虚拟喉镜构建在先天性梨状窝瘘中的应用

目的：介绍一种构建虚拟喉镜（VL）的方法及其在先天性梨状窝瘘（CPSF）诊治中的临床应用。方法：从CPSF患儿身上获取CT数据，使用三维可视化软件对喉部解剖结构及上呼吸道进行三维重建、表面渲染及图像分割。获取计算机辅助的内外部解剖视图和交互式穿通连续的内腔视图。结果：成功构建CPSF患儿三维喉部和上呼吸道解剖结构。获取VL梨状窝的常规视图与传统喉镜视图比较情况。LV能够在逆行和顺行可视化中获得梨状窝的独特视图。分割和透明化三维解剖模型，能显示CPSF解剖结构和走向以及与周围器官的空间关系。在低年资组中，其有利于诊断的比例为85.71%，而在高年资组中，其有利于诊断的比例为57.89%（P ＜0.05）；在低年资组和高年资组中，其有利于术中解剖参考的比例分别为89.29%和84.21%（P ＞0.05）。结论：VL作为评估CPSF及其范围的非侵入性工具具有潜在临床应用价值。结合二维图像，可为CPSF的诊治提供超越传统内窥镜检查的信息。VL可能对低年资医师的参考价值更大。

Application of virtual laryngoscope construction in congenital pyriform sinus fistula

Objective: To introduce a method of constructing virtual laryngoscopy (VL) and its clinical application in the diagnosis and treatment of congenital pyriform sinus fistula (CPSF). Methods: CT data were obtained from children with CPSF. Three-dimensional reconstruction, surface rendering and image segmentation of laryngeal anatomical structure and upper respiratory tract were performed by using three-dimensional visualization software. Obtain computer-aided internal and external anatomical views and interactive penetrating continuous internal cavity views. Results: Three-dimensional laryngeal and upper respiratory tract anatomical structures of children with CPSF were successfully constructed. Obtain the comparison between the conventional view of the VL pyriform sinus and the traditional laryngoscope view. A unique view of the pyriform sinus that can be obtained in retrograde and antegrade visualization. Segmentation and transparency of the three-dimensional anatomical model can show the anatomical structure and orientation of CPSF as well as the spatial relationship with surrounding organs. The feedback from the use of virtual laryngoscope showed that: in the junior group,the rate conducive to diagnosis was 85.71%, and the rate of advantage for guiding intraoperative anatomy was 89.29%; while in the senior group, its conducive diagnosis rate was 57.89%, and the advantage rate for guiding intraoperative anatomy was 84.21%. Conclusion: VL has potential clinical application value as a non-invasive tool for evaluating CPSF and its scope. Combined with two-dimensional images, it can provide information beyond traditional endoscopy for the diagnosis and treatment of CPSF. VL may have a greater reference value for junior doctors.