3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用

doi:10.6040/j.issn.1673-3770.0.2016.410

山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (1): 80-84.doi: 10.6040/j.issn.1673-3770.0.2016.410

3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用

吴昆旻^1,2,李泽卿²,陈伟³,朱春晖²,安静娟²,沈洁²,吴建¹

1.第二军医大学附属长征医院耳鼻咽喉科, 上海 200003;
2.南京中医药大学第二附属医院耳鼻咽喉科, 江苏南京 210017;
3.南京总医院耳鼻咽喉科, 江苏南京 210002

收稿日期:2016-09-21 出版日期:2017-02-16 发布日期:2017-02-16
通讯作者: 吴建. E-mail:jianwu2008@126.com
基金资助:
上海市科学技术委员会西医引导重点科研项目(1441196000);上海市科学技术委员会产学研项目(14DZ1940103)

Application of three-dimensional technology in the reconstruction of orbital wall defects in malignant tumors of maxillary sinus.

Department of Otolaryngology, 1. Changzheng Hospital of Second Military Medical University, Shanghai 200003, China;2. Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210017, Jiangsu, China;3. Nanjing General Hospital, Nanjing 210002, Jiangsu, China

Received:2016-09-21 Online:2017-02-16 Published:2017-02-16

摘要/Abstract

摘要： 目的评价3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用效果。方法对6例鼻窦恶性肿瘤破坏眶壁的患者,根据术前CT扫描数据,应用3D技术打印出患侧眼眶的树脂模型,在此模型上对钛网进行塑形,术中将预成形钛网植入眶壁缺损区。通过临床和CT检查,根据眼球容积和眼球突出度评价眶壁恢复情况。结果所有病例手术顺利,预成形的钛网不需要术中再次修整,植入的钛网与缺损周边骨床贴合紧密。术后3个月经临床和CT检查,所有病例眶壁重建成功,未发生严重并发症,6例患者眼球内陷矫正在3 mm内,无眼球内陷,1例一个象限存在复视,患侧眼眶容积和眼球突度与健侧相近,差异无统计学意义(P>0.05)。随访6~30个月,未见肿瘤复发。结论应用3D技术预成型的钛网用于鼻窦肿瘤术后的眶壁修复,能精确恢复眼眶的解剖形态和容积。

关键词: 3D技术, 眼眶骨缺损, 鼻窦肿瘤, 预成形钛网

Abstract: Objective To assess the effect of three-dimensional(3D)technology in the reconstruction of orbital walls defects in malignant tumor of maxillary sinus. Methods A total of 6 patients suffering from malignant tumors of maxillary sinus with destruction of orbital walls who received surgical treatment in our department were enrolled. Before operation, all patients received computed tomography(CT). A resin stereo model of the affected orbital wall was printed with 3D printing technique, based on which a titanium mesh was modeled. The performed titanium mesh was then implanted into the defect area of orbital wall for reconstruction. Orbital volumes and globe projections were evaluated with clinical and CT examinations to assess the recovery of orbital walls. Results All 6 cases came through the operation successfully. During operation, the performed titanium mesh did not require reshaping and pruning. It fit bone bed surrounding the defect closely. Clinical and CT examinations 3 months after surgery showed successful reconstruction of orbital wall in all cases without serious complications. During the follow-up of 6 to 30 months, no recurrence occurred. Enophthalmos was corrected to less than 3mm. No clinical enophthalmos could be observed. Single quadrant diplopia occurred in one patient. The differences of orbital volumes and globe projections between the affected and unaffected orbits were both statistically insignificant(both P>0.05). Conclusion With exact reconstruction of anatomic shape and orbital volumes, 3D preformed titanium mesh is suitable for the repair of surgical orbital defect in sinus malignant tumor.

Key words: Preformed orbital titanium mesh, Sinus neoplasma, Bone defect of orbit, Three-dimensional technology

中图分类号:

R765.9

吴昆旻,李泽卿,陈伟,朱春晖,安静娟,沈洁,吴建. 3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 80-84.

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3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用

Application of three-dimensional technology in the reconstruction of orbital wall defects in malignant tumors of maxillary sinus.

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