数字化三维重建钛网在大面积颅骨缺损修补中的应用

Application of digital three-dimensional reconstructed titanium mesh to cranioplasty of large skull defect

背景:数字化三维重建钛网修补大面积额颞顶部颅骨缺损时能最大限度地达到生理解剖形态上的成型。目的:通过与传统手工塑形钛网比较,观察数字化三维重建钛网在大面积颅骨缺损修补中的临床应用效果。方法:109例颅骨缺损患者按照不同的成形方法随机分为两组:手工塑形组大面积额颞顶部颅骨缺损患者60例:采用手工塑形钛网修补;数字化三维成形组49例:采用数字化三维重建钛网,通过计算机三维重建、将钛网制成个性化颅骨修复体进行修补。结果与结论:手工塑形组手术时间、手术并发症发生率及塑形满意度分别为108min,22%,67%;数字化三维成形组分别为78min,4%,100%。数字化三维成形组在手术时间及并发症发生率上明显低于手工塑形组,在塑形满意度则明显增高(P<0.05)。结果说明,数字化三维重建钛网修补颅骨缺损节约了手术时间、术后并发症少、患者满意度高。

BACKGROUND： Digital three-dimensional reconstructed titanium mesh can best achieve physiologic and anatomical molding during large defect of skull in the frontotemporal area. OBJECTIVE： To compare the clinical effect of digital three-dimensional reconstructed titanium mesh and manual modeled titanium mesh for cranioplasty of defect of skull. METHODS： A total of 109 patients with skull defect were randomly assigned to two groups according to different methods： 60 patients with large skull defect were repaired with manual shaped titanium mesh, and 49 patients with digital three-dimensional reconstructed titanium mesh. Titanium mesh was made into individual skull prosthetic replacement by computer three-dimensional reconstruction. RESULTS AND CONCLUSION： The operation time, the incidence rate of complication and the degree of moulding satisfaction were 108 minutes, 22% and 67% in the manual modeled group, which were 78 minutes, 4% and 100% in the digital three-dimensional reconstructed group respectively. In the digital three-dimensional reconstructed group, the operation time was shorter and the incidence rate of complication was fewer, while the degree of moulding satisfaction was significantly higher than the manual modeled group （P 0.05）. Results have shown that digital three-dimensional reconstructed titanium mesh can save surgical duration, with less postoperative complications and have high satisfaction in cranioplasty.