应用MIMICS制作个体化预成型钛网修复眶下壁骨折的临床研究

Clinical application of individually preformed titanium mesh rapidly designed by MIMICS for orbital floor fractures

目的:探索应用Mimics软件快速制作个体化预成型钛网修复眶下壁骨折的临床效果和临床可行性。方法:本研究共包括10例单侧单纯性眶下壁骨折患者。均采用经下睑结膜切口修复眶下壁骨折。首先应用MIMICS软件重建患者眼眶的三维模型,然后将该3D模型在眶下壁上方平行切割,形成内含眶下壁缺损形态的2D模型,将该模型1∶1打印输出到纸张上,于术中消毒后作为模板。根据该模板塑型和修剪钛网,使个体化成型的钛网与眼眶缺损形态完全吻合,然后植入眶内。所有患者均于术后3d内复查眼眶三维CT,观察植入钛网的位置和形态,以此来评估该方法的临床可行性。结果:CT复查表明,全部患者的预成型钛网均达到精确重建眶下壁骨折缺损的目的。9例患者复视和眼球内陷得以治愈,1例患者内陷治愈残留下转复视。结论:应用Mimics软件快速制作个体化预成型钛网可以精确修复眶下壁骨折,该技术可以应用于临床。

AIM： To present a method of repairing orbital floor fractures using pre-shaped titanium mesh implants that were formed on templates designed on the basis of computed tomography images by MIMICS. METHODS： Ten patients with simple unilateral inferior orbital wall fracture were included in this study. All patients underwent transconjunctival repair of isolated orbital floor fractures. First, 3D virtual models and then 2D models with fracture areas were created on the basis of computed tomography images using MIMICS software. These 2D models were printed on the papers in real size and then sterilized as templates to shape the titanium mesh and which were then used in the reconstruction of orbital floor defects. Within 3 days after surgery, the orbits were then scanned by spiral CT to evaluate the reconstruction accuracy of preformed titanium mesh implants. RESULTS： CT scans reveal that the preformed titanium mesh implants had great accuracy to reconstruct the orbital floor defects in all patients. Significant improvement resulted in 1 case with respect to diplopia and enophthalmos and total recoveryin 9 cases. CONCLUSION： It is clinically viable to build templates by MIMICS, on the basis of CT studies, that can be used to shape the titanium mesh in the repair of orbital floor fractures.