3D打印技术在颅底肿瘤切除术中的临床应用

Three-dimensional printing in resection of skull base tumors

目的探讨3D打印技术在颅底肿瘤切除术中的应用价值。方法南方医科大学第三附属医院神经外科自2016年5月至2017年11月应用3D打印技术辅助切除颅底肿瘤14例，术前通过3D打印技术构建含颅底骨质、肿瘤组织和肿瘤主要供血动脉的肿瘤实体模型，在该模型上进行术前模拟并确定手术入路和手术方式。回顾性分析患者的临床资料和疗效。结果3D颅底肿瘤模型制作的平均时间为18．5h，费用为5000元左右；术后颅脑CT、MRI扫描显示显微镜下肿瘤全切8例，次全切除5例，1例右侧颈静脉孔区肿瘤患者颅内肿瘤全切，但颅外肿瘤仅次全切除：1例患者术后出现大面积脑梗死，经去骨瓣减压术后存活，余13例患者均恢复良好，未出现严重并发症和死亡病例。结论3D打印技术可以辅助颅底肿瘤切除手术的术前模拟和手术方案制定．提高手术效率和安全性。

Objective To explore the application value of three-dimensional （3D） printing in skull base tumor resection. Methods Fourteen patients accepted resection of skull base tumors in our hospital from May 2016 to November 2017 were chosen in our study; before surgery, solid models of the tumors, having bones of the skull base, tumor tissues and main blood supply arteries, were established by 3D printing; resection was simulated in these models and the surgical approaches and surgical methods were determined accordingly. The disease history, preoperative and postoperative imaging data were analyzed retrospectively. Results The mean time for making a solid model of the tumors was 18.5 h, and the cost was about 5,000 Yuan. Postoperative CT and MR imaging showed that total excision was achieved in 8 patients, subtotal excision was achieved in 5 patients, and one with tumor of the jugular foramen achieved total excision of the intracranial tumor and subtotal excision of the extracranial tumor. One patient had large hemispheric infarction after operation and decompressive craniectomy was performed; the other 13 patients recovered well without serious complications or death. Conelusion The 3D printing technique can assist the preoperative simulation and formulation of skull base tumor resection, and improve the efficiency and safety of the operation.