Feasibility and potential effect of a low-cost virtual reality system on reducing pain and anxiety in adult burn injury patients during physiotherapy in a developing country

Objective

The purpose of this study was to ascertain the feasibility and potential effect of a low-cost VR system (eMagin Z800 3DVisor), used in conjunction with pharmacological analgesia, on reducing pain and anxiety in adult burn patients undergoing physiotherapy treatment, compared to pharmacologic analgesia alone at a South African hospital.

Study design

Single-blind, within-subject study design.

Methods

Pain and anxiety outcome measures were measured by a blinded assessor using the Numeric Pain Rating Scale and Burn Specific Pain and Anxiety Scale. Box-and-whisker plot method, Chi-square tests as well as the Student's paired t-test were used to analyze data.

Main findings

Eleven eligible adult burn patients consented to participate in this study (3 female, 8 male; median age 33 years: range 23–54 years). A marginal (p = 0.06) to insignificant (p = 0.13) difference between the two sessions (analgesia with VR and analgesia without VR) in reducing pain was found. No significant difference (p = 0.58) was found between the two sessions (analgesia with VR and analgesia without VR) for anxiety.

Conclusion

There seems to be a trend that the low-cost VR system, when added to routine pharmacological analgesics, is a safe technique and could be of considerable benefit if implemented into the pain management regime of burn units at a South African hospital.     

A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns

This randomized, controlled, within-subjects (crossover design) study examined the effects of immersive virtual reality as an adjunctive analgesic technique for hospitalized pediatric burn inpatients undergoing painful physical therapy. Fifty-four subjects (6-19 years old) performed range-of-motion exercises under a therapist's direction for 1-5 days. During each session, subjects spent equivalent time in both the virtual reality and the control conditions (treatment order randomized and counterbalanced). Graphic rating scale scores assessing the sensory, affective, and cognitive components of pain were obtained for each treatment condition. Secondary outcomes assessed subjects’ perception of the virtual reality experience and maximum range-of-motion. Results showed that on study day one, subjects reported significant decreases (27-44%) in pain ratings during virtual reality. They also reported improved affect (“fun”) during virtual reality. The analgesia and affect improvements were maintained with repeated virtual reality use over multiple therapy sessions. Maximum range-of-motion was not different between treatment conditions, but was significantly greater after the second treatment condition (regardless of treatment order). These results suggest that immersive virtual reality is an effective nonpharmacologic, adjunctive pain reduction technique in the pediatric burn population undergoing painful rehabilitation therapy. The magnitude of the analgesic effect is clinically meaningful and is maintained with repeated use.     

A comparison of interactive immersive virtual reality and still nature pictures as distraction-based analgesia in burn wound care

PurposeNon-pharmacologic adjuncts to opioid analgesics for burn wound debridement enhance safety and cost effectiveness in care. The current study explored the feasibility of using a custom portable water-friendly immersive VR hardware during burn debridement in adults, and tested whether interactive VR would reduce pain more effectively than nature stimuli viewed in the same VR goggles.MethodsForty-eight patients with severe burn injuries (44 adults and 4 children) had their burn injuries debrided and dressed in a wet wound care environment on Study Day 1, and 13 also participated in Study Day 2.InterventionThe study used a within-subject design to test two hypotheses (one hypothesis per study day) with the condition order randomized. On Study Day 1, each individual (n = 44 participants) spent 5 min of wound care in an interactive immersive VR environment designed for burn care, and 5 min looking at still nature photos and sounds of nature in the same VR goggles. On Study Day 2 (n = 12 adult participants and one adolescent from Day 1), each participant spent 5 min of burn wound care with no distraction and 5 min of wound care in VR, using a new water-friendly VR system. On both days, during a post-wound care assessment, participants rated and compared the pain they had experienced in each condition.Outcome measures on Study Days 1 and 2Worst pain during burn wound care was the primary dependent variable. Secondary measures were ratings of time spent thinking about pain during wound care, pain unpleasantness, and positive affect during wound care.ResultsOn Study Day 1, no significant differences in worst pain ratings during wound care were found between the computer-generated world (Mean = 71.06, SD = 26.86) vs. Nature pictures conditions (Mean = 68.19, SD = 29.26; t < 1, NS). On secondary measures, positive affect (fun) was higher, and realism was lower during computer-generated VR. No significant differences in pain unpleasantness or “presence in VR” between the two conditions were found, however.VR vs. No VR. (Study Day 2)Participants reported significantly less worst pain when distracted with adjunctive computer generated VR than during standard wound care without distraction (Mean = 54.23, SD = 26.13 vs 63.85, SD = 31.50, t(11) = 1.91, p < .05, SD = 17.38). In addition, on Study Day 2, “time spent thinking about pain during wound care” was significantly less during the VR condition, and positive affect was significantly greater during VR, compared to the No VR condition.ConclusionThe current study is innovative in that it is the first to show the feasibility of using a custom portable water-friendly immersive VR hardware during burn debridement in adults. However, contrary to predictions, interactive VR did not reduce pain more effectively than nature stimuli viewed in the same VR goggles.     

