计算机辅助设计个性化硅橡胶及钛网制作缺损颅骨补片模型的比较

目的:观察嵌入性修补材料和覆盖性修补材料个性化修补颅骨缺损的效果.方法:回顾性分析80例颅骨缺损患者,选用了计算机辅助设计个性化硅橡胶及钛网制作缺损颅骨补片模型,经患者认可后植入修补.调查手术并发症发生率及患者对塑形的满意度.结果:80例中采用嵌入性修补材料(硅橡胶)35例、覆盖性修补材料(钛网)45例,补片与颅骨均完整适配.93.7%(75例)患者认为基本或完全恢复了原有颅骨形状.硅橡胶组发生头痛3例,钛网组发生头痛2例,硅橡胶组术后出现积液9例,钛网组术后出现积液3例,硅橡胶组出现松动及移位2例.结论:以计算机辅助设计个性化修补材料,应根据患者颅骨缺损部位和特点,选择不同的修补材料.对美观要求高的部位建议应用嵌入性修补材料;对于缺损面积较大,美观要求相对较低的部位建议应用生物相容性较好的钛网修补材料,实现了按人配置的目的,能够恢复缺损部位的生理原貌,达到自然的外观效果.

Comparison between individualized methyl silicon rubber and titanium mesh for establishing a cranial defect patch model

OBJECTIVE: To compare the clinical effect of imbedded and coated biomaterials on repairing cranial defect. METHODS: A total of 80 patients with cranial defect were analyzed retrospectively. Computer aided design was used to make individualized methyl silicon rubber and titanium mesh which were used to establish cranial defect patch model. With patients' consent, the individualized patch models were implanted to repair the cranial defect. Incidence of complication and satisfaction of moulding were investigated after implantation. RESULTS: Among 80 patients, cranial defect of 35 cases was repaired using imbedded materials (methyl silicon rubber) and cranial defect of 45 cases was repaired using coated materials (titanium mesh). The individualized patch highly matched to cranium. The cranium of 75 patients (93.7%) was generally or completely recovered. Three patients had headache in the methyl silicone rubber group, and 2 in the titanium mesh group. Additionally, 9 patients had effusion in the methyl silicone rubber group, and 3 in the titanium mesh group. Loosening and displacement were observed in 2 patients in the methyl silicone rubber group. CONCLUSION: Computer aided design was used to individualize the repairing materials based on the location and characteristics of the cranial defect. Imbedded materials were approached physiological shape while titanium mesh was satisfied for large defect region and poor physiological shape. Therefore, the individualized materials benefited for human demands and recovery of physiological shape.