计算机辅助设计与制造技术在颧骨复合体缺损个性化三维重建中的应用研究

Application of CAD/CAM technique in three-dimensional reconstruction of zygomatic complex defect

目的:探讨计算机辅助设计与制造技术(computer-aided design/computer-aided manufacturing,CAD/CAM)在颧骨复合体缺损的个性化修复重建中的应用效果。方法:对13例颧骨复合体肿瘤及外伤后缺损的患者以三维CT及快速原型技术预成实体模型,通过CAD/CAM将健侧颧骨复合体复制到患侧缺损处,在模型上塑形精确钛网,结合自体骨移植和带蒂颊脂垫瓣内衬,重建颧骨复合体形态和功能。结果:在实体模型病变区域测量数据和术中所见病变范围基本一致,预制的个性化重建钛网与术中颧骨复合体外形匹配,术后患者面型基本对称,三维CT显示重建颧骨复合体两侧基本对称,术后外形满意。结论:计算机辅助设计与制造技术在颅颌面缺损修复体的个体化重建方面具有良好的应用前景,为面部畸形整复开辟了新的途径。

Objective： To evaluate the efficacy of computer-aided design and computer-aided manufacturing（CAD/CAM） technique in reconstruction of zygomatic complex defect. Methods： Three- dimensional computed tomography （3D-CT） and rapid prototyping （RP） techniques were applied to produce facsimile models in 13 patients with zygomatic complex defects resulted from trauma or tumor ablation. The zygomatic complex defect was reconstructed using a mirroring technique by CAD/CAM. Titanium mesh was prefabricated on individual facsimile models and combined with autologous bone graft and pedicled buecal fat pad flap for reconstruction. Results： The measuring data of zygomatic complex defect between facsimile model and intraoperative findings was extremely consistent. The prefabrication of reconstructive titanium mesh was matched with zygomatic complex defect in the surgery. The postoperative 3D-CT image demonstrated the symmetry of reconstructed zygomatic complex. The functional recovery and facial contours were satisfactory in all cases. Conclusions： The application of CAD/CAM technique can simulate the surgery procedures accurately, which contributes to shorten the actual operative time. RP techniques can reconstruct the facial contours symmetry and recover the function of zygomatic complex defect.