Ueda Koichi, Kino Hiromi, Katayama Misato, Hirota Yuka
Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.
Plast Reconstr Surg Glob Open. 2020 Aug 19;8(8):e3072. doi: 10.1097/GOX.0000000000003072. eCollection 2020 Aug.
We made realistic, three-dimensional, computer-assisted 3-layered elastic models of the face. The surface layer is made of polyurethane, the intermediate layer is silicone, and the deep layer is salt, representing the skin, subcutaneous tissue, and the bone. We have applied these 3-layer models to congenital anomaly cases and have understood that these models have a lot of advantages for simulation surgery.
We made 8 models. The models consisted of 2 models of 2 cases with Crouzon disease, 1 model of Binder syndrome, 1 model of facial cleft, 2 models of one case with Goldenhar syndrome, 1 model of cleft lip and palate, and 1 model of the hemifacial macrosomia.
We could try several methods, could recognize whether the graft size is adequate, and could visualize the change of the facial contour. We could analyze how to approach the osteotomy line and actually perform osteotomy. The changes of the lower facial contour can be observed. We grafted the models of the graft and confirmed that the incisions could be closed well. We were able to visualize the change in the soft tissue contour by simulating distraction.
The most versatile merit of our models is that we could visualize the change of the soft tissue by movement of the hard tissue with bone graft, distraction osteogenesis, and so on. We must improve the model further to make it more realistic.
我们制作了逼真的三维计算机辅助面部三层弹性模型。表层由聚氨酯制成,中间层是硅胶,深层是盐,分别代表皮肤、皮下组织和骨骼。我们已将这些三层模型应用于先天性异常病例,并了解到这些模型在模拟手术方面有很多优势。
我们制作了8个模型。这些模型包括2例克鲁宗病的2个模型、1例宾德综合征模型、1例面部裂隙模型、1例眼耳脊椎综合征的2个模型、1例唇腭裂模型和1例半侧颜面肥大模型。
我们可以尝试多种方法,能够识别移植大小是否合适,并能可视化面部轮廓的变化。我们可以分析如何接近截骨线并实际进行截骨。可以观察到面部下部轮廓的变化。我们对移植模型进行了移植,并确认切口可以很好地闭合。通过模拟牵张,我们能够可视化软组织轮廓的变化。
我们模型最普遍的优点是,通过植骨、牵张成骨等硬组织的移动,我们能够可视化软组织的变化。我们必须进一步改进模型,使其更逼真。