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立体光刻技术在颅面骨置换规划中的准确性。

The accuracy of stereolithography in planning craniofacial bone replacement.

作者信息

Chang Peter Shih-Hsin, Parker Thornwell H, Patrick Charles W, Miller Michael J

机构信息

Division of Plastic Surgery, Department of Surgery, Mackey Memorial Hospital, Taipei, Taiwan.

出版信息

J Craniofac Surg. 2003 Mar;14(2):164-70. doi: 10.1097/00001665-200303000-00006.

Abstract

Stereolithography can be used to produce physical models of the craniofacial skeleton from three-dimensional computed tomography (CT) data. The purpose of this study was to assess its accuracy for modeling osseous defects of the midface. Maxillary resections simulating unilateral maxillectomy (N = 3), bilateral maxillectomy (N = 3), and unilateral orbitomaxillectomy (N = 3) were performed as for sinus tumor resection on nine fresh cadaver skulls. Stereolithographic models (SLMs) were made from the specimen's CT data. The accuracy of SLMs was determined by comparing distances between key landmarks on the skulls and SLMs. Each SLM was grossly accurate with some loss of thin delicate structures. The mean differences in overall dimensions between the SLMs and skull specimens were 1.5 mm (range: 0-5.5 mm) for craniofacial measures, 1.2 mm (range: 0-4.8 mm) for skull base measures, 1.6 (range: 0-5.8 mm) for midface measures, 1.9 mm (range: 0-7.9 mm) for maxilla measures, and 1.5 mm (range: 0-5.7 mm) for orbital measures. The mean differences in defect dimensions were 1.9 mm (range: 0.1-5.7 mm) for unilateral maxillectomy, 0.8 mm (range: 0.2-1.5 mm) for bilateral maxillectomy, and 2.5 mm (range: 0.2-7.0 mm) for orbitomaxillectomy defects. Midface SLMs may be more prone to error than those of other craniofacial regions because of the presence of thin walls and small projections. Thus, one should consider designing midface bone replacements that are larger in critical dimensions than those predicted by preoperative modeling. These findings have important implications for the planning of current surgical methods as well as future applications of tissue-engineered bone replacement.

摘要

立体光刻技术可用于根据三维计算机断层扫描(CT)数据制作颅面骨骼的物理模型。本研究的目的是评估其在模拟面中部骨缺损建模方面的准确性。在九个新鲜尸体头骨上进行了模拟单侧上颌骨切除术(N = 3)、双侧上颌骨切除术(N = 3)和单侧眶上颌骨切除术(N = 3)的上颌骨切除术,如同鼻窦肿瘤切除术一样。根据标本的CT数据制作了立体光刻模型(SLM)。通过比较头骨和SLM上关键标志点之间的距离来确定SLM的准确性。每个SLM总体上是准确的,但一些薄而精细的结构有所缺失。SLM与头骨标本在整体尺寸上的平均差异为:颅面测量为1.5毫米(范围:0 - 5.5毫米),颅底测量为1.2毫米(范围:0 - 4.8毫米),面中部测量为1.6毫米(范围:0 - 5.8毫米),上颌骨测量为1.9毫米(范围:0 - 7.9毫米),眼眶测量为1.5毫米(范围:0 - 5.7毫米)。缺损尺寸的平均差异为:单侧上颌骨切除术为1.9毫米(范围:0.1 - 5.7毫米),双侧上颌骨切除术为0.8毫米(范围:0.2 - 1.5毫米),眶上颌骨切除术缺损为2.5毫米(范围:0.2 - 7.0毫米)。由于存在薄壁和小突起,面中部的SLM可能比其他颅面区域更容易出现误差。因此,在设计面中部骨替代物时,应考虑在关键尺寸上比术前建模预测的尺寸更大。这些发现对当前手术方法的规划以及组织工程骨替代物的未来应用具有重要意义。

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