The effect of virtual reality on pain,anxiety, and fear during burn dressing in children: A randomized controlled study

Aim and objectivesVirtual Reality (VR) can be used during painful procedures in children. This research was conducted to determine the effect of VR on the pain, anxiety, and fear levels experienced by patients during burn dressing.MethodsA randomized between groups study design was used to test whether VR reduced pain, fear, and anxiety during burn wound cleaning. The experimental (VR group) (n = 33) and the control group (n = 32) were determined using the simple randomization method for the children participating in the study (n = 65). The data were collected using the Wong–Baker FACES Pain Rating Scale, Children’s Fear Scale, and State- Trait Anxiety Inventory for Children. In addition, oxygen saturation and heart rate measurements were recorded before and after the procedure.ResultsUsing a between groups t-test, burn injured children in the group that received virtual reality (M = 2.6, SD = 1.9, SE= 0.21) showed significantly less pain intensity during burn wound care than the No VR control group (M = 4.2, SD =1.0, SE= 0.19, t = −5.89, p < 0.005). Similarly, the VR group reported significantly lower fear during wound care (M= 2.24, SD = 1.1, SE=0.19) than the No VR control group (M=3.72, SD = 0.6, SE=0.10, t = 6.70, p < 0.005), and on a scale from 0 to 100, patients in the VR group showed significantly less anxiety (36.46, SD = 8.1, SE=1.40) than patients in the No VR group (M= 53.16, SD = 7.4, SE=1.35, t = 8.52, p < 0.005). Heart rate during wound care was significantly lower in the VR group (M=119.60, SD = 8.1, SE=1.40) than in the No VR control group (M=129.56, SD = 10.64, SE=1.88, t = −4.25, p < 0.005). However, no significant difference in Oxygen saturation was found, (VR = 97.03, SD = 0.90, SE= 0.17, vs. No VR = 96.94, SD = 0.29, SE=0.23, t = 0.326, p > 0.05).ConclusionsVR is an effective method in reducing pain, fear, and anxiety caused by burn dressing in children aged 7–12. The use of VR during burn dressing was determined to have positive results on some physical and psychological parameters.     

Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial

Background

Effective pain management remains a challenge for adolescents during conscious burn wound care procedures. Virtual reality (VR) shows promise as a non-pharmacological adjunct in reducing pain.

Aims

This study assessed off-the-shelf VR for (1) its effect on reducing acute pain intensity during adolescent burn wound care, and (2) its clinical utility in a busy hospital setting.

Methods

Forty-one adolescents (11–17 years) participated in this prospective randomized controlled trial. Acute pain outcomes including adolescent self-report, nursing staff behavioral observation, caregiver observation and physiological measures were collected. Length of procedure times and adolescent reactions were also recorded to inform clinical utility.

Results

Nursing staff reported a statistically significant reduction in pain scores during dressing removal, and significantly less rescue doses of Entonox given to those receiving VR, compared to those receiving standard distraction. For all other pain outcomes and length of treatment, there was a trend for lower pain scores and treatment times for those receiving VR, but these differences were not statistically significant.

