MR及3D打印在陈旧性颧眶复合体骨折手术中的应用

doi:10.19438/j.cjoms.2020.06.008

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (6): 512-515.doi: 10.19438/j.cjoms.2020.06.008

MR及3D打印在陈旧性颧眶复合体骨折手术中的应用

吕继连, 赵媛, 蔡晓清, 张瑞

郑州大学附属郑州中心医院口腔颌面外科,河南郑州 450007

收稿日期:2020-04-26 修回日期:2020-06-23 发布日期:2020-12-31
通讯作者: 吕继连,E-mail:jilianlv@163.com
作者简介:吕继连(1980-),女,硕士,副主任医师
基金资助:
河南省科技攻关项目(182102311118,201702307);河南省科技攻关计划联合共建项目(2018020779);河南省高等学校重点科研项目(19A320071)

The Application of mixed reality and 3D printing in the treatment of long-standing zygomatic orbital complex fracture

LYU Ji-lian, ZHAO Yuan, CAI Xiao-qing, ZHANG Rui

Department of Oral and Maxillofacial Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007,Henan Province, China

Received:2020-04-26 Revised:2020-06-23 Published:2020-12-31

摘要/Abstract

摘要： 目的: 探讨混合现实(MR) 及3D 打印技术在陈旧性颧眶复合体骨折手术中的应用效果。方法: 8例陈旧性颧骨骨折患者应用MR及3D打印技术实施手术,术前将CT数据导入计算机医学图像处理软件行骨折块分割、虚拟复位,3D打印骨折复位后模型,术中行钛板坚固内固定、MR精准验证定位,术后对比观察健、患侧面部外形及对称性。采用SPSS 22.0软件包中的配对t检验比较手术前、后双侧颧骨的突度和高度差值。结果: 患者术后开口度及咀嚼功能恢复正常,手术创面均一期愈合,无出血及感染等并发症。双侧面型对称,双侧颧骨突度及高度一致,手术前、后颧骨的突度差值分别为(9.82±1.11)和(1.12±0.48)mm;高度差值分别为(10.19±1.01)和(1.13±0.42)mm;与术前相比,差异均有统计学意义(t=24.77,P<0.05;t=24.68,P<0.05)。结论: 应用混合现实及3D打印技术修复陈旧性颧眶复合体骨折,有效恢复了面中部外形和咀嚼功能,实现了精确、个性化治疗目的: ,为临床诊疗提供了新的手段。

关键词: 混合现实, 3D打印, 陈旧性颧眶复合体骨折

Abstract: PURPOSE: To investigate the effect of mixed reality (MR) and 3D printing in the treatment of long-standing zygomatic orbital complex fracture. METHODS: Eight cases with long-standing zygomatic fracture were operated based on MR and 3D printing technology. CT data were imported into the computer medical image processing software for fracture segmentation, virtual reduction, 3D printing of fracture reduction model. During operation, titanium plate rigid internal fixation, MR accurate verification and positioning were performed. Facial shape and symmetry were compared and observed on the healthy side after operation. The difference of protrusion and height of bilateral zygoma before and after operation was compared by t test with SPSS 22.0 software package. RESULTS: Mouth opening and masticatory function of the patients returned to normal after operation. The wounds healed at one stage without bleeding and infection. The two sides of the face, the protrusion and height of the bilateral zygoma were the same. The difference of protrusion and height of the zygoma before and after operation were (9.82±1.11) mm, (1.12±0.48) mm and (10.19±1.01) mm, (1.13±0.42) mm, respectively. The difference was statistically significant compared with that before operation (t=24.77, P<0.05; t=24.68, P<0.05). CONCLUSIONS: MR and 3D printing technology can effectively restore the shape of the middle face and masticatory function, achieve accurate and personalized treatment, and provide a new way for clinical diagnosis and treatment.

