数字化及三维打印技术在颌骨恶性肿瘤术后复杂缺损重建中的应用

Digital and three-demention print technique in reconstruction for complex defect after resection ofjaw neoplasms

目的评价数字化技术在游离腓骨瓣修复恶性肿瘤术后复杂颌骨缺损的应用价值。方法回顾性分析2013年5月-2015年1月，中国医学科学院北京协和医学院肿瘤医院头颈外科10例颌骨恶性肿瘤患者的病历资料，其中3例上颌骨缺损，7例下颌骨缺损。术前应用数字化技术对病变切除和重建进行虚拟设计，应用三维打印技术制作手术模型和导板，于模型上预先弯制钛板；术中依据导板进行切除和腓骨塑形，塑形后的腓骨瓣按术前计划固定，并缝合皮瓣，吻合血管。术后随访患者外观和进食功能。结果全部病例均按术前计划切除、塑形和固定成功。全部腓骨瓣及皮岛均成活，所有患者于术后2周恢复经口进食，对外观满意。结论数字化技术结合手术导板应用于腓骨瓣修复复杂颌骨缺损准确简便，具有良好的实用价值。

Objective To evaluate the application of digital and three-demention （3D） print technique in reconstruction of complex jaw defect after removal of maxillofacial cancer. Methods From May 2013 to January 2015,10 cases were enrolled in the study, 3 were maxillary defects and 7 were mandibular defects. The process included preoperative computer aided design, template and model manufacture with 3D Printer, intraoperative ablation and shaping of fibula based on template, flap suture and vessel anastomosis. Results All the cases were successfully operated according to preoperative computer aided design, and all the fibulas and skin islands survived. All the cases had regular diet 2 weeks after surgery and showed satisfying appearance. Conclusion Digital and 3D print technique has good practicability in reconstruction of complex jaw defect with free fibula.