3D打印技术在晚期头颈恶性肿瘤手术治疗中的临床应用初探

目的为减少晚期头颈肿瘤手术的风险及盲目性，增加头颈肿瘤手术的精准度，利用3D打印技术构建患者头颈部模型，精准切除肿瘤，优化修复及重建方案。方法收集2013年1月~2015年12月10例晚期头颈部肿瘤患者，术前行术区三维CT,MRI及血管功能成像，将影像学数据导入，构建3D打印模型，确定手术切除及手术修复重建范围。结果所有患者均顺利整体切除及修复重建，其中下颌骨肿块5例，上颌骨肿块2例，侵犯上颌骨，软腭及颅底肿块2例，翼腭窝肿块1例，术后随访6～24个月(中位随访时间14个月)，除1例发生原发灶复发外，其余9例治疗效果满意。结论利用3D打印技术可辅助完成复杂的头颈肿瘤切除手术，能较好提高手术精准度。

Clinical application of three dimensional (3D) printing technique in surgical treatment of advanced malignant tumors of head and neck

ObjectiveTo decrease the surgical risk and blindness and increase surgical accuracy for advanced malignant tumors of head and neck, three dimension (3D) printing technique is applied to reestablish the model of patients''head and neck region, concisely remove the tumor and optimize the reconstruction and rehabilitation strategies for postoperative defect.Methods10 patients with advanced malignant tumors of head and neck hospitalized in our department from Jan 2013 to Dec 2015 were enrolled. Before operation, 3D CT or MRI and blood vessel function imaging were performed to construct 3D model for the confirmation of operation and rehabilitation scopes in all the patients.ResultsEn bloc removal of tumor and reconstruction of postoperative defect was achieved successfully in all patients. The removed tumors were primarily located at mandible (n=5), maxilla (n=2), combined invasion of maxilla, soft palate and skull base (n=2), and pterygopalatine fossa (n=1). No serious complications occurred after operation. Postoperative follow up durations ranged from 6 to 24 months with a median of 14 months. All the patients got satisfactory effect except primary tumor recurrence in one case.ConclusionsThe 3D printing technique can assist surgeons in completing removal of advanced tumor in head and neck region with reduction of surgical risk. Meanwhile it can also greatly improve the function and appearance of patients after operation.