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    3D打印技术在Nagata法全耳廓再造术中的应用

    Application of 3D printing in Nagata auricle reconstruction

    • 摘要: 目的 探讨3D打印技术在Nagata法全耳廓再造术的应用效果。方法 选取2019年6月-2021年7月徐州医科大学附属医院整形外科收治的30例单侧耳畸形患者。根据耳模制作方法将上述患者分为实验组(3D耳模)和对照组(胶片耳模),每组15例。实验组利用肋软骨三维CT扫描数据重建第6-8肋软骨,术前模拟雕刻耳支架,术中用3D打印模板指导肋软骨支架的雕刻拼接。对照组术前常规进行肋软骨三维CT扫描以供手术参考,术中采用传统胶片耳模法指导手术。比较2组耳模指导Nagata法全耳廓再造术的手术时间差异。术后采用Likert 量表法对术者进行模型使用效果满意度调查。术后半年复诊,对比分析患者的满意度。Ⅱ期术后测量健侧颅耳角,及术后即刻患侧颅耳角,比较不同组再造的颅耳角与健侧的差异。结果 实验组患者手术时间短于对照组,差异有统计学意义(P<0.05)。术者对3D耳模的使用效果满意度高于胶片耳模,差异有统计学意义(P<0.05)。术后半年实验组患者对再造耳廓外观的满意度优于对照组,差异有统计学意义(P<0.05)。2组患者对再造耳廓功能的满意度比较,差异无统计学意义(P>0.05)。实验组术后即刻再造耳廓颅耳角(34.94±4.73)°与健侧颅耳角(34.85±4.85)°更为接近,差异无统计学意义(P>0.05)。结论 3D打印技术指导Nagata法全耳廓再造,再造耳轮廓清晰,患侧颅耳角与健侧更接近,患者满意度,医生使用满意度高,值得临床推广。

       

      Abstract: Objective To evaluate the clinical effect of 3D digital printing in Nagata total auricle reconstruction.Methods A total of 30 patients with unilateral ear deformity who were admitted to Department of Plastic Surgery, the Affiliated Hospital of Xuzhou Medical University from June 2019 to July 2021 were selected. They were divided into two groups (n=15):an experimental group and a control group. In the experimental group, the 6th-8th costal cartilage was reconstructed using the 3D CT scanning data from the costal cartilage, simulating to carve the ear scaffold before surgery, as well as engraving and splicing of the costal cartilage scaffold guided by the 3D printing template. The control group underwent conventional three-dimensional CT scanning of costocartilage before surgery, and the operation was guided by the traditional film ear mold method. Both groups were compared for the duration of surgery using Nagata method. After surgery, surgeon's satisfaction was evaluated through the Likert scale. Six months after surgery, patient's satisfaction was assessed evaluated. The cranial ear angles on the healthy side and the affected side were measured immediately after surgery. Both groups were compared for the reconstructed cranial ear angle between the healthy side and the affected side.Results The experimental group showed significantly shorter operation time than the control group (P<0.05). The surgeons presented better satisfaction towards 3D ear mold than the film ear mold (P<0.05). Six months after operation, the experimental group showed better satisfaction towards the appearance of the reconstructed auride than the control group(P<0.05). Both groups presertcel satisfaction towards the function of the reconstracted auricle, withont statistical difference (P>0.05). For the experimental group, there was no statistical difference between the cranial ear angles at the healthy side (34.85±4.85)ånd those the affected side (34.94±4.73)° immediately after surgery (P>0.05).Conclusions 3D printing can be used for guiding the Nagata method during the reconstruction of the whole auricle, with the cranial ear horn is closer to the healthy side.

       

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