计算机辅助测量颧眶骨折术前后眼眶容积的临床意义

目的:通过测量颧眶骨折术前术后眼眶容积的变化,得出术后可能仍然出现眼球内陷的术前眼眶容积大小。方法:20例颧眶骨折患者在术前及行坚固内固定术后,分别做多排三维螺旋CT(MSCT)扫描,利用Simplant软件测量眼眶容积进行比较,并做统计学分析。结果:术前20例患者均存在眼眶容积的增大,与健侧眼眶容积相比增大范围为0.07～7.50cm3。术前两侧眼眶容积差值的平均值为(3.06±1.96)cm3,术后差值减少到(0.93±1.00)cm3,术前术后眼眶容积存在显著差异(P<0.01)。10例患者术后仍然存在不同程度的眼球内陷,其术前眼眶容积差值为(4.60±1.27)cm3。结论:眼眶容积测定有助于术者制定手术方案,恢复应有的眼眶容积。     

眼球突度和眼眶容积比的实验研究

目的：通过Hertel眼球突度测量计测量新鲜尸体上眼球突度与眼眶容积的变化,得到两者之间的直线关系。方法：选择新鲜尸体5具共10侧眼眶,将气管插管的气囊部分置入眶底与眶骨膜之间,用注射器注入7ml生理盐水,每抽出1ml生理盐水后,用Hertel眼球突度测量计测量眼球突度,共得到80个数据,采用SAS6.12软件包进行统计学分析。结果：眼球突度与眼眶容积之间呈线性相关关系,Y=8.57-0.96X（r=-0.86,P=0.0001≤0.05）。结论：气管插管球囊是一种测量眼眶容积变化的有效实验工具。新鲜尸体上眼球突度与眼眶容积增量之间存在直线相关关系。     

非单纯性眼眶骨折眶腔容积改变与眼球内陷相关性研究方法初探基于CT图像数据的计算机辅助测量

目的应用计算机辅助三维CT影像分析系统，测量分析非单纯性眼眶骨折术前术后眶腔容积变化，为定量诊断和矫治骨折继发眼球内陷探索可行性研究方法。方法2004年10月～12月北京大学口腔医院颌面创伤中心经治的7例颅颌面创伤合并单侧非单纯性眼眶骨折。投照薄断层（0．625mm）CT，将图像数据以DICOM格式输入图像分析软件，对眼眶及眶内容物进行三维重建。描述眶腔破坏特征。测量眼球突度、原骨折和虚拟恢复眶外缘后的眶腔容积，并做术前术后比较分析。结果应用该系统可形象直观地显示眼眶畸形部位、范围。定量明确眼眶体积扩大量。在该类眼眶骨折中，骨折可波及整个眶壁。与眶缘骨折相比较，眶壁骨折与眼球内陷关系密切。术前术后比较，眼球内陷得到不同程度的改善，健患侧眼眶体积之差进一步缩小。结论基于CT图像数据的计算机图像分析系统可以清晰直观的显示出骨折眶壁畸形，以及健患侧眶腔体积的差异。球前和球后眶腔容积差可以为进一步探求眼眶破坏与眼球内陷的相关关系及量化诊断提供重要参数。     

上颌骨性扩弓器对成年女性眼眶容积的评价

评价上颌骨性扩弓器（MSE）治疗成年女性上颌骨宽度不足（MTD）对眼眶容积及眶周骨骼间宽度的影响。     

单侧眼眶部缺损修复的计算机辅助设计

目的：利用三维设计软件对单侧眼眶部缺损进行修复体的计算机辅助设计，探讨颜面部缺损修复设计的新方法。方法：通过激光扫描仪对一例单侧眼眶部缺损患者石膏面部模型进行数据采集，经三维设计软件处理数据，依据健侧眼眶部组织设计出缺损处组织外形。结果：由激光扫描采得的面部模型数据清晰、精确；通过Digisurf逆向工程软件对面部点数据构面和设计，利用健侧眼眶部组织数据镜面反转到缺损处修复缺损设计获得成功。结论：利用激光扫描技术和三维设计软件可以圆满地完成单侧眼眶部缺损修复的设计。     

