内镜下鼻颅底肿瘤切除及颅底功能重建手术研究之3d影像解剖研究.doc

内镜鼻颅底肿瘤切除及颅底功能重建手术的3D影像解剖研究 卢晓清 吴建* ［摘要］ 目的：运用3D影像重建及3D打印技术，对鼻窦及相邻颅底结构进行影像解剖学研究，探讨3D技术对内镜鼻颅底肿瘤切除及颅底功能重建手术的价值。方法：对4例正常成人及6例鼻颅底肿瘤患者行鼻窦冠状位CT扫描并行3D重建，计算机测量正常成人前鼻棘至蝶窦口、鞍底及筛板前、中、后部距离、前鼻棘至这些结构连线与鼻底所成角度；对6例鼻颅底肿瘤患者颅底结构行3D重建及打印。结果：前鼻棘至蝶窦口距离：60.8±2.5mm，角度：36.0±1.2°；前鼻棘至鞍底距离：80.1±3.6mm，角度：26.7±1.3°；前鼻棘至筛板前部距离：49.8±2.3mm，角度：69.9±3.2°；前鼻棘至筛板中部距离：54.3±2.2mm，角度：56.6±2.3°；前鼻棘至筛板后部距离：62.5±2.4mm，角度：45.7±2.6°。3D打印模型能清楚显示颅底骨质缺损的大小及形状。结论：3D成像及打印技术对内镜鼻颅底肿瘤切除及颅底功能重建手术的手术径路的选择、避免颅内手术并发症的发生及颅底缺损修补材料大小和形状的选择，具有重要临床指导意义。 ［关键词］3D技术；内镜鼻颅底手术；影像解剖； 基金项目：上海市科委西医引导重点科研项目（14411960400）、上海市科委产学研项目（14DZ1940103） 作者单位：第二军医大学附属长征医院耳鼻咽喉科，200003 *通信作者：吴建，电子邮箱：jianwu2008@126.com 3D image anatomy study on intranasal endoscopic skull base tumor resection and the functional reconstruction of the skull base surgery Wu Jian lu Xiaoqing (Department of Otolaryngology, changzheng Hospital, the Second Military Medical University, shanghai, 200003) [Abstract] Objective: Using the 3D image reconstruction and 3D printing technology to make the image anatomy study on the sinus and the skull base adjacent. Discuss the value of 3D printing technology for intranasal endoscopic skull base tumor resection and the functional reconstruction of the skull base surgery. Methods: Carried sinus coronal CT scan parallel 3D reconstruction on 4 cases of normal adults and 6 cases of patients who have nasal skull base tumor. Used computer measure the distance from normal adults anterior nasal spine to sphenoid sinus mouth, the bottom of the saddle and the sieve plate. And measure angle between those structure and the baseline. Carry 3D printing on 6 cases of patients who have nasal skull base tumor. Results: the distance from anterior nasal spine to sphenoid sinus mouth: 60.8?2.5mm，Angle：36.0±1.2°；the distance from anterior nasal spine to the bottom of the saddle: 80.1±3.6mm，Angle: 26.7±1.3°；the distance from anterior nasal spine to the front of sieve plate: 49.8±2.3mm，Angle: 69.9±3.2°；the distance from anterior nasal spine to the cen