基于3dMD动态表面捕捉系统的多根肋软骨采取术后胸廓形变特征分析

3dMD photogrammetric system study of thoracic deformation after multi-rib autologous rib cartilage transplantation for auricle reconstruction

目的基于3dMD摄影测量技术分析多根自体肋软骨移植耳再造患儿胸廓形变的特征。方法回顾性分析2019年7至9月,中国医学科学院整形外科医院耳整形再造一科收治的采取多根自体肋软骨行耳廓再造耳术患儿术后的胸廓3dMD数据。以正中线为中轴线,将正常侧胸廓影像镜像翻转叠加于肋软骨采取侧胸廓进行自动注册配准,距离数值通过颜色映射技术在笛卡尔热力图中呈现(负值表示突起,正值表示凹陷)。通过观察肋软骨采取侧胸廓发生明显胸廓矢状径线形态形变的区域,测量其在矢状径线上凹凸峰值的距离差判断患儿胸廓形变程度(≤10 mm为无,>10~20 mm为轻度,>20~30 mm为中度,>30 mm为严重)。结果共纳入42例患儿,男27例,女15例,年龄7~12岁。胸廓形变笛卡尔热力图显示,胸廓明显凹陷处位于锁骨中内1/3垂直线与第7肋骨交界区,明显突起处位于乳头至第5肋上缘。上胸部乳头区域凸出峰值范围为-7.6389~-14.2884 mm;肋弓凹陷区域凹陷峰值的范围为7.2387~14.6532 mm;凹凸峰值距离差范围为14.8776~28.9416 mm。患儿胸廓形变程度:轻度5例,中度37例。结论基于3dMD摄影测量技术分析,多根自体肋软骨移植耳再造患儿术后胸廓形变的总体特征为上胸部乳头区域凸起和肋软骨采取区域凹陷同时存在,在矢状径线上距离均发生变化。

ObjectiveTo analyze the characteristics of postoperative thoracic deformation in patients who underwent multi-rib autologous rib cartilage transplantation auricle reconstruction based on 3dMD imaging system.MethodsA retrospective study was conducted using 3dMD data of the thorax from patients who underwent auricle reconstruction surgery using multiple autologous costal cartilages at the First Department of Ear Reconstruction of the Plastic Surgery Hospital,Chinese Academy of Medical Sciences,from July to September 2019.The normal-side chest wall image was superimposed on the rib-harvested side chest wall for automatic registration and alignment,with distance numerical data presented in a Cartesian heat map through color mapping technology.By observing the areas where the rib-harvested side thorax had obvious deformation,the distance difference of the concave and convex peaks on the sagittal diameter was measured to judge the degree of thoracic deformation in children(≤10 mm as none;>10-20 mm as mild;>20-30 mm as moderate;>30 mm as severe).ResultsA total of 42 children were included,with 27 males and 15 females,aged from 7 to 12 years old.The Cartesian heat map of thoracic deformation showed that the obvious concave area of the chest wall was located at the junction of the middle and inner one-third of the clavicle and the 7th rib,and the obvious convex area was located in the area from the nipple to the 5th rib.The measurement range of the protrusion peak in the upper chest nipple area was from-7.6389 to-14.2884 mm;the measurement range of the depression peak in the rib arch area was from 7.2387 to 14.6532 mm.The range of the distance difference between the concave and convex peaks was from 14.8776 to 28.9416 mm.The degree and incidence of thoracic deformation in children:mild in 5 cases;moderate in 37 cases.ConclusionBased on the analysis with 3dMD photogrammetry,the overall characteristics of chest wall deformation in patients who underwent ear reconstruction with autologous rib cartilage grafts were the coexistence of protrusion in the upper chest nipple area and depression in the area where the rib cartilage was harvested,with changes occurring on the sagittal diameter.