眼眶爆裂性骨折修复术中3D打印技术应用的效果观察

目的:观察眼眶爆裂性骨折修复手术中应用3D打印技术的效果。方法:回顾性分析北京大学国际医院2016年7月至2017年12月眼眶爆裂性骨折13例的临床资料。术前根据CT扫描的数据行三维重建,获得患侧眶壁骨折区的模型,依照对侧正常眶壁形状,通过镜像技术,获得患侧眶壁骨折区的解剖修复形状指导片模型,使用3D打印机打印眶骨折区和修复形状指导片模型。以此为模板,在手术中指导修复材料的塑形,使之契合骨折区,修复眶骨折。术后观察效果。结果:本组13例术后CT显示骨折修复效果满意,修复材料与骨折区契合,术后无视力下降,术后3个月双眼球突出度之差为(0.54±0.78)mm,5例术前复视者中1例残留轻微复视,其余4例恢复良好。结论:3D打印技术用于指导修复模片,能使眼眶骨折达到满意的修复效果。

Observation on the efficacy of application of 3D printing technique in repair surgery for the orbital blowout fracture

Objective To observe the efficacy of application of 3D printing technique in repair surgery for orbital blowout fracture.Methods A retrospective study.The clinical data of 13 patients with orbital blowout fracture from Jul.2016 to Dec.2017 in Peking University International Hospital were analyzed.All patients received thin-slice spiral CT scanning.The data were used to three-dimensional reconstruction and obtained the model of orbital wall fracture.With mirror image repair technique,the fracture area of the affected side was reconstructed with the normal orbital wall shape of the opposite side.The model of fractured orbit and the patch of repair model with individualized shape were printed with 3D printer which was used as template to guide bioresorbable plate shaping during the surgery.The orbital fracture was repaired with the after-shaping bioresorbable plate which accorded with the anticipated anatomical shape.The efficacy of repair was observed after the surgery.Results The postoperative CT showed that the efficacy of fracture repair was satisfactory and the repair matereial fitted well with fracture area.All patients had no visual impairment after surgery.The average measurement of enophthalmometric was(0.54±0.78)mm.Among 5 cases with diplopia before surgery,4 cases recovered completely and only 1 case had residual slight peripheral diplopia.Conclusion Application of 3D printing technique to guide and repair orbital fracture can achieve satisfactory repair effect.