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额筛部脑膜脑膨出手术的多材料3D打印术前规划

Multimaterial 3D printing preoperative planning for frontoethmoidal meningoencephalocele surgery.

作者信息

Coelho Giselle, Chaves Thailane Marie Feitosa, Goes Ademil Franco, Del Massa Emilio C, Moraes Osmar, Yoshida Maurício

机构信息

Department of Neurosurgery, Santa Marcelina Hospital, Rua Martiniano de Carvalho, 548/apto 121-Bela Vista, Sao Paulo, SP, 01321-001, Brazil.

SIEDI Institute, Sao Paulo, Brazil.

出版信息

Childs Nerv Syst. 2018 Apr;34(4):749-756. doi: 10.1007/s00381-017-3616-6. Epub 2017 Oct 24.

Abstract

INTRODUCTION

Surgical correction of frontoethmoidal meningoencephalocele, although rare, is still challenging to neurosurgeons and plastic reconstructive surgeons. It is fundamental to establish reliable and safe surgical techniques. The twenty-first century has brought great advances in medical technology, and the 3D models can mimic the correct tridimensional anatomical relation of a tissue organ or body part. They allow both tactile and spatial understanding of the lesion and organ involved. The 3D printing technology allows the preparation for specific surgery ahead of time, planning the surgical approach and developing plans to deal with uncommon and high-risk intraoperative scenarios.

CASE PRESENTATION

The present report describes a case of frontoethmoidal encephalocele, (nasofrontal subtype) of a 19-month-old girl, whose surgical correction was planned using 3D printing modeling.

CONCLUSION

The 3D model allowed a detailed discussion of the aspects of the surgical approach by having tissues of different consistencies and resistances, and also predicting with millimetric precision the bilateral orbitotomy measurements. Moreover, it was a fundamental and valuable factor in the multidisciplinary preoperative discussion. This approach allowed reducing the time of surgery, accurately planning the location of the osteotomies and precontouring the osteosynthesis material. 3D models can be very helpful tools in planning complex craniofacial operative procedures.

摘要

引言

额筛部脑膨出的手术矫正虽然罕见,但对神经外科医生和整形重建外科医生来说仍然具有挑战性。建立可靠且安全的手术技术至关重要。21世纪医学技术取得了巨大进步,三维(3D)模型能够模拟组织器官或身体部位正确的三维解剖关系。它们能让人们从触觉和空间上了解所涉及的病变和器官。3D打印技术能提前为特定手术做好准备,规划手术入路,并制定应对罕见及高风险术中情况的方案。

病例报告

本报告描述了一名19个月大女孩的额筛部脑膨出(鼻额型)病例,其手术矫正计划采用3D打印建模。

结论

3D模型通过呈现不同质地和阻力的组织,使手术入路的各个方面得到了详细讨论,还能以毫米级精度预测双侧眶切开术的测量数据。此外,它在多学科术前讨论中是一个重要且有价值的因素。这种方法有助于缩短手术时间,精确规划截骨位置并对骨合成材料进行预塑形。3D模型在规划复杂的颅面手术操作中可能是非常有用的工具。

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