硬腭两维牵张器的研制及体外实验研究

Design of a 2-D distraction appliance for palatal bone distraction osteogenesis and experimental study of its application in vitro

目的:探讨腭骨外固定两维牵张器在腭裂修复中关闭骨裂隙和后退腭骨的可行性。方法:设计并制作两维硬腭骨牵张器,在离体犬颅骨模型上制造人工腭裂模型．根据机械移动原理和牵张成骨原理,在硬腭后部设计2块可相对移动的转移盘,在一定范围内使骨块向内和向后移动,进行两维牵张成骨,并进行了手术模拟。结果:研制的两维缝牵张器可将转移盘前后方向移动16mm,近中方向左右各移动4mm,牵张器固定牢靠,转运盘稳定,牵张控制准确,在离体模型上可实现关闭裂隙、后退硬腭的设计要求。结论:设计的外固定两维牵张器可以向后、内牵张腭骨,从而达到关闭裂隙和硬腭后退的目的。

PURPOSE： To explore the feasibility of palate bone distraction osteogenesis for closure of cleft palate and lengthening of palate bone by devising a 2-dimensional distractor. METHODS： A 2-D distraction appliance for hard palate was designed and manufactured. A midline hard cleft palate model was created artificially in a vitro canine skull. Surgery and distraction were simulated on the model. According to the principle of mechanical movement and distraction osteogenesis, the DO devices were fixed, when two mobile transport discs were created at the posterior part of the hard palate. The transport discs were distracted posteriorly and medially to implement 2-D distraction osteogenesis. RESULTS： The results revealed that by application of the self-devised 2-D distraction appliance, the transport discs were lengthened approximately 16mm, and distracted approximately 4mm medially. At the period of distraction osteogenesis, the distractor was fixed firmly, the transport discs were steady, and control parameter was accurate. The closure of the cleft and lengthening of the hard palate were realized in vitro canine skull. CONCLUSION： By application of the devised external 2-D distraction appliance, the palate bone can be distracted posteriorly and medially, the aim of closure of the cleft and lengthening of the hard palate can be achieved, which could be a new treatment approach for repair of cleft palate.