三维耳廓模型在小耳畸形二期再造术中的应用

Three-dimensional Auricular Models in Application of Secondary Reconstructive Operation for Microtia

目的应用3D打印技术为小耳畸形患者患侧耳廓再造提供手术指导。方法选取2015年11月—2016年2月小耳一期再造术后患者,应用软件对患者健患侧耳廓3D-CT数据进行分割、镜像、膨胀等处理,获得双侧耳廓及双耳差值的三维虚拟模型,将其导入3D打印机生产三维实体模型,并应用于小耳二期再造。结果 8例（8耳）小耳畸形二期患者耳支架测量高度1.9~2.7 cm,平均2.3 cm术后随访观察,1例出现植皮区感染,软骨外露,其余7例（7耳）再造耳廓与健侧耳匹配,形状相似、逼真,颅耳角与健侧耳对称。结论应用软件和3D打印技术制作的耳廓三维模型,能很好地指导术中精细雕刻耳廓软骨支架并调整二期再造术中耳后支架、颅耳角高度。

Objective To provide guidance for congenital microtia patients with auricular reconstruction by using3 D printing technology.Methods Patients treated with primary reconstruction between November 2015 and February2016 were recruited in this study,The software was used to process 3D-CT data of healthy and affected ears such as spliting,mirroring and expanding,and binaural difference value of 3D virtual models were obtained,and then 3D solid models were produced on the basis of the value for the secondary reconstructive operation.Results Aural branches of 8 patients（8 ears） were detected,and height values were 1.9-2.7 cm with the 2.3 cm of average height.During postoperative follow-up,1 patient had skingrafting area infection with exposed cartilage,and reconstructing external ears of other 7patients（7 ears） were marched with the healthy sides with similar and life-like in shape.The cranioauricular angles were symmetrical with healthy sides.Conclusion Three-dimensional auricular models produced by software and 3D printing technology can well guide intraoperative carving auricular cartilage branches and adjusting post aurem branches and height of cranioauricular angle for secondary reconstruction.