仿活体尸头模型的建立及导航辅助鼻内镜下解剖训练

目的自制仿活体的人尸头解剖模型,利用该模型,进行影像导航辅助鼻内镜下解剖训练,以提高鼻科医生手术技能,加深对影像学的理解。方法首先建立仿活体手术尸头解剖模型。解剖出尸头的颈总动脉及颈内静脉,分别给予仿人体动、静脉血液灌注,使血管内有"血液"充盈。在此模型基础上,影像导航辅助鼻内镜下进行鼻腔、鼻窦及前颅底解剖,首先对各解剖标志进行定位,辨认;当动脉解剖暴露时,可见血管内有血液充盈,受到损伤时,有血液喷出,在此情形下,可进行止血训练,比较接近真实的手术情景。结果 (1)通过对人尸头颈部血管灌注,建立仿活体手术尸头解剖模型。(2)仿活体手术尸头解剖训练达到了接近活体的术野情景。(3)解剖定位准确,加深对影像学的理解。结论仿活体手术尸头解剖模型的建立及影像导航辅助鼻内镜下解剖训练为鼻内镜下解剖训练提供了更加真实有效的方式。

The establishment of cadaver head model that simulates living surgery for nasal endoscopic surgery training under image guided navigation system

Objective　To establish a novel cadaver head model and do dissection in this model that simulates the living surgery. The objective is to use this model for nasal endoscopic surgical training under image guided navigation system (IGNS) and to improve rhinologist's surgical dissection skills.　Methods　We established a cadaver head model that simulates the living surgery. The common carotid arteries (CCA) and the internal jugular veins (JV) were exposed on the model. We connected a "heart-like" pump to the cadaver head, using plastic tube filled  with artificial blood (red fluid for arterial blood, blue fluid for venous blood. The pump rate and presser mimicked human conditions.) The blood flows from the CCA on the other side through the arterial circle in the skull base. When a blood vessel is cut in a dissection training session, the bleeding of the blood vessel can be stopped by bipolar diathermy or mono polar diathermy at the time of the dissection just as that in the living surgery.　Results　The cadaver head model creates a very realistic dissection scenario. We could distinguish the anatomical landmarks, and have a deeping understanding of the imaging.　Conclusions　This novel cadaver head model which simulates living surgery provides better nasal endoscopic surgery training with or without IGNS. This also made the nasal endoscopic dissection training significantly move forward. This model could be beneficial for all types of surgical training in the future with or without IGNS, not just nasal endoscopic surgical training.