Santa Marcelina Hospital, São Paulo, Brazil.
EDUCSIM Institute, São Paulo, Brazil.
Neurosurg Rev. 2021 Jun;44(3):1767-1774. doi: 10.1007/s10143-020-01361-9. Epub 2020 Aug 8.
Congenital transsphenoidal encephalocele (CTE) surgical correction is a challenging procedure. Although rare, this anomaly, characterized with neural herniation elements, including the pituitary gland or optic pathway through the sphenoid bone with anatomical alteration, can be presented in many different ways and should be individually analyzed. Significant advances in medical technology and the 3D models may simulate the complex anatomical relations of the human body. Nowadays, medical education relies on the availability of standardized materials that can reliably emulate human anatomy. Therefore, realistic anatomical models have become an alternative for cadavers or animal specimens. In this technical note, the authors present a new technique to create personalized models that combine 3D printing, molding, and casting to create an anatomically and tactilely realistic model based on magnetic resonance and computerized tomography images. Produced from different silicon types, the model recreated the anatomic alterations precisely, allowing a multidisciplinary team to determine the adequate surgical approach for this patient. We describe a case of congenital transsphenoidal encephalocele of a 3-year-old boy, whose surgical correction was planned using a hybrid model. The technical description of the model is given in detail. This new hybrid model allowed a detailed discussion of the surgical approach aspects by having tissues of different consistencies and resistances and a very high prediction rate. This approach may allow a reduction in surgery time and possible complications after operative procedures.
先天性经蝶窦脑膨出（CTE）的手术矫正具有挑战性。尽管罕见，但这种异常表现为神经疝出，包括通过蝶骨的垂体或视路，伴有解剖学改变，可能有多种不同的表现，需要单独分析。医学技术的显著进步和 3D 模型可以模拟人体的复杂解剖关系。如今，医学教育依赖于可用的标准化材料，这些材料可以可靠地模拟人体解剖结构。因此，逼真的解剖模型已成为尸体或动物标本的替代品。在本技术说明中，作者提出了一种新的技术，可将 3D 打印、模塑和铸造相结合，根据磁共振和计算机断层扫描图像创建具有解剖学和触觉逼真的个性化模型。该模型由不同类型的硅制成，可精确再现解剖学改变，使多学科团队能够为该患者确定合适的手术方法。我们描述了一个 3 岁男孩先天性经蝶窦脑膨出的病例，该病例使用混合模型来规划手术矫正。详细介绍了模型的技术描述。这种新的混合模型允许对手术方法进行详细讨论，包括不同硬度和阻力的组织，以及非常高的预测率。这种方法可能会减少手术时间和手术操作后可能出现的并发症。