计算机辅助测量唇腭裂继发颌骨畸形患者手术前后口腔及气道容积的变化

目的 采用计算机辅助三维重建技术,测量并比较单侧完全性唇腭裂继发颌骨畸形患者双颌手术前后固有口腔(oral cavity proper)及上气道容积的变化,评估数字外科引导下正颌手术对于患者气道及语音的影响.方法 获取2015年7月至2019年12月收治的5例单侧完全性唇腭裂继发颌骨畸形患者接受双颌手术前后口腔CBCT...     

中国汉族成年人骨性眼眶的应用测量

目的 :建立中国汉族男女骨性眼眶区域各解剖标志之间线性关系的参考值。方法 :对 86例 (男62例 ,女 2 4例 )中国汉族成年干颅骨标本眼眶区域的解剖标志点进行测量 ,对测量结果进行统计学处理。结果 :男性左右眶宽、眶下孔a、眶上孔a和眶下孔c存在明显差异 ,女性左右眶宽和眶上裂前距存在统计学差异 (P <0 .0 5 ) ,并得出眼眶解剖标志的的参考值范围和形态学参数 ;男、女眼眶各项指标中 ,眶深、眶宽和两眶宽等测量结果显示出性别差异 (P <0 .0 5 )。结论 :得出了中国正常成年人男、女眼眶形态及各解剖标志外科操作的安全参考值范围。累及眼眶的颅面骨折手术时要以此参考值为依据 ,以提高手术的效果 ,减少并发症     

计算机辅助Delaire头影测量分析方法的研究

目的实现Delaire头影测量分析法在WinCeph8.0软件中的计算机辅助分析,减少该法手工测量过于复杂、工作量大的不足。方法基于Delaire头影测量分析法的原理和WinCeph8.0中的编程模块,通过自定义标记点、辅助线,编写相关测量、分析程序,构建计算机辅助Delaire头影测量分析法,并对Delaire计算机辅助测量和手工测量结果做配对t检验和离散性分析。结果计算机辅助Delaire头影测量分析法能方便、快速、准确地进行标记点、辅助线描记,自动完成数据的测量计算,显示分析结果。统计分析显示Delaire计算机辅助测量较手工测量准确性更高,适合临床应用。结论本研究为Delaire头影测量分析法提供了一个方便、快捷、准确的计算机辅助测量分析平台,具有较好的临床推广价值。     

口腔医学专业开设眼眶解剖和眼眶影像课程的实践及探索

目的： 探讨眼眶解剖与影像学结合在口腔医学专业学生眼眶解剖课程中的教学效果。方法： 对87名口腔医学专业学生设计并开展“眼眶解剖及眼眶影像”课程,将教学大纲范围内的眼眶解剖一节与影像学相结合,引入临床实例进行大课教学。课程开展期间,以同期93名临床医学专业学生为对照（单纯眼眶解剖教学）。总课程结束后进行试卷考核,对2组学生掌握眼眶解剖的专业知识程度进行比较。自编问卷调查表,对在读口腔医学专业学生和毕业1年以上口腔临床医师进行问卷调查,评价口腔医学专业开设“眼眶解剖及眼眶影像”课程的教学效果。采用SPSS 22.0软件包对数据进行独立样本t检验。结果： 既往口腔医学专业学生的平均分为7.5分,临床医学专业学生的平均分为8.67,2组存在显著差异（P=0.004）。开设眼眶解剖及眼眶影像课程的口腔医学专业学生的平均得分为9.67分,临床医学专业学生的平均得分为9分,2组比较无显著差异（P=0.184）。问卷调查结果显示,口腔医学专业学生课后复习时间为20 min,临床医学专业学生课后复习时间为30 min。74.7%的口腔医学专业学生和80%的口腔医师在此之前未系统学习过眼眶解剖及影像课程;87.4%的口腔医学专业学生和100%的口腔医师认为开展眼眶影像学课程有助于掌握眼眶的解剖特点;89.7%的口腔专业学生和100%的口腔医师认为开设眼眶影像课程对口腔医师的临床工作有帮助。结论： 眼眶解剖及眼眶影像课程针对口腔医学专业设计,是对原有大纲的补充和完善。在口腔医学专业开设眼眶影像课程,成功激发了学生的学习兴趣,培养了学生的整体思维和综合思维能力,有助于学生掌握眼眶解剖学的知识点,缩小与临床医学专业学生的教学差距。     