Conclusion

Despite only minimal pain reduction achieved using off-the-shelf VR, other results from this trial and previous research on younger children with burns suggest a customized, adolescent and hospital friendly device may be more effective in pain reduction.     

Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator

Background The aim of this study was to develop summary metrics and assess the construct validity for a virtual reality laparoscopic simulator (LapSim) by comparing the learning curves of three groups with different levels of laparoscopic expertise.Methods Three groups of subjects (‘expert’, ‘junior’, and ‘naïve’) underwent repeated trials on three LapSim tasks. Formulas were developed to calculate scores for efficiency (‘time-error’) and economy of ‘motion’ (‘motion’) using metrics generated by the software after each drill. Data (mean ± SD) were evaluated by analysis of variance (ANOVA). Significance was set at p < 0.05.Results All three groups improved significantly from baseline to final for both ‘time-error’ and ‘motion’ scores. There were significant differences between groups in time error performances at baseline and final, due to higher scores in the ‘expert’ group. A significant difference in ‘motion’ scores was seen only at baseline.Conclusion We have developed summary metrics for the LapSim that differentiate among levels of laparoscopic experience. This study also provides evidence of construct validity for the LapSim.Presented in part at the annual meeting of The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Denver, CO, USA April 2004     

Utilizing multi-user virtual reality to bring clinical therapy into stroke survivors' homes

IntroductionLifespans after the occurrence of a stroke have been lengthening, but most stroke survivors will experience chronic impairment. Directed, repetitive practice may reduce deficits, but clinical access is often limited by a variety of factors, such as transportation.Purpose of the StudyTo introduce a multiuser virtual reality platform that can be used to promote therapist-client interactions when the client is at home.MethodsThe Virtual Environment for Rehabilitative Gaming Exercises encourages exploration of the hand workspace by enabling multiple participants, located remotely and colocated virtually, to interact with the same virtual objects in the shared virtual space. Each user controls an avatar by corresponding movement of his or her own body segments. System performance with stroke survivors was evaluated during longitudinal studies in a laboratory environment and in participants' homes. Active arm movement was tracked throughout therapy sessions for both studies.ResultsStroke survivors achieved considerable arm movement while using the system. Mean voluntary hand displacement, after accounting for trunk displacement, was greater than 350 m per therapy session for the Virtual Environment for Rehabilitative Gaming Exercises system. Compliance for home-based therapy was quite high, with 94% of all scheduled sessions completed. Having multiple players led to longer sessions and more arm movement than when the stroke survivors were trained alone.ConclusionsMultiuser virtual reality offers a relatively inexpensive means of extending clinical therapy into home and enabling family and friends to support rehabilitation efforts, even when physically remote from each other.     

Challenges to the development of complex virtual reality surgical simulations

Virtual reality simulation in surgical training has become more widely used and intensely investigated in an effort to develop safer, more efficient, measurable training processes. The development of virtual reality simulation of surgical procedures has begun, but well-described technical obstacles must be overcome to permit varied training in a clinically realistic computer-generated environment. These challenges include development of realistic surgical interfaces and physical objects within the computer-generated environment, modeling of realistic interactions between objects, rendering of the surgical field, and development of signal processing for complex events associated with surgery. Of these, the realistic modeling of tissue objects that are fully responsive to surgical manipulations is the most challenging. Threats to early success include relatively limited resources for development and procurement, as well as smaller potential for return on investment than in other simulation industries that face similar problems. Despite these difficulties, steady progress continues to be made in these areas. If executed properly, virtual reality offers inherent advantages over other training systems in creating a realistic surgical environment and facilitating measurement of surgeon performance. Once developed, complex new virtual reality training devices must be validated for their usefulness in formative training and assessment of skill to be established.     

A general overview of burn care

The majority of burn victims do not need to be treated in a burn centre. Adequate care can be given by non specialised medical personnel, provided that proper guidelines are followed. The article outlines and reviews these guidelines.     

