山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (5): 27-30.doi: 10.6040/j.issn.1673-3770.0.2018.040

• ·论著· • 上一篇    下一篇

术前模拟力学研究在拟植入耳赝附体先天性外中耳畸形患者中的应用价值

孟玮1,于振坤1,郑雅丽2,李光飞1,梁龙君1,王小敏3   

  1. YKK10190)第一作者:孟玮。 E-mail:xm526069@126.comDOI:10.6040/j.issn.1673-3770.0.2018.040·论著·术前模拟力学研究在拟植入耳赝附体先天性外中耳畸形患者中的应用价值孟玮1, 于振坤1, 郑雅丽2, 李光飞1, 梁龙君1, 王小敏3(1.东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科, 江苏 南京210001;
    2.首都医科大学附属同仁医院耳鼻咽喉头颈外科, 北京 100730;
    3.解放军陆军工程大学供应保障处, 江苏 南京 210001
  • 收稿日期:2018-01-15 出版日期:2018-09-20 发布日期:2018-09-20
  • 基金资助:
    南京市医学科技发展项目(YKK10190)

Simulation of the biomechanical effects of deaf appendage implantation in mastoid cortical bone

MENG Wei1, YU Zhenkun1, ZHENG Yali2, LI Guangfei1, LIANG Longjun1, WANG Xiaomin3   

  1. Otolaryngology and neck surgery, Tongren Hospital, Capital Medical University, Beijing 100730, China;3. PLA Army Engineering University Supply Support Office, Nanjing, 210001, Jiangsu, China
  • Received:2018-01-15 Online:2018-09-20 Published:2018-09-20

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摘要： 目的 探讨术前模拟力学研究在拟植入耳赝附体先天性外中耳畸形患者中的应用价值。 方法 选取20例已行外耳道成形术的先天性外中耳畸形患者(研究组),术后复查MSCT,另选取乳突发育良好的20例正常人群作为对照组,行耳颞骨MSCT。利用Mimics10.01软件建立研究对象颞骨CT图像的三维模型,并对其进行网格化处理,通过ANSYS14.5对研究对象耳赝附体植入前的三维定位及颞骨结构进行力学分析,应用球钻750 r/min。 结果 术前薄层颞骨CT图像可实现快速三维化,耳赝附体术前植入位置定位精确。外中耳畸形患者距所开放的骨性外耳道周缘(2.07±0.05)mm距离较为安全,无外中耳畸形患者距骨性外耳道周缘(1.83±0.07)mm较为安全。 结论 对于外中耳畸形已行听力重建拟行耳赝附体植入术患者,术前针对耳赝附体植入钛钉进行模拟力学研究有助于寻找合适的植入点及距外耳道的距离。

关键词: 有限元模型, 力学分析, 耳赝附体, 中耳畸形

Abstract: Objective To assess the ability of preoperative mastoid cortical bone implantation points and surrounding tissue to accept accurate positioning. Methods The study enrolled 20 sides of congenital external middle ear malformations that had undergone external auditory canal reconstructive surgery and had been evaluated with multislice computed tomography(MSCT). The control group included 20 normally developed mastoid processes that were also evaluated with temporal bone MSCT. Modeling software was used to create and mesh a three-dimensional tibial CT image for each study subject. The three-dimensional location of the premolars and tibial structure of each subject was analyzed. Results The analysis method used can perform rapid three-dimensional CT imaging of preoperative thin sacroiliac bone, precise positioning of preoperative implantation position, and evaluation of peripheral bone force conditions. After surgery for external and middle ear deformities, implantation using a ball drill at 750 rpm allowed a safe distance from the open osseous external auditory canal at a circumference of 2.07±0.05 mm. For patients without external middle ear malformations, the safe distance from the talus external auditory canal circumference was 1.83±0.07 mm, and cortical bone of the external auditory canal that has been formed will not be deformed by excessive instantaneous impact force of the drill during surgery. Conclusion This method is flexible and simple. For patients with external and middle ear deformities who have undergone auditory reconstructive surgery and wish to proceed with implantation surgery, this preoperative method can assess the mechanical effects of implantable titanium nails on mastoid cortical bone and the reconstructed external auditory canal wall.

Key words: Ear turns appendage, Finite element model, Middle ear malformation, Mechanics analysis

中图分类号: 

  • R764.72
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[1] 王侠，王培成，宋建京，于晓伟，张宇，王爱初，刘秀玲，王学海. 人工听骨植入前后听力学分析及相关因素研究[J]. 山东大学耳鼻喉眼学报, 2013, 27(2): 18-20.
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