基于眼球三维空间精确定位测量的外伤性眼眶缺损的个体化重建

目的：探讨外伤性眼眶缺损损伤程度的精确评估以及个体化重建方法。方法：对2003年7月—2012年6月间收治的 97例外伤性眼眶缺损患者进行回顾性研究,患者手术前、后均进行螺旋CT扫描,采用眼球空间定位方法测量眼球的三维位置,计算眶容积的变化量,利用计算机辅助技术和快速原型技术制作个体化眶模型,进行模型外科,制订手术方案,并预制植入物和接骨板等。术中回纳疝出的眶内容物,植入预制的钛网、Medpor或其他植入物,精确重建缺损区的眶外形,恢复正常的眶和眶内容物的比例关系。根据术后外形、患者满意度、眼功能检查及CT检查结果评估疗效,分析并发症。结果：除1例患者面部外形欠满意,2例陈旧性患者眼球内陷矫正不佳,术后6个月复视仍无明显改善,2例术后轻度下睑外翻外,其余病例均取得满意疗效。缺损区的眶外形、眶及内容物的比例关系恢复满意,未发生明显并发症。结论：对外伤性眼眶缺损患者进行眼球三维空间位置、眶容积变化等损伤程度的精确数字化评估,通过个体化模型外科制定手术方案,早期手术,减少创伤,在恢复眶容积、维持和纠正眼球位置的同时精确重建眶壁解剖外形,可实现眶缺损个体化的重建,提高眶畸形整复效果。     

Intra- and interreader variability of orbital volume quantification using 3D computed tomography for reconstructed orbital fractures

PurposeManagement of orbital fractures continues to present some difficulties, particularly regarding the prediction of late complications. Radiographic assessment provides a detailed evaluation, but the results lack consistency to be considered a standard factor in the decision-making process. Studies focusing on reliability of post-operative imaging are lacking.Materials and methodsWe performed a retrospective study using patients from a major trauma center with unilateral orbital floor fracture who underwent surgery. Using three-dimensional volume assessment software, we performed a volume calculation and determined the intra- and interreader variation by intraclass correlation coefficient analysis.ResultsTwenty-four orbits were assessed. Mean orbital volume (SD) was 24.02 (2,43) cm³ for reader 1 and 24.08 (2,51) cm³ for reader 2. The intraclass correlation coefficient (95% CI) was 0.95 (0.91–0.98) between readers and 0.96 (0.91–0.98) for intra-reader variability. Normal and reconstructed orbits assessed separately also showed very high correlation coefficient for both intra- and inter-subject variability.ConclusionResults show an almost perfect agreement of volume assessment between readers. The presence of reconstruction material does not seem to add variability. Although reproducible and reliable, radiological volume assessments have not yet shown a clear correlation with clinical outcomes and post-operative management decisions should be based mainly on clinical findings.     

