基于面部三维重建模型设计个性化外壳在面部下颏填充整形术中的应用

目的探讨通过红外线、自然光扫描技术、三维重建技术及快速成形技术制作个性化外壳的方法,为自体脂肪颏部填充术提供客观精确的手术辅助及参考。方法自2018年11月至2019年6月对收治的39例下颏短小患者随机分为对照组(19例)和观察组(20例)。对照组根据医师的临床经验采用传统的自体脂肪填充术;观察组通过手持式三维扫描仪采集患者面部信息重建面部三维模型,并在此基础上设计术后形态,利用三维打印等快速成形技术制作个性化三维透明外壳并消毒备用。行面部填充术时将其置于术区表面,在外壳的引导下手术。术后6个月,使用李克特量表采集两组患者的满意度,使用t检验比较两组术中自体脂肪利用率、患者满意度和手术时间。结果术后6个月与对照组相比,观察组患者达预期整形效果的满意度均高于对照组,其差异具有统计学意义(P<0.05);手术并发症及生活质量满意度比较,其差异无统计学意义(P>0.05)。观察组自体脂肪利用率(平均91%)大于对照组(平均71%),其差异具有统计学意义(P<0.05)。两组手术时间比较,其差异无统计学意义(P>0.05)。术后面部手术效果较好。获随访6个月,无并发症发生。结论制作面部个性化外壳能够更客观地指导自体脂肪颏部填充术,满足患者和医师对个性化的要求,为术后效果评估提供量化依据,同时能提高患者的满意度及自体脂肪利用率。

Application of personalized shell based on facial three-dimensional reconstruction model in chin filling

Objective To explore the method of making personalized shell by infrared ray, natural light scanning technology,three-dimensional(3D) reconstruction technology and rapid prototyping technology, so as to provide objective and accurate surgical assistance and reference for chin filling with autologous fat grafting. Methods From November 2018 to June 2019, 39 patients with microgenia were randomly divided into control group(19 patients) and observation group(20 patients). The traditional autologous fat grafting based on the clinical experience of the surgeon was adopted in the control group. In the observation group, the hand-held 3D scanner was used to collect the facial information of patients to reconstruct the 3D model of the face. The postoperative morphology was designed on the basis of 3D model of the face. A personalized 3D transparent shell was made and sterilized for future use. It was placed on the surface of the surgical area during the facial filling. The surgery was performed under the guidance of the shell. Six months after operation, the Likert scale was used to collect the patients’ satisfaction of both groups. The intraoperative autologous fat utilization rate, patients’ satisfaction and operation duration was compared by t test. Results The satisfaction of patients in the observation group was higher than that in the control group at 6 months after operation, the difference was statistically significant(P<0.05). There was no significant difference in surgical complications and quality of life between two groups(P>0.05). The average value of autologous fat utilization rate of the observation group was 91% and the control group was 71%, the difference was statistically significant(P<0.05). There was no statistically significant difference in operation duration(P>0.05). The efficacy after operation was good. No complications occurred during the follow-up period of 6 months. Conclusion Making the personalized shell could objectively guide the chin filling by autologous fat grafting, meet the personalized requirements of patients and doctors, provide a quantitative basis for the evaluation of postoperative efficacy and improve patients’ satisfaction and autologous fat utilization rate.