数字化模型制备个性化钛网修复眼眶骨折的应用

Application of an individualized titanium mesh based on digital model in the repair of orbital fracture

背景:应用3D打印制作数字化模型可以提高眼眶骨折修复的精确性,有较好的临床应用前景。目的:在数字化模型上制作个性化钛网重建眼眶骨折,评价其治疗效果。方法:选取西南医科大学附属口腔医院2014年1月至2015年10月期间收治的眼眶骨折患者12例,术前行眼眶水平位、冠状位、矢状位CT扫描及三维重建,以CT数据为基础,应用3D打印技术制作数字化模型,在其上制作个性化钛网,术中植入钛网行眼眶重建。术后复查眼眶CT,观察钛网植入位置和眼功能。结果与结论:(1)术后CT显示12例患者植入的个性化钛网均能够精确重建骨折的眼眶,所有患者未出现感染和钛网松动、脱出、排斥现象;(2)以健眼为对照,11例眼球内陷得到完全矫正,1例欠矫治;(3)9例有复视症状的患者,8例复视症状消失,1例复视症状减轻;(4)7例有眼球运动受限的患者,术后均恢复正常;(5)结果表明,个性化预成形钛网在解剖上可以精确地重建眼眶骨折,取得了良好的临床效果。

BACKGROUND： Three-dimensional printing to prepare a digital model can improve the accuracy of orbital fracture repair, and has a good clinical prospect. OBJECTIVE： To evaluate the effect of individualized titanium mesh based on the digital model in the reconstruction of orbital fracture. METHODS： Twelve cases of orbital fracture were admitted at the Hospital of Stomatology, Southwest Medical University from January 2014 to October 2015. CT scanning in axial, coronal, sagittal planes and three-dimensional reconstruction were performed routinely in all cases preoperatively. Digital model was designed by 3D printing technology according to the CT data. Individualized titanium mesh was shaped based on the digital model and used to repair orbital fracture. The accuracy of the reconstructed orbit was assessed based on the postoperative CT scan. RESULTS AND CONCLUSION： Postoperative CT scans showed that the implanted individualized titanium meshes were capable of accurately reconstructing the fractured orbit in all the 12 patients, and there was no infection, and titanium mesh loosening, prolapse, and rejection. With healthy eyes as controls, 11 cases of eyeball retraction were corrected completely, and only 1 case was still under correction. Diplopia symptoms disappeared in the 8 of 9 cases, end relieved in the 1 of 9 cases. Seven cases of eye movement limitation recovered postoperatively. To conclude, the individualized titanium mesh has great accuracy to repair orbital fractures in patients without serious complications, which has achieved aood clinical outcomes in the orbital reconstruction.