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使用快速成型技术和自体移植修复颅面缺损——病例报告

Reconstruction of a Craniofacial Defect Using Rapid Prototyping and an Autograft - A Case Report.

作者信息

Palaskar Jayant N, Athavale Swapna N, Joshi Nikhil P, Gunjal Anuja P

机构信息

Department of Prosthodontics & Crown and Bridge, Sinhgad Dental College and Hospital, MUHS, Pune, Maharashtra, India.

Department of Plastic Surgery, Smt. Kashibai Navale Medical College and General Hospital, MUHS, Pune, Maharashtra, India.

出版信息

Ann Maxillofac Surg. 2021 Jul-Dec;11(2):309-312. doi: 10.4103/ams.ams_57_20. Epub 2022 Feb 1.

DOI:10.4103/ams.ams_57_20
PMID:35265504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8848696/
Abstract

RATIONALE

Achieving predictable aesthetic results of large craniofacial defects has always been difficult, and it requires a multidisciplinary approach.

PATIENT CONCERN

The chief concern of the patient was poor aesthetics due to a congenital craniofacial defect.

DIAGNOSIS

The patient was a known case of plexiform neurofibromatosis and had a congenital temporo-orbital bone defect of unknown origin.

TREATMENT

The reconstruction of the defect was done using rapid prototyping (RPT) and iliac crest graft. Three-dimensional computed tomography imaging and RPT were used to obtain a customized titanium prosthesis to rehabilitate the temporal defect and the defect lateral to the orbit was reconstructed using an iliac crest graft.

OUTCOME

Postoperative results were satisfactory and predictable. The positive change in appearance has improved the psychological well-being of the patient.

TAKE-AWAY LESSONS: A multidisciplinary approach, use of advanced and improved technology helps in better treatment planning and achieving desired aesthetic results.

摘要

原理

实现大型颅面缺损可预测的美学效果一直很困难,这需要多学科方法。

患者关注点

患者主要关注的是先天性颅面缺损导致的美学效果不佳。

诊断

该患者为已知的丛状神经纤维瘤病病例,存在原因不明的先天性颞眶骨缺损。

治疗

使用快速成型技术(RPT)和髂嵴移植进行缺损修复。通过三维计算机断层扫描成像和RPT获取定制的钛假体来修复颞部缺损,并用髂嵴移植修复眼眶外侧的缺损。

结果

术后结果令人满意且可预测。外观上的积极变化改善了患者的心理健康。

经验教训

多学科方法、使用先进和改良技术有助于更好地进行治疗规划并实现理想的美学效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f2/8848696/1e3b33e8f5f4/AMS-11-309-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f2/8848696/cbd27d534d25/AMS-11-309-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f2/8848696/1e3b33e8f5f4/AMS-11-309-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f2/8848696/cbd27d534d25/AMS-11-309-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f2/8848696/67f0a9dbb798/AMS-11-309-g002.jpg
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本文引用的文献

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Three-Dimensional Technology Applications in Maxillofacial Reconstructive Surgery: Current Surgical Implications.三维技术在颌面重建手术中的应用:当前的手术意义
Nanomaterials (Basel). 2020 Dec 16;10(12):2523. doi: 10.3390/nano10122523.
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Comparison of two different titanium cranioplasty methods: Custom-made titanium prostheses versus precurved titanium mesh.两种不同钛颅骨修补术方法的比较:定制钛假体与预弯钛网。
Surg Neurol Int. 2020 Jun 13;11:148. doi: 10.25259/SNI_35_2020. eCollection 2020.
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Long-Term Complications of Cranioplasty Using Stored Autologous Bone Graft, Three-Dimensional Polymethyl Methacrylate, or Titanium Mesh After Decompressive Craniectomy: A Single-Center Experience After 596 Procedures.
去骨瓣减压术后应用自体骨移植物、三维聚甲基丙烯酸甲酯或钛网进行颅骨修补的长期并发症:596 例单中心经验
World Neurosurg. 2019 Aug;128:e841-e850. doi: 10.1016/j.wneu.2019.05.005. Epub 2019 May 10.
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Staged reconstruction of large skull defects with soft tissue infection after craniectomy using free flap and cranioplasty with a custom-made titanium mesh constructed by 3D-CT-guided 3D printing technology: Two case reports.应用3D-CT引导的3D打印技术制作定制钛网,采用游离皮瓣及颅骨成形术对颅骨切除术后伴有软组织感染的大型颅骨缺损进行分期重建:两例报告
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