Zheng Jia-Ping, Li Chu-Zhong, Chen Guo-Qiang, Song Gui-Dong, Zhang Ya-Zhuo
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery Center, Aviation General Hospital of China Medical University, Beijing, China.
World Neurosurg. 2018 Mar;111:e773-e782. doi: 10.1016/j.wneu.2017.12.169. Epub 2018 Jan 5.
Transnasal endoscopic skull base surgery (SBS) presents a major challenge for inexperienced neurosurgeons because of the complicated anatomic structures, 2-dimensional endoscopic view, limited operative field, and required skills. We designed a personalized multimaterial and multicolor three-dimensional (3D)-printed SBS simulation to reproduce the complex anatomy of the skull base. The fidelity and feasibility for anatomic education and surgical training were assessed.
Two-dimensional computer tomography and magnetic resonance images were collected from a 42-year-old healthy male volunteer. After 3D modeling and spatial alignment, personalized SBS simulations were produced using a multimaterial 3D printer. The fidelity of the models was assessed by 3 experienced neurosurgeons, and the effects for anatomic education and surgical training were evaluated by 10 resident trainees. Both evaluations were based on 5-point Likert questionnaires.
The mean scores for fidelity of tissue structure ranged from 3.7 to 4.7, and scores for aid in anatomic education and surgical training ranged from 3.5 to 4.9.
The 3D-printed SBS simulation is a practical, economical, high-fidelity model. It has great potential for anatomic education and operative training in transnasal endoscopic surgery.
经鼻内镜颅底手术（SBS）对于经验不足的神经外科医生来说是一项重大挑战，因为其解剖结构复杂、二维内镜视野、手术视野有限以及所需技能要求高。我们设计了一种个性化的多材料多色三维（3D）打印的SBS模拟模型，以重现颅底的复杂解剖结构。评估了其在解剖学教育和手术培训方面的逼真度和可行性。
从一名42岁健康男性志愿者收集二维计算机断层扫描和磁共振图像。经过3D建模和空间对齐后，使用多材料3D打印机制作个性化的SBS模拟模型。由3名经验丰富的神经外科医生评估模型的逼真度，由10名住院医师培训学员评估其在解剖学教育和手术培训方面的效果。两项评估均基于5点李克特问卷。
组织结构逼真度的平均得分在3.7至4.7之间，在解剖学教育和手术培训辅助方面的得分在3.5至4.9之间。
3D打印的SBS模拟模型是一种实用、经济、高逼真度的模型。它在经鼻内镜手术的解剖学教育和手术培训方面具有巨大潜力。