虚拟现实技术在神经外科术前计划中的应用

目的探讨虚拟现实（virtual reality，VR）技术在神经外科术前计划中的临床应用价值。方法对拟采用手术治疗的颅脑疾病26例，分别采集磁共振成像（MRI）、磁共振动脉成像（MRA）、磁共振静脉成像（MRV），计算机体层摄影（CT）等多种医学影像数据，输入Dextroscope术前计划系统，运用Radiodexter软件在VR环境中进行融合、提取、切割等处理显示为一个三维立体物像。同时运用软件内的三维处理工具对病灶及其局部解剖结构进行观察测量、手术模拟。制定术前计划，并与真正手术中情况进行对照比较。结果26例病例均成功地实现了三维立体虚拟现实影像的重建，术前计划中对于病灶及其局部解剖学特征的判定与术中实际情况吻合。结论Dextroscope系统的虚拟现实技术能快速、直观、全面地整合多种医学影像数据，以提供病灶及其局部解剖结构的综合信息，在神经外科手术前为制定和优化手术方案提供帮助，有可能有助于提高手术的安全性与病灶的全切除率。     

Curriculum-based solo virtual reality training for laparoscopic intracorporeal knot tying: objective assessment of the transfer of skill from virtual reality to reality

BACKGROUND: Very few studies have addressed the transferability of skills from virtual reality (VR) to real life. The aim of this study was to assess the feasibility and effectiveness of teaching intracorporeal knot tying (ICKT) by VR simulation only. METHODS: Twenty novices underwent structured training of basic skills training on the Minimally Invasive Surgical Trainer simulator (Mentice AB, Gothenburg, Sweden) followed by knot tying training on the LapSim simulator (Surgical Science, Gothenburg, Sweden). They were assessed pre- and post-training on a video trainer. Assessment of performance included motion tracking and video-based checklist. Nonparametric statistical analysis was used, and P < .05 was deemed significant. RESULTS: All participants completed a correct knot as compared with only 25% before VR training. Time to completion was 66% faster and knot quality 45% better after VR training. Significant reduction in number of movements (P = .006) and distance traveled (P < .000) by both hands after VR training. CONCLUSIONS: Teaching ICKT by VR simulators only is feasible and effective. Furthermore, this study highlights the complementary use of different VR simulators within a structured curriculum.     

Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies

BACKGROUND: Virtual reality (VR) training has been shown previously to improve intraoperative performance during part of a laparoscopic cholecystectomy. The aim of this study was to assess the effect of proficiency-based VR training on the outcome of the first 10 entire cholecystectomies performed by novices. METHODS: Thirteen laparoscopically inexperienced residents were randomized to either (1) VR training until a predefined expert level of performance was reached, or (2) the control group. Videotapes of each resident's first 10 procedures were reviewed independently in a blinded fashion and scored for predefined errors. RESULTS: The VR-trained group consistently made significantly fewer errors (P = .0037). On the other hand, residents in the control group made, on average, 3 times as many errors and used 58% longer surgical time. CONCLUSIONS: The results of this study show that training on the VR simulator to a level of proficiency significantly improves intraoperative performance during a resident's first 10 laparoscopic cholecystectomies.     

Evaluating the effectiveness of the Voxel-Man TempoSurg virtual reality simulator in facilitating learning mastoid surgery

INTRODUCTION

The Chief Medical Officer''s 2008 annual report highlighted the importance of simulation in medical training.¹ Simulator development has focused on increasing authenticity and fidelity. Development has not necessarily been guided by evidence for educational improvement. On reviewing 34 years of literature, Issenberg et al identified ten features of high-fidelity medical simulators that facilitate learning.² This study compares cadaveric temporal bone (CTB) simulation with the Voxel-Man TempoSurg (VT) virtual reality simulator in addressing these features.

SUBJECTS AND METHODS

A questionnaire was designed comparing the VT with CTB. Fourteen trainees and six consultants completed the questionnaire after using the simulator.

