快速成型技术在下颌骨偏颌畸形治疗中的应用-第三军医大学学报.DOC

PAGE PAGE 4 快速原型技术在下颌角肥大矫正术中的应用 曹川1 李世荣1 毕胜1 陈华1 戴霞1 覃霞1 何鹏2 第三军医大学西南整形美容外科医院，重庆，400038） 重庆市激光快速原形及模具制造中心，重庆，401147） 【摘要】 目的 探讨计算机三维重建及快速原型技术辅助下颌角肥大矫正术的临床应用。方法 15例下颌角肥大方脸型患者，行下颌骨电子束CT扫描及三维重建，应用快速原型技术制作下颌骨实体模型，根据模型设计手术方案。手术方法包括下颌角部分截除及外板矢状劈开切除、自体下颌骨移植隆颏等，其中下颌角部分截除5例，外板矢状劈开切除6例，下颌角部分截除＋外板切除4例，另3例颏部短小者行自体下颌骨移植隆颏，均按照模型上确定的截骨部位及范围进行操作。结果 所有患者快速成型制作的下颌骨模型外形完整，真实反映患者的下颌骨形态。手术过程顺利，所有患者术后下面部外形得到不同程度的改善，面部宽度明显减小，双侧对称，达到术前设计的预期效果。其中12例随访3月～1年，面部外形良好，手术效果满意。结论 快速原型技术能真实再现下颌骨的形态，为准确评估下颌骨肥大程度、设计手术方案与指导手术操作提供理想的外科模型，是面部轮廓整形手术良好的辅助手段。 【关键词】快速原型技术；模型外科；下颌角肥大；截骨术 Application of rapid prototyping techniques in correction of prominent mandibular angle Cao Chuan, Li Shi-rong, Dai Xia, et al（Southwestern Plastic and Aesthetic Surgery Hospital，Third Military Medical University, Chongqing, 400038） 【Abstract】Objective To investigate the application of computer-aided 3D reconstruction and rapid prototyping(RP) techniques in the correction of prominent mandibular angle. Methods Computer tomography scanning and three dimensional reconstruction were performed on 15 square face patients with prominent mandibular angles, then the actual mandible models were made by RP techniques. Surgical programs were made according to the model, including partial mandibular angle osteotomy, outer mandible table sagittal splitting osteotomy, chin augmentation with autogenous mandibule bones, and so on. In 15 cases, mandibular angle partial cutting was performed in 5 cases, sagittal splitting osteotomy in 6, mandibular angle partial cutting combined with splitting osteotomy in 4. The autogenous mandibule bones were transplanted for chin augmentation in 3 chin microsomia patients. All the cases were treated according to the position and range set by the RP model. Results All the mandibular models produced by RP techniques were real and complete, which could directly and precisely show the state of mandible. The operations completed smoothly and accomplished the expected effect designed before operation.