数字化及3D打印联合内镜辅助技术治疗12例颧骨颧弓骨折效果评价

目的:探讨数字化及3D打印联合内镜辅助技术在颧骨颧弓骨折治疗中的应用效果。方法:选择2020年12月—2021年9月于蚌埠医学院第一附属医院行手术治疗的12例单侧颧骨颧弓骨折患者纳入研究。所有患者术前均行全头颅薄层CT检查,利用镜像反求原理对骨折部位进行模拟复位,并打印复位后的骨折模型,在模型上进行钛板预弯。术中在内镜辅助下采用前庭沟切口结合耳屏前切口对骨折断端进行解剖复位。术后所有患者均再次行全头颅薄层CT检查,将术后重建的三维模型数据与术前模拟复位的三维模型数据进行光谱融合色差对比分析,评价术后效果。结果:12例患者手术顺利,术后面部外形及功能恢复良好,无明显并发症,面部皮肤瘢痕隐蔽。术后CT与术前模拟设计光谱融合色差对比分析最大上偏差为2.998 7 mm,最大下偏差为-2.998 6 mm,平均上偏差为（0.243 0±0.025 0）mm,平均下偏差为（-0.310 0± 0.180 0）mm。结论:数字化及3D打印联合内镜辅助技术在直视下对骨折部位进行解剖复位,有助于提高骨折复位的精准度,减少术中组织损伤、术后并发症的发生,术后瘢痕隐蔽,具有良好的美观效果。

Application of digital, 3D printing combined with endoscopic assisted technology in the treatment of12patients with zygomatic,zygomatic arch fractures

PURPOSE: To explore the application and effect of digital and 3D printing combined with endoscopic-assisted technology in the treatment of zygomatic bone-zygomatic arch fractures. METHODS: Twelve patients with unilateral zygomatic fractures who underwent surgical treatment in First Affiliated Hospital of Bengbu Medical College from December 2020 to September 2021 were included in this study. All patients underwent 3-D CT reconstruction of the whole head before operation, by simulating reduction of the fracture site using the principle of mirror reverse, printing the fracture model after reduction, and performing titanium pre-bending on the model. Intraoperatively, the fracture was dissected and repositioned using an endoscopically assisted vestibular sulcus incision combined with an anterior auricular incision. All patients underwent 3-D CT reconstruction of the whole head again after operation. The three-dimensional model data reconstructed after operation and the 3-D model data before preoperative simulated reduction were analyzed by spectral fusion chromatic aberration to evaluate the postoperative effect. RESULTS: The operation in 12 patients went smoothly. The facial appearance and function recovered well after operation. There was no obvious complication and the facial skin scars were inconspicuous. Compared with postoperative CT and preoperative simulated design spectral fusion chromatic aberration analysis; the maximum upper deviation was 2.998 7 mm, the maximum lower deviation was -2.998 6 mm, the average upper deviation was (0.243 0±0.025 0) mm, the average lower deviation was (-0.310 0±0.180 0) mm. CONCLUSIONS: Digital and 3D printing combined with endoscopic-assisted techniques help improve the accuracy of fracture reduction, reduce intraoperative tissue damage, postoperative complications, and provide good aesthetics with hidden postoperative scars when performing anatomical repositioning of the fracture site under direct vision.