RESULTS

The VT is better at allowing repetitive practice, ease of control of difficulty, and capturing clinical and pathological variation. The VT is as good as CTB in curriculum integration, allowing multiple learning strategies, providing a controlled environment, individualising learning and defining benchmarks. It appears worse with regards to face validity and feedback.

CONCLUSIONS

Virtual reality simulation and CTB have features that allow effective learning. Some of these are common to both, in some CTB is better and in others virtual reality is better. Virtual reality could be a significant mode of learning supplementary to CTB and experience in the operating theatre.     

The effects of relaxation breathing on procedural pain and anxiety during burn care

Introduction

Burn patients experience high levels of pain and anxiety during dressing changes. Relaxation breathing is a simple behavioral intervention to manage pain and anxiety. However, the information about the effects of relaxation breathing on pain and anxiety levels for burn patients during dressing changes is limited.

Methods

This study followed a quasi-experimental, pretest-posttest comparison group design without random assignment to groups. A total of 64 burn patients from Daejeon, South Korea were recruited by a convenience sequential sampling approach. With institutional approval and written consent, the experimental group practiced relaxation breathing during dressing change procedures. Data were collected from June to September 2011 using a VAS for pain and a VAS-A for anxiety.

Results

The homogeneity test was used to detect any significant group differences in the demographic data and pretest measures. The pain scores significantly differed between the 2 groups after intervention (RB group vs. control group, P = .01) and over time (pretest vs. posttest, P = .001). The anxiety scores significantly differed between the 2 groups (P = .01) and over time (P = .02).

Conclusion

Relaxation breathing is a simple and inexpensive technique nurses can use to help burn patients manage pain and anxiety during dressing changes.     

Objective assessment of laparoscopic skills using a virtual reality stimulator

Background Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills. The study was carried out to investigate whether the LapSim system (Surgical Science Ltd., Gothenburg, Sweden) was able to differentiate between subjects with different laparoscopic experience and thus to demonstrate its construct validity. Methods Subjects 24 were divided into two groups: experienced (performed > 100 laparoscopic procedures, n = 10) and beginners (performed <10 laparoscopic procedures, n = 14). Assessment of laparoscopic skills was based on parameters measured by the computer system. Results Experienced surgeons performed consistently better than the residents. Significant differences in the parameters time and economy of motion existed between the two groups in seven of seven tasks. Regarding error parameters, differences existed in most but not all tasks. Conclusion LapSim was able to differentiate between subjects with different laparoscopic experience. This indicates that the system measures skills relevant for laparoscopic surgery and can be used in training programs as a valid assessment tool.     

Evidence-based burn care—An assessment of the methodological quality of research published in burn care journals from 1982 to 2008

Introduction

The quantity and quality of research evidence in peer-reviewed burn care journals have never been evaluated. The aim of this study was to empirically assess the evidence available in this literature.

Methods

All studies published in Burns and Journal of Burn Care and Research between 1st January 1982 and 31st December 2008 were reviewed. Articles were tabulated according to their study design into the following groups: meta-analyses; randomised controlled trials; controlled trials; comparative studies and case series/reports.

Results

A total of 2215 original articles were evaluated, of which 67.0% were from Burns and 33.0% were from Journal of Burn Care and Research. There were 3 meta-analyses (0.1%), 179 (8.1%) randomised controlled trials, 56 (2.5%) controlled clinical trials, 715 (32.3%) comparative studies and 1262 (57.1%) case series/reports. Journal of Burn Care and Research published a higher proportion of randomised controlled trials than Burns (11.9% vs. 6.2%; p < 0.001). There was no significant difference in the proportion of published controlled trials between the two journals (3.0% vs. 2.3%; p = 0.333). Journal of Burn Care and Research published a higher proportion of comparative studies than Burns (27.9% vs. 41.4%; p < 0.001). Case series/reports made up the highest proportion of articles in both Burns (63.6%) and Journal of Burn Care and Research (43.7%), with Burns publishing a higher proportion of these than Journal of Burn Care and Research (p < 0.001). From 1982 to 2008, when articles from both journals were considered together there were significant increases in the proportion of randomised controlled trials (0 (0%) to 10 (9%); p < 0.001) and controlled clinical trials (0 (0%) to 1 (1%); p < 0.001). There were no significant changes in the proportion of comparative studies (11 (44%) to 28 (16%); p = 0.846) or case series/reports (14 (56%) to 71 (65%); p = 0.448).