Key words: Mixed reality, 3D printing, Long-standing zygomatic orbital complex fracture

中图分类号:

R782

吕继连, 赵媛, 蔡晓清, 张瑞. MR及3D打印在陈旧性颧眶复合体骨折手术中的应用[J]. 中国口腔颌面外科杂志, 2020, 18(6): 512-515.

LYU Ji-lian, ZHAO Yuan, CAI Xiao-qing, ZHANG Rui. The Application of mixed reality and 3D printing in the treatment of long-standing zygomatic orbital complex fracture[J]. China J Oral Maxillofac Surg, 2020, 18(6): 512-515.

参考文献

[1] GyeongHyeon D, Sujin B, Ki YH, et al. Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates[J]. Arch Craniofac Surg, 2018, 19(2): 143-147.
[2] Miyazaki H, Okuda K, Ueno K, et al.Swinging eyelid approach to zygomaticomaxillary complex fracture[J]. J Craniofac Surg, 2019, 30(7): e655-e658.
[3] Lin Q, Hong X Y, Zhang D, et al.Preoperative evaluation and surgical technique of functional and cosmetic aspects in zygomatic complex fracture patients[J]. J Biol Regul Homeost Agents, 2017, 31(4): 1005-1012.
[4] Tepper OM, Rudy HL, Lefkowitz A, et al.Mixed reality with holoLens: where virtual reality meets augmented reality in the operating room[J]. J Plast Reconstr Aesthet Surg, 2017, 140(5): 1066-1070.
[5] Brun H, Bugge RAB, Suther LKR, et al.Mixed reality holograms for heart surgery planning: first user experience in congenital heart disease[J]. Eur Heart J Cardiovasc Imaging, 2019, 20(8): 883-888.
[6] He Y, Zhang Y, An JG, et al.Zygomatic surface marker-assisted surgical navigation: a new computer-assisted navigation method for accurate treatment of delayed zygomatic fractures[J]. J Oral Maxillfac Surg, 2013, 71(12): 2101-2114.
[7] El-Anwar MW, Sweed A H.Infraorbital foramen localization in orbitozygomatic fractures: a CT study with intraoperative finding[J]. Eur Arch Otorhinolaryngol, 2018, 275(3): 809-813.
[8] 中华口腔医学会口腔颌面外科专业委员会. 导航引导单侧陈旧性颧骨骨折整复术技术流程及操作的专家共识[J]. 中华口腔医学杂志, 2019, 54(6): 363-367.
[9] Shikara MA, Vakharia KT, Greywoode JD.Greywoode zygomaticomaxillary complex-orbit fracture alignment: comparison of buccal and orbital approach techniques[J]. JAMA Facial Plast Surg, 2018, 20(5): 428-429.
[10] Yang L, Grottkau B, He Z, et al.Three dimensional printing technology and materials for treatment of elbow fractures[J]. Int Orthop, 2017, 41(11): 2381-2387.
[11] 徐冰冰, 李雅南, 来庆国, 等. 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.
[12] 马小军, 林艳萍, 黄亚磊, 等. 混合现实技术在骨与软组织肿瘤精准手术中的应用探索[J]. 中华解剖与临床杂志, 2019, 24(4): 322-326.
[13] Ogawa H, Hasegawa S, Tsukada S, et al.A pilot study of augmented reality technology applied to theacetabular cup placement during total hip arthroplasty[J]. J Arthroplasty, 2018, 33(6): 1833-1837.
[14] Zavattero E, Romano M, Gerbino G, et al.Evaluation of the accuracy of virtual planning in orthognathic surgery:a morphometric study[J]. J Craniofac Surg, 2019, 30(4):1214-1220.
[15] Zeiger J, Costa A, Bederson J, et al.Use of mixed reality visualization in endoscopic endonasal skull base surgery[J]. Oper Neurosurg, 2020, 19(1): 43-52.

MR及3D打印在陈旧性颧眶复合体骨折手术中的应用

The Application of mixed reality and 3D printing in the treatment of long-standing zygomatic orbital complex fracture

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