Liptak Julius M, Thatcher Graham P, Bray Jonathan P
J Am Vet Med Assoc. 2017 Apr 15;250(8):900-908. doi: 10.2460/javma.250.8.900.
CASE DESCRIPTION A 12-year-old neutered male domestic shorthair cat had been treated for a mass arising from the lingual aspect of the caudal right mandibular body. Cytoreductive surgery of the mass had been performed twice over a 2-year period, but the mass recurred following both surgeries. The mass was diagnosed as an osteosarcoma, and the cat was referred for further evaluation and treatment. CLINICAL FINDINGS Clinical findings were unremarkable, except for a 2-cm-diameter mass arising from the lingual aspect of the right mandible and mild anemia and lymphopenia. Pre- and postcontrast CT scans of the head, neck, and thorax were performed, revealing that the osteosarcoma was confined to the caudal right mandibular body, with no evidence of lymph node or pulmonary metastasis. TREATMENT AND OUTCOME The stereolithographic files of the CT scan of the head were sent for computer-aided design and manufacture of a customized 3-D-printed titanium prosthesis. Segmental mandibulectomy was performed, and the mandibular defect was reconstructed in a single stage with the 3-D-printed titanium prosthesis. The cat had 1 minor postoperative complication but had no signs of eating difficulties at any point after surgery. The cat was alive and disease free 14 months postoperatively. CLINICAL RELEVANCE Reconstruction of the mandible of a cat following mandibulectomy was possible with computer-aided design and manufacture of a customized 3-D-printed titanium prosthesis. Cats have a high rate of complications following mandibulectomy, and these initial findings suggested that mandibular reconstruction may reduce the risk of these complications and result in a better functional outcome.
病例描述 一只12岁已绝育的雄性家养短毛猫因右下颌骨体尾侧舌面出现肿物而接受治疗。在两年时间里对该肿物进行了两次减瘤手术,但两次手术后肿物均复发。该肿物被诊断为骨肉瘤,这只猫被转诊以进行进一步评估和治疗。
临床发现 临床检查结果无异常,只是右下颌骨舌面有一个直径2厘米的肿物,伴有轻度贫血和淋巴细胞减少。对头、颈和胸部进行了增强CT扫描,结果显示骨肉瘤局限于右下颌骨体尾侧,没有淋巴结或肺转移的迹象。
治疗与结果 头部CT扫描的立体光刻文件被送去进行计算机辅助设计,并制造定制的3D打印钛假体。实施了节段性下颌骨切除术,并用3D打印钛假体一次性重建下颌骨缺损。这只猫术后有1个轻微并发症,但术后任何时候都没有进食困难的迹象。术后14个月,这只猫存活且无疾病。
临床意义 通过计算机辅助设计和制造定制的3D打印钛假体,可以对猫下颌骨切除术后的下颌骨进行重建。猫下颌骨切除术后并发症发生率很高,这些初步研究结果表明下颌骨重建可能会降低这些并发症的风险,并产生更好的功能结果。