MR及3D打印在陈旧性颧眶复合体骨折手术中的应用

The Application of mixed reality and 3D printing in the treatment of long-standing zygomatic orbital complex fracture

目的:探讨混合现实(MR)及3D打印技术在陈旧性颧眶复合体骨折手术中的应用效果。方法:8例陈旧性颧骨骨折患者应用MR及3D打印技术实施手术,术前将CT数据导入计算机医学图像处理软件行骨折块分割、虚拟复位,3D打印骨折复位后模型,术中行钛板坚固内固定、MR精准验证定位,术后对比观察健、患侧面部外形及对称性。采用SPSS 22.0软件包中的配对t检验比较手术前、后双侧颧骨的突度和高度差值。结果:患者术后开口度及咀嚼功能恢复正常,手术创面均一期愈合,无出血及感染等并发症。双侧面型对称,双侧颧骨突度及高度一致,手术前、后颧骨的突度差值分别为(9.82±1.11)和(1.12±0.48)mm;高度差值分别为(10.19±1.01)和(1.13±0.42)mm;与术前相比,差异均有统计学意义(t=24.77,P<0.05;t=24.68,P<0.05)。结论:应用混合现实及3D打印技术修复陈旧性颧眶复合体骨折,有效恢复了面中部外形和咀嚼功能,实现了精确、个性化治疗目的,为临床诊疗提供了新的手段。

PURPOSE:To investigate the effect of mixed reality(MR)and 3D printing in the treatment of long-standing zygomatic orbital complex fracture.METHODS:Eight cases with long-standing zygomatic fracture were operated based on MR and 3D printing technology.CT data were imported into the computer medical image processing software for fracture segmentation,virtual reduction,3D printing of fracture reduction model.During operation,titanium plate rigid internal fixation,MR accurate verification and positioning were performed.Facial shape and symmetry were compared and observed on the healthy side after operation.The difference of protrusion and height of bilateral zygoma before and after operation was compared by t test with SPSS 22.0 software package.RESULTS:Mouth opening and masticatory function of the patients returned to normal after operation.The wounds healed at one stage without bleeding and infection.The two sides of the face,the protrusion and height of the bilateral zygoma were the same.The difference of protrusion and height of the zygoma before and after operation were(9.82±1.11)mm,(1.12±0.48)mm and(10.19±1.01)mm,(1.13±0.42)mm,respectively.The difference was statistically significant compared with that before operation(t=24.77,P<0.05;t=24.68,P<0.05).CONCLUSIONS:MR and 3D printing technology can effectively restore the shape of the middle face and masticatory function,achieve accurate and personalized treatment,and provide a new way for clinical diagnosis and treatment.