3D打印联合影像导航技术辅助内镜下鼻颅底肿瘤切除病例分析

目的探讨3D打印联合影像导航技术在内镜鼻颅底外科治疗中的应用。方法回顾性分析2015年8月至2016年2月由同一术者实施的3D打印联合影像导航系统辅助下内镜鼻颅底手术5例患者的临床资料,术前完成导航准备及3D模型打印,根据影像导航和3D模型指导完成手术,并进行术后处理及随访。结果本组5例鼻颅底肿瘤患者均顺利完成手术,其中,4例行肿瘤全切术,1例中颅窝底脊索瘤患者行减瘤术。术后随访4~12个月,1例肿瘤全切术者因脑脊液鼻漏并颅内感染,最后因动脉瘤破裂死亡,减瘤术者未见肿瘤增长,余3例患者均未见肿瘤复发。结论应用3D打印联合影像导航技术辅助内镜治疗鼻颅底肿瘤可以减少术中并发症及副损伤,符合精准医疗理念。

3D printing combined with image navigation technology assisting endoscopic nasal skull base tumor resection:cases analysis

Objective To investigate the feasibility of 3D printing and image navigation technology in endoscopic nasal skull base sur-gery . Methods A retrospective study was performed by the same surgeon on 5 patients who underwent the endoscopic surgery assisted by 3D printing and the image navigation system from August 2015 to February 2016. Image navigation system and 3D model printing were prepared before surgery,and to be a guide to finish the operation,and follow-up results were analysed. Results This group of 5 patients with nasal skull base tumor were successfully completed surgery. Among the patients,there were 4 cases of total resection,and 1 case of middle skull base chordoma cytoreductive surgery. Postoperative follow-up was carried out for 4-12 months. One case devel-oped cerebrospinal fluid leak and intracranial infection and died in aneurysm rupture,the other 3 cases were not recurrent. The tumor in patient that underwent cytoreductive surgery did not develop. Conclusion 3D printing combined with image navigation technology in endoscopic nasal skull base surgery can reduce the intraoperative complications and vice injury,which conforms to the characteris-tics of precision medical treatment.