Discussion

The burn care literature suffers from a relative shortage of high-quality evidence. More randomised controlled trials are warranted.     

Consensus guidelines for validation of virtual reality surgical simulators

The Work Group for Evaluation and Implementation of Simulators and Skills Training Programmes is a newly formed sub-group of the European Association of Endoscopic Surgeons (EAES). This work group undertook a review of validation evidence for surgical simulators and the resulting consensus is presented in this article. Using clinical guidelines criteria, the evidence for validation for six different simulators was rated and subsequently translated to a level of recommendation for each system. The simulators could be divided into two basic types; systems for laparoscopic general surgery and flexible gastrointestinal endoscopy. Selection of simulators for inclusion in this consensus was based on their availability and relatively widespread usage as of July 2004. Whilst level 2 recommendations were achieved for a few systems, it was clear that there was an overall lack of published validation studies with rigorous experimental methodology. Since the consensus meeting, there have been a number of new articles, system upgrades and new devices available. The work group intends to update these consensus guidelines on a regular basis, with the resulting article available on the EAES website ( ). Sponsored by the EAES Work Group for Evaluation and Implementation of Simulators and Skills Training Programmes, residing under the European Association for Endoscopic Surgery     

A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill

BACKGROUND: Studies have demonstrated the beneficial effect of training novice laparoscopic surgeons using virtual reality (VR) simulators, although there is still no consensus regarding an optimal VR training curriculum. This study aims to establish and validate a structured VR curriculum to provide an evidence-based approach for laparoscopic training programmes. METHODS: The minimally invasive VR simulator (MIST-VR) has 12 abstract laparoscopic tasks, each at 3 graduated levels of difficulty (easy, medium, and hard). Twenty medical students completed 2 sessions of all tasks at the easy level, 10 sessions at the medium level, and finally 5 sessions of the 2 most complex tasks at the hard level. At the medium level, subjects were randomized into 2 equal groups performing either all 12 tasks (group A) or the 2 most complex tasks (group B). Performance was measured by time taken, path length, and errors for each hand. The results were compared between groups, and to those of 10 experienced laparoscopic surgeons. RESULTS: Baseline performance of both groups was similar at the easy level. At the medium level, learning curves for all 3 parameters reached plateau at the second (group A, P < .05) and sixth (group B, P < .05) repetitions. Performance at the hard level was similar between the 2 groups, and all achieved the pre-set expert criteria. CONCLUSION: A graduated laparoscopic training curriculum enables trainees to familiarise, train and be assessed on laparoscopic VR simulators. This study can aid the incorporation of VR simulation into established surgical training programmes.     

Impact of COVID-19 on global burn care

BackgroundWorldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care.MethodsThe Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher’s exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic.ResultsThe survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors.ConclusionsDuring the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.     

虚拟现实技术构建岩骨三维解剖模型

目的 利用虚拟现实技术构建岩骨三维解剖模型,探讨其应用价值.方法 对15例尸头进行CT平扫.获得DICOM数据利用虚拟现实技术进行图像三维重建,提取并重建岩骨表面、听骨链等骨性结构三维图像,利用反转图像强度技术获得岩骨骨管和压迹内结构三维图像.在虚拟影像中测量膝状神经节、耳蜗、颈内动脉、颈静脉球、内听道外口之间距离.结果 虚拟现实三维影像能直观清楚地显示岩骨内神经、血管和骨性结构的空间关系,三维影像数据测量方便快捷,不受死角限制.结论 虚拟现实系统所构建岩骨三维解剖模型,可视化效果良好并可测量解剖数据.