计算机辅助设计、快速成型技术大面积颅眶缺损个性化整复

目的：探讨利用CT数据、计算机辅助设计、快速成型技术,预制个体化修复体在大面积颅眶缺损整复中的应用。方法：2004年6月～2009年8月共6例外伤后颅眶缺损患者运用该方法修复。先行CT连续薄层容积扫描获得断层数据,在三维造型软件中运用原位贴合、交互式屏幕法行缺损修复,设计个体化修复体三维曲面模型。然后将三维曲面模型数据格式转换后传入快速成型机制造修复体三维原型,利用医用钛合金铸造修复体,植入缺损区域。结果：预制的个性化修复体曲度、边缘与缺损区域吻合良好,6例颅眶缺损患者术后外观形态对称,痊愈后容貌恢复正常,平均随访4年无感染、假体外露等并发症出现,治疗效果满意。结论：计算机辅助设计、快速成型技术预制个性化修复体在整复大面积颅眶缺损畸形可有效地解决修复体塑形难、手术时间长、整复后外形欠佳等治疗难题,具有广泛的临床应用前景。

Application of computer aided design and rapid prototyping in treating large-format cranioorbital defect individually

Objective Ta explore the method of prefabricated, individualized implant for reconstruction of large-format cranio-orbital defect by the techniques of CT data, computer aided designing and rapid prototyping. Methods 6 patients who was suffered from post-traumatic and turmor resection cranio-orbital defect was involved in this group from June 2004 to August 2009. The data was obtained from continuous thin-layer volume computer tomography scanning.Three-dimensional curved model of implant was designed by in situ fully fit and interactive screen method with three-dimensional image processing software and three-dimensional fabricating software （surface 9.0） through a serial disposal of CT imaging. Three-dimensional curved data of implant was extracted and transmitted to rapid prototyping machine after format conversion. Resin prosthesis model was made using RP. The individualized implant was prefabricated by exact foundry of titanium alloy. Titanium prosthesis was obtained by casting.The titanium prosthesis was implanted in the defect area to restore the cranio-orbital defect. Results The prefabricated individual cranial implant was well fitting with cranio-orbital defect area in curvature and margin. The appearances of cranio-orbital area looked beautiful and symmetric.Followed up 4 years,no complications occurred,such as infectious,titanium plate exposed. Conclusion Using computer aided design and rapid prototyping technique has many advantages,such as simple surgical steps,no need of intro-operative reshaping and few complications.It was to be a feasible and effective methods for reconstruction the large-format defect of cranio-orbital area and would be recommended in clinical practice.