Application of digital, 3D printing combined with endoscopic assisted technology in the treatment of12patients with zygomatic, zygomatic arch fractures

doi:10.19438/j.cjoms.2022.02.016

Abstract

Abstract: PURPOSE: To explore the application and effect of digital and 3D printing combined with endoscopic-assisted technology in the treatment of zygomatic bone-zygomatic arch fractures. METHODS: Twelve patients with unilateral zygomatic fractures who underwent surgical treatment in First Affiliated Hospital of Bengbu Medical College from December 2020 to September 2021 were included in this study. All patients underwent 3-D CT reconstruction of the whole head before operation, by simulating reduction of the fracture site using the principle of mirror reverse, printing the fracture model after reduction, and performing titanium pre-bending on the model. Intraoperatively, the fracture was dissected and repositioned using an endoscopically assisted vestibular sulcus incision combined with an anterior auricular incision. All patients underwent 3-D CT reconstruction of the whole head again after operation. The three-dimensional model data reconstructed after operation and the 3-D model data before preoperative simulated reduction were analyzed by spectral fusion chromatic aberration to evaluate the postoperative effect. RESULTS: The operation in 12 patients went smoothly. The facial appearance and function recovered well after operation. There was no obvious complication and the facial skin scars were inconspicuous. Compared with postoperative CT and preoperative simulated design spectral fusion chromatic aberration analysis; the maximum upper deviation was 2.998 7 mm, the maximum lower deviation was -2.998 6 mm, the average upper deviation was (0.243 0±0.025 0) mm, the average lower deviation was (-0.310 0±0.180 0) mm. CONCLUSIONS: Digital and 3D printing combined with endoscopic-assisted techniques help improve the accuracy of fracture reduction, reduce intraoperative tissue damage, postoperative complications, and provide good aesthetics with hidden postoperative scars when performing anatomical repositioning of the fracture site under direct vision.

Key words: Digitization, 3D printing, Endoscopic, Zygomatic bone, Zygomatic arch, Fracture, Reduction

CLC Number:

R782.4

LUO Bin, ZHOU Mei-yun, TIAN Xiu-yun, CHEN Xin-ru, HAN Rui, XU Jin-cheng. Application of digital, 3D printing combined with endoscopic assisted technology in the treatment of12patients with zygomatic, zygomatic arch fractures[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(2): 188-192.

References

[1] Birgfeld CB, Mundinger GS, Gruss JS.Evidence-based medicine: evaluation and treatment of zygoma fractures[J]. Plast Reconstr Surg, 2017, 139(1): 168e-180e.
[2] 吕继连, 钟克涛, 叶克强, 等. 3D打印辅助口内入路精准治疗下颌骨粉碎性骨折[J].实用医学杂志, 2020, 36(17): 2339-2343.
[3] 江灿洋, 黄建平, 江燕,等. 数字化3D仿真模型辅助精准化整复颅眶畸形的效果评价[J]. 中国口腔颌面外科杂志, 2019, 17(6):513-517.
[4] 林诗耿, 徐雄均, 陈洋,等. 内镜辅助下经口入路与口外入路切除咽旁间隙巨大良性肿瘤的效果比较[J]. 中国口腔颌面外科杂志, 2020, 18(1):28-32.
[5] 高宁, 付坤, 张瑞璞, 等. 数字化及3D打印技术结合非血管化骼骨修复外伤性上颌骨前牙区骨缺损的疗效[J]. 中华创伤杂志, 2021, 37(2): 136-145.
[6] 李永锋, 刘华蔚, 王超, 等. 三维打印个性化修复体修复颧眶-上颌复合体骨缺损初探[J].中华口腔医学杂志,2021,56(7):633-638.
[7] 张志愿, 石冰, 张陈平, 等. 口腔颌面外科学[M]. 第8版. 北京: 人民卫生出版社, 2020: 167-168.
[8] 张辉秋, 孙连碧. 微创切口治疗颧骨颧弓骨折[J]. 临床军医杂志, 2015, 43(4): 431-433.
[9] Li P, Tang W, Liao CH, et al.Clinical evaluation of computer-assisted surgical technique in the treatment of comminuted mandibular fractures[J]. J Oral Maxillofac Surg Med Pathol, 2015, 27(3): 332-336.
[10] Munante-Cardenas JL, Fachina Nunes PH, Passer LA.Etiology, treatment, and complications of mandibular fractures[J]. J Craniofac Surg, 2015, 26(3): 611-615.
[11] Parthasarathy J.3D modeling, custom implants and its future perspectives in craniofacial surgery[J]. Ann Maxillofac Surg, 2014, 4(1): 9-18.
[12] 吕继连, 钟克涛, 郑永红, 等. 3D打印技术联合三维重建在下颌骨骨折中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(11): 1057-1059.
[13] 李铀, 曾勇, 吕俊, 等. 计算机辅助设计及3D打印模型在复杂下颌骨骨折手术中的应用[J].中华创伤杂志, 2018, 34(4): 299-304.
[14] Sinha P, Skolnick G, Patel KB, et al.A 3-dimensional-printed short-segment template prototype for mandibular fracture repair[J]. JAMA Facial Plast Surg, 2018, 20(5): 373-380.
[15] Skrzat J, Spulber A, Walocha J.Three-dimensional model of the skull and the cranial bones reconstructed from CT scans designed for rapid prototyping process[J]. Folia Med Cracov, 2016, 56(2): 45-52.
[16] 李立峰, 屠军波, 侯成群, 等. 3D打印技术在单侧粉碎性颧骨颧弓骨折治疗中的应用[J].上海口腔医学, 2019, 28(2): 154-157.
[17] 李树华, 关建, 张玉君, 等. 改良头皮冠状切口在治疗颧骨复杂性骨折中的临床应用[J].中国耳鼻咽喉头颈外科, 2018, 25(1): 38-40.
[18] 虎小毅, 李立峰, 史婧怡, 等. 手术导航技术在颧骨颧弓骨折治疗应用中的精确度评价[J]. 中国美容医学, 2019, 28(10): 82-85.
[19] 孙强, 朱梅, 邓佳蕴, 等. 联合切口结合内镜辅助治疗颧骨颧弓骨折临床效果分析[J].中国美容医学, 2019, 28(7): 92-95.
[20] Akdag O, Guray Evin S, Isik C, et al.Endoscopic-assisted zygomatic arch fracture repair with a preauricular approach[J]. J Oral Maxillofac Surg, 2019, 27(2): 107-111.
[21] 廖洪斐, 余进海, 胡长青, 等. 三维打印联合手术导航及内镜在眼眶骨折整复术中的应用[J]. 中华眼科杂志,2019, 55(9): 658-664.