Song Wen-Ling, Ma Hai-Ou, Nan Yu, Li Yu-Jia, Qi Na, Zhang Li-Ying, Xu Xin, Wang Yuan-Yi
Department of Obstetrics, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
Prenatal Diagnosis Center, The Second Hospital of Jilin University, Changchun 130021, Jilin Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7196-7204. doi: 10.12998/wjcc.v9.i24.7196.
Lateral facial clefts are atypical with a low incidence in the facial cleft spectrum. With the development of ultrasonography (US) prenatal screening, such facial malformations can be detected and diagnosed prenatally rather than at birth. Although three-dimensional US (3DUS) can render the fetus' face 3D reconstruction, the 3D images are displayed on two-dimensional screens without field depth, which impedes the understanding of untrained individuals. In contrast, a 3D-printed model of the fetus' face helps both parents and doctors develop a more comprehensive understanding of the facial malformation by creating more interactive aspects. Herein, we present an isolated lateral facial cleft case that was diagnosed US combined with a 3D-printed model.
A 31-year-old G2P1 patient presented for routine prenatal screening at the 22 wk of gestation. The coronal nostril-lip section of two-dimensional US (2DUS) demonstrated that the fetus' bilateral oral commissures were asymmetrical, and left oral commissure was abnormally wide. The left oblique-coronal section showed a cleft at the left oral commissure which extended to the left cheek. The results of 3DUS confirmed the cleft. Furthermore, we created a model of the fetal face using 3D printing technology, which clearly presented facial malformations. The fetus was diagnosed with a left lateral facial cleft, which was categorized as a No. 7 facial cleft according to the Tessier facial cleft classification. The parents terminated the pregnancy at the 24 wk of gestation after parental counseling.
In the diagnostic course of the current case, in addition to the traditional application of 2D and 3DUS, we created a 3D-printed model of the fetus, which enhanced diagnostic evidence, benefited the education of junior doctors, improved parental counseling, and had the potential to guide surgical planning.
面部侧裂不常见，在面部裂谱系中发病率较低。随着超声（US）产前筛查的发展，此类面部畸形可在产前而非出生时被检测和诊断。尽管三维超声（3DUS）能对胎儿面部进行三维重建，但三维图像显示在二维屏幕上，没有景深，这妨碍了未经培训者的理解。相比之下，胎儿面部的三维打印模型通过创造更多互动方面，有助于父母和医生对面部畸形有更全面的了解。在此，我们报告一例通过超声联合三维打印模型诊断的孤立性面部侧裂病例。
一名31岁、孕2产1的患者在妊娠22周时前来进行常规产前筛查。二维超声（2DUS）的冠状位鼻孔-唇部切面显示胎儿双侧口角不对称，左侧口角异常增宽。左侧斜冠状切面显示左侧口角处有一裂隙，延伸至左侧脸颊。三维超声结果证实了该裂隙。此外，我们使用三维打印技术创建了胎儿面部模型，清晰地呈现了面部畸形。胎儿被诊断为左侧面部侧裂，根据泰西埃面部裂分类法归类为7号面部裂。经父母咨询后，父母在妊娠24周时终止了妊娠。
在本病例的诊断过程中，除了传统应用二维和三维超声外，我们创建了胎儿的三维打印模型，这增强了诊断依据，有利于低年资医生的培训，改善了对父母的咨询，并有可能指导手术规划。
