Run-qi, ZOU Bin, XING Hong-yu. Application of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch[J]. China J Oral Maxillofac Surg, 2018, 16(1): 44-47.

参考文献

[1] Ellstrom CL, Evans GR.Evidence-based medicine: zygoma fractures[J]. Plast Reconstr Surg, 2013, 132(6): 1649-1657.
[2] 何冬梅,张益,张震康,等. 颧骨复合体骨折的分类研究和治疗[J]. 中华口腔医学杂志, 2004, 39(3): 211-213.
[3] Prakasam M, Dolas RS, Managutti A, et al.A modified temporal incision: an alternative approach to the zygomatic arch[J]. J Maxillofac Oral Surg, 2010, 9(4): 428-433.
[4] Zhang QB, Dong YJ, Li ZB, et al.Coronal incision for treating zygomatic complex fractures[J]. J Craniomaxillofac Surg, 2006, 34(3): 182-185.
[5] Shetty SK, Saikrishna D, Kumaran S.A study on coronal incision for treating zygomatic complex fractures[J]. J Maxillofac Oral Surg, 2009, 8(2): 160-163.
[6] Lee CH, Lee C, Trabulsy PP, et al.A cadaveric and clinical evaluation of endoscopically assisted zygomatic fracture repair[J]. Plast Reconstr Surg, 1998, 101(2): 333-345.
[7] Adam AA, Zhi L, Bing LZ, et al.Evaluation of treatment of zygomatic bone and zygomatic arch fractures: a retrospective study of 10 years[J]. J Maxillofac Oral Surg, 2012, 11(2): 171-176.
[8] Marinho RO, Freire-Maia B.Management of fractures of the zygomaticomaxillary complex[J]. Oral Maxillofac Surg Clin North Am, 2013, 25(4): 617-636.
[9] Balakrishnan K, Ebenezer V, Dakir A, et al.Management of tripod fractures (zygomaticomaxillary complex) 1 point and 2 point fixations: A 5-year review[J]. J Pharm Bioallied Sci, 2015, 7(Suppl 1): S242-247.
[10] Kumar A, Yadav N, Singh S, et al.Minimally invasive (endoscopic-computer assisted) surgery: Technique and review[J]. Ann Maxillofac Surg, 2016, 6(2): 159-164.
[11] Luers JC, Damm M, Klussmann JP, et al.The learning curve of sialendoscopy with modular sialendoscopes: a single surgeon's experience[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(8): 762-765.
[12] Bayat M, Parvin M, Meybodi AA.Mandibular subcondylar fractures: a review on treatment strategies[J]. Electron Physician, 2016, 8(10): 3144-3149.
[13] Mast G, Ehrenfeld M, Cornelius CP, et al.Maxillofacial fractures: midface and internal orbit-part II: principles and surgical treatment[J]. Facial Plast Surg, 2015, 31(4): 357-367.
[14] Atienza G, López-Cedrún JL.Management of obstructive salivary disorders by sialendoscopy: a systematic review[J]. Br J Oral Maxillofac Surg, 2015, 53(6): 507-519.
[15] Al-Moraissi EA.Open versus arthroscopic surgery for the management of internal derangement of the temporomandibular joint: a meta-analysis of the literature[J]. Int J Oral Maxillofac Surg, 2015, 44(6): 763-770.
[16] Miki T, Iwai T, Kotani K, et al.Development of a virtual reality training system for endoscope-assisted submandibular gland removal[J]. J Craniomaxillofac Surg, 2016, 44(11): 1800-1805.
[17] You HJ, Moon KC, Yoon ES, et al.Clinical and radiological outcomes of transoral endoscope-assisted treatment of mandibular condylar fractures[J]. Int J Oral Maxillofac Surg, 2016, 45(3): 284-291.
[18] Dai J, Yu H, Wu J, et al.Le Fort I osteotomy combined with endoscopic assistance for treatment of compound fracture of maxilla, zygoma, and orbital floor[J]. J Craniofac Surg, 2014, 25(2):495-498.
[19] Chen CT, Lai JP, Chen YR, et al.Application of endoscope in zygomatic fracture repair[J]. Br J Plast Surg, 2000, 53(2): 100-105.

3D打印术前设计和内镜辅助在颧骨颧弓骨折复位固定术中的应用

Application of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch

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