3D打印术前设计和内镜辅助在颧骨颧弓骨折复位固定术中的应用

目的: 探讨3D打印术前设计和内镜技术应用于颧骨颧弓骨折复位固定手术的可行性及效果。方法: 选择4例B型颧骨颧弓骨折患者,均伴发颧弓骨折,面部凹陷明显伴开口受限。术前行CT扫描后将数据转化为STL格式,3D打印骨折模型和镜像模型,在模型上完成手术设计和钛板预弯制。手术采用耳屏前小切口和颧弓表面隧道手术入路,内镜辅助下完成颧弓骨折的复位及坚固内固定。结果: 所有患者术后面部恢复对称性,面部凹陷消失,开口度正常,面部瘢痕不明显,无感染和神经损伤等并发症。结论: 术前3D模型手术设计降低了内镜辅助下行颧弓骨折复位固定术的难度,提高了手术精准度,避免了头皮冠状切口,创伤小,美容效果好。

Application of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch

PURPOSE: To evaluate the feasibility and effect of 3D printing design and endoscope in reduction and fixation of fractures of zygoma and zygomatic arch. METHODS: Four patients diagnosed as B type fractures of zygoma and zygomatic arch with limited mouth opening and facial depression were included. After CT scanning data were tranformed into STL type, the fracture model and mirror-imaged model were printed. Preoperative design and premolding of titanium plates were completed on the models. Through a small preauricular incision and tunnel on the zygomatic arch, reduction and fixation of fractures of zygoma and zygomatic arch were performed under endoscope. RESUITS: All patients achieved symmetrical face and normal mouth opening. Facial scar was not obvious and there was no complication such as infection and nerve damages. CONCLUSIONS: 3D printing design reduces the difficulty of endoscopic surgery in reduction and fixation of fractures of zygoma and zygomatic arch and improves the precision of operation. This method avoided coronal incision and achieved cosmetic results with minimal invasion.