计算机辅助设计与制造技术在个性化甲状软骨重建中的应用

发布时间：2018-10-18 09:17

【摘要】：目的:探讨计算机辅助设计/计算机辅助制造(CAD/CAM)技术在甲状软骨缺损的个性化修复重建中的价值。方法:选取30只成年新西兰大白兔(雌雄不限),随机分为2组。A组在术前行喉部CT扫描,三维重建甲状软骨成像,手术切除任意一侧甲状软骨,缺损处植入运用CAD/CAM技术和镜像技术制备的个性化修复材料;B组手术切除任意一侧甲状软骨,缺损处植入大致按照实验动物单侧甲状软骨制作的非个性化修复材料。术后通过大体观察、电子喉镜检查等观察实验动物的喉腔情况。结果:A组实验动物喉腔黏膜无炎症、无肉芽生长,声带闭合良好,喉腔通畅、无塌陷现象发生;B组喉腔黏膜无炎症,第3周喉前连合处见肉芽生长,第7周见术侧喉腔轻度塌陷,喉腔欠通畅,声带闭合欠佳。结论:运用CAD/CAM技术制备的个性化修复材料比非个性化材料能起到更好的喉支撑作用。CAD/CAM技术为术前设计提供了个性化实体模型,提高了手术的精确性,节省了手术时间,降低了手术并发症。
[Abstract]:Objective: to investigate the value of computer aided design (CAD) / computer aided manufacturing (CAD/CAM) in the individualized reconstruction of thyroid cartilage defects. Methods: thirty adult New Zealand rabbits (male and female) were randomly divided into two groups: group A underwent laryngeal CT scan before operation, three-dimensional reconstruction of thyroid cartilage, and resection of any side of thyroid cartilage. CAD/CAM technique and mirror image technique were used to make individualized repair material. In group B, any side of thyroid cartilage was resected, and the defect site was implanted with non-individualized prosthetic material made according to unilateral thyroid cartilage of experimental animals. The laryngeal cavity of experimental animals was observed by gross observation and electronic laryngoscopy after operation. Results: there was no inflammation in laryngeal cavity mucosa, no granulation, no vocal cord closure, no collapse in laryngeal cavity in group A, no inflammation in laryngeal cavity mucosa in group B, and granulation growth in the anterior conjunction of larynx at week 3, the laryngeal cavity mucosa of group A had no inflammation, the vocal cord was well closed, and there was no collapse of laryngeal cavity mucosa. At 7 th week, the laryngeal cavity collapsed slightly, the laryngeal cavity was not smooth, and the vocal cord was not well closed. Conclusion: the individualized repair material made by CAD/CAM technology can support the larynx better than the non-individualized material. The CAD/CAM technology provides the individualized solid model for preoperative design, improves the accuracy of the operation and saves the operation time. The complications of the operation were reduced.
【作者单位】：中国人民解放军第三0三医院耳鼻咽喉头颈外科;马鞍山市人民医院耳鼻咽喉科;中国人民解放军第三0三医院放射科;广西大学材料科学与工程学院;
【基金】：全军医药卫生科研项目(面上项目No:06MA122) 广西自然科学基金项目(No:2011GXNSFA018209)
【分类号】：TP391.7;R318.08

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