Zeng Hui, Yuan-Liang Shih, Xie Gan, Lu Feng, Fu Rong
Department of Infectious Disease, Sichuan Provincial People's Hospital, Chengdu, Sichuan.
Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong.
Medicine (Baltimore). 2019 Jan;98(2):e12919. doi: 10.1097/MD.0000000000012919.
Facial contouring is a complex procedure performed to alter tissue contents and restore facial appearance. However, it is difficult to measure the amount of the tissue volume that is needed. This study demonstrated the use of preoperative computer simulation (PCS) and 3-dimensional (3D) printing in contouring procedure to maximize outcomes.Three-dimensional surface imaging (3DSI) or computed tomography imaging (CTI) data were reconstructed into a 3D model by Mimics software. PCS was performed by simulating the changes in bone and soft tissue. The stimulating volume change was calculated by Boolean operations. Finally, the virtual model was exported into 3D printer to produce physical templates to guide surgical plan. PCS and actual postoperative results were compared using objective rating scales and by cephalometrical measurements.With the direct guidance of PCS and 3D templates, contouring procedure was performed accurately. Satisfactory facial contouring was achieved with less operative time. As the plastic surgery panel rated, 45.8% of the 3DSI results and 41.7% of the CTI results were identical with the actual outcome, and 0% of them was poor. There were no significant differences in patient satisfaction between the PCS of 3DSI and CTI.Preoperative computer simulation is an accurate method for designing contour adjustment plans, and can be an efficient and reliable predictor of outcomes with customized templates.
面部轮廓整形是一项用于改变组织成分和恢复面部外观的复杂手术。然而，测量所需组织体积的量却很困难。本研究展示了术前计算机模拟（PCS）和三维（3D）打印在轮廓整形手术中的应用，以实现最佳效果。通过Mimics软件将三维表面成像（3DSI）或计算机断层扫描成像（CTI）数据重建为三维模型。通过模拟骨骼和软组织的变化来进行PCS。刺激体积变化通过布尔运算计算得出。最后，将虚拟模型导入3D打印机以制作物理模板，用于指导手术方案。使用客观评分量表并通过头影测量比较PCS和实际术后结果。
在PCS和3D模板的直接指导下，轮廓整形手术得以精确进行。手术时间缩短，实现了令人满意的面部轮廓整形效果。根据整形手术小组的评分，3DSI结果中有45.8%、CTI结果中有41.7%与实际结果一致，且无一结果较差。3DSI和CTI的PCS在患者满意度方面无显著差异。术前计算机模拟是设计轮廓调整方案的准确方法，并且可以通过定制模板成为结果的高效可靠预测指标。