Enhancing the dental histology curriculum using computer technology

The predominant difference between the histology offered to dental students and that taken by other health care professionals is the emphasis placed on the oral tissues. The oral histology component of the dental curriculum is commonly handled in one of three ways, all delivering far more detailed information than the often less than one hour that a typical medical histology course spends on the oral cavity and its component tissues. Overall, three general curricular styles can be defined: 1) dental histology is taught by medical or dental faculty as a separate course, the oral histology component being a separate course taught by either faculty group; 2) medical and dental students take histology together in a single class with the oral histology component taught separately by faculty from either college; and 3) both basic and oral histology is taught within a single semester, the format used at the University of Kentucky College of Dentistry. The oral histology topics are similar in all of the course formats, regardless of whether they occur as a stand-alone course or are merged with basic histology. The main portion of this paper will describe a self-study, non-microscope-based laboratory experience designed to complement this fused topic course. Self-study labs using digital media are becoming more popular across both medical and dental histology curricula, specifically with the oral histology component where the histological skills for preparing these tissues are rapidly disappearing from many schools. This paper describes a typical syllabus for a fused course, outlining the topics for basic and oral histology, and demonstrates how the laboratory portion has been enhanced using digital technology.     

Characterization of the orbital volume in normal population

Introduction

The aim of the study was to describe the normal orbital volume and its most important relationships with other clinical variables.

Measurement of orbital volume by a 3-dimensional software program: an experimental study.

PURPOSE: This study reports a simple method with high accuracy for determining orbital volume from computed tomography (CT) scans. MATERIALS AND METHODS: The volume of 20 orbits was evaluated in 20 dry skulls by use of a 3-dimensional software program in General Electric High-Speed Advantage CT/I (Milwaukee, WI), and compared with the volume obtained by direct measurement using the water displacement method. Accuracy of volume measurement by this software program was assessed statistically by paired samples t-test. RESULTS: The mean volume was found to be 28.37 mL +/- 2.15 by direct impression and 28.41 mL +/- 2.09 by the software program. Volume difference between the 2 methods averaged 0.93 +/- 1.08 mL for each orbit (P < .01). The correlation between the techniques was found to be high (r = 0.887, P < .01). There was no significant volume discrepancy between the 2 methods. CONCLUSION: Measurement by the technique described is an easy and accurate method of assessing the volume of the orbit.     

Reconstruction of acquired orbital deformity characterized by volume change

Acquired orbital deformity is a common disease in the practice of craniofacial surgery. Defective orbital volume and abnormality of eyeball position are the most important characteristics of pathologic changes. This study includes 87 cases of acquired orbital deformity, which received surgery for volume aberration from 2002 to present. Among them, 73 cases received orbital volume expansion surgery and 14 cases received reduction surgery. Coronal scalp, lower eyelid, or intraoral gingival-buccal incisions were carried out for the approach. In some patients, the original scar around the orbit was chosen for the incision. Operation aims were reduction of orbit and reconstruction of the orbital wall integrity. Operative methods were osteotomy for reduction and implantation of autologous bone or artificial materials. Orbital volume and eyeball position were restored to normal in all patients after the operation, and no serious complications occurred. Treatment of acquired orbital deformity should make restoration of orbital volume as the most important target of therapy. Autologous bone should be the material of first choice, and the selection and amount of implanted material should be decided by the specialty and experience of the physician.     

Analysis of bone volume using computer simulation system for secondary bone graft in alveolar cleft

The purpose of this study was to measure the bone volume necessary for secondary bone grafting in the alveolar cleft using surgical simulation software based on three-dimensional computed tomography (CT) scan data, to compare this measurement with the actual volume of the bone graft, and to evaluate consistency. The subjects were 13 patients with cleft lip and palate who underwent CT using a cone-beam CT unit (CB-CT) 1 month before surgery, followed by bone grafting with particulate cancellous bone and marrow (PCBM) to close the cleft. The bone volume necessary for grafting was measured based on the CB-CT scan data. Correlation analysis, a test of the population mean between two samples, and Wilcoxon's signed rank test were conducted between these measurements and the actual bone volume (PCBM volume) used for grafting. SPSS was used for statistical analysis, and the level of significance was set below the 5% level. The results showed a significant correlation, with no significant differences between the two in all tests. These results suggest that measuring and preoperatively calculating the bone volume necessary for bone grafting with surgical simulation software using CB-CT scan data is beneficial.