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目的评价3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用效果。方法对6例鼻窦恶性肿瘤破坏眶壁的患者,根据术前CT扫描数据,应用3D技术打印出患侧眼眶的树脂模型,在此模型上对钛网进行塑形,术中将预成形钛网植入眶壁缺损区。通过临床和CT检查,根据眼球容积和眼球突出度评价眶壁恢复情况。结果所有病例手术顺利,预成形的钛网不需要术中再次修整,植入的钛网与缺损周边骨床贴合紧密。术后3个月经临床和CT检查,所有病例眶壁重建成功,未发生严重并发症,6例患者眼球内陷矫正在3 mm内,无眼球内陷,1例一个象限存在复视,患侧眼眶容积和眼球突度与健侧相近,差异无统计学意义(P>0.05)。随访6~30个月,未见肿瘤复发。结论应用3D技术预成型的钛网用于鼻窦肿瘤术后的眶壁修复,能精确恢复眼眶的解剖形态和容积。
Objective To evaluate the application of 3D technique in repairing orbital wall defects of sinus malignant tumors. Methods Six patients with malignant orbital malignancy of the orbital wall were enrolled. According to the preoperative CT scan data, the resin model of the affected orbit was printed by 3D technique. The titanium mesh was shaped on this model. The preformed titanium mesh Implanted orbital wall defect area. Through clinical and CT examination, according to eyeball volume and eyeball protrusion evaluation of orbital recovery. Results All the cases were operated smoothly. The preformed titanium mesh did not need to be reconstructed intraoperatively. The implanted titanium mesh was closely attached to the peripheral bone defect. 3 months after surgery and CT examination, all cases of orbital reconstruction was successful, no serious complications, 6 cases of correction of eyeball within 3 mm, no ocular retraction, diplopia in one quadrant there, the ipsilateral Orbital volume and ocular protrusion and contralateral similar, the difference was not statistically significant (P> 0.05). Follow-up 6 to 30 months, no tumor recurrence. Conclusions The titanium mesh preformed by 3D technique can be used to repair the orbital wall of the sinus tumor, which can accurately restore the anatomy and volume of the orbit.