三维软硬组织模拟与虚拟截骨导板在牵张成骨中的应用:附1例报告

目的:探讨三维软硬组织模拟以及应用虚拟截骨导板将手术设计转移至牵张成骨术的效果.方法:将患者全头颅三维CT扫描数据以DICOM格式输入surgiCase CMF 4.0软件,重建颅面骨三维影像.在计算机三维头颅影像中模拟截骨,通过预测不同方向牵张后软硬组织的三维改变,确定合理的截骨线及牵张器位置;利用快速原型(rapid意prototyping,RP)技术制作虚拟截骨导板,指导术中截骨和牵张器安置.结果:在实际手术中,导板与下颌骨表面贴合良好,根据导板引导孔钻孔,确定牵张器及截骨线位置.牵引完成后,面形改变与术前软件预测吻合程度高.结论:计算机辅助设计软件和快速原型截骨导板的应用,使牵张成骨手术的设计更加直观方便,并能够将设计精确转移到实际手术中,术前预测与术后实际吻合度高,提高了手术精密度,具有一定的临床应用前景.

Three-dimensional simulation and virtual osteotomy guide for distraction osteogenesis in a case with hemifacial microsomia

PURPOSE： This study is aimed to evaluate the application of three-dimensional simulation and virtual osteotomy guide in distraction osteogenesis. METHODS： Three-dimensiunal virtual skull was reconstructed from CT data with SurgiCase CMF 4.0 software and virtual osteotomy was pertbrmed on the virtual mandible.A reasonable location of osteotomy line and distraction device was obtained by predicting the virtual morphological change in varied distraction directions.The virtual plan was brought to real time surgery using a rapid prototyping guide. RESULTS： The virtual osteotomy guide matched the ramus directly during operation. The postoperative images was consistent with the preoperative prediction. CONCLUSIONS： Computer-aided design and virtual usteutomy guide for distraction osteogenesis make the surgery plan visualized and transferation of the virtual surgical planning to real time operation precisely.