计算机辅助设计的颅骨成形术治疗颞部颅骨缺损

Cranioplasty of Computer-assisted design for Temporal Skull Defect

目的研究颞部颅骨缺损的计算机辅助设计的颅骨成形术的材料制作和固定方法。方法对32例颞部颅骨缺损患者采用计算机辅助设计的颅骨成形术进行处理。头颅超薄CT扫描,了解颅骨及周围软组织的形状,制作患者缺损颅骨及颅骨缺损区周围感兴趣软组织的模型及补片模型;患者认可后制作钛合金网补片,手术植入。结果手术处理32例,补片与缺损颅骨完整适配,平均手术时间50分钟。手术并发症:2例术后出现头痛,1例于2周后、1例于4周后症状消失。术后随访3个月,无植入物松动、移位及感染发生。结论对于颞部颅骨缺损患者,根据CT的颅骨及周围软组织信息,采用计算机辅助设计颅骨成形术,制作钛合金植入材料,联合应用钛钉和加长钛螺丝将颅骨缺损补片固定在颞肌与头皮之间,可以简化手术,提高疗效。

Objective To study the design, manufacturing and fixation of implants for cranioplasty in the patients with temporal cranial defects. Methods Ultrathin cranial CT scan was performed to simulate the shapes and contours of skull defects and their surrounding soft tissues in 32 patients with temporal skull defects. The templates of skull defect and their surrounding soft tissues were made under computer assistance. After patient＇s consent, the skull defect patches were manufactured with titanium-networks and were implanted by the operation. Results The patches matched skull defects in size and shape in all the patients. The average operation duration was 50 minutes. The headache which occurred in 2 patients after the operation disappeared respectively 1 week and 4 weeks after the operation. The shift of the implants and infection did not occur in all the patients during follow-up for 3 months. Conclusions The manufacture of the skull defect patches based on CT data of skull defect and its surrounding soft tissues and the fixation of the patches between skull and scalp with nails and lengthened screws can make operation easy and improve curative effect in the patients with temporal skull defect.