手术模拟系统在中耳手术中的应用

发布时间：2018-06-29 02:53

本文选题：计算机模拟 + 耳外科手术　；参考：《中国微创外科杂志》2017年03期

【摘要】：目的探讨耳科手术模拟系统Voxel-Man Tempo Surg在不同类型中耳手术的模拟操作中的特点与应用。方法选择2012年6月~2015年3月中耳手术40例,包括中耳胆脂瘤21例,胆固醇肉芽肿6例,先天性外中耳畸形4例,颞骨多发骨折9例,留取手术录像。利用耳科手术模拟系统对上述病例进行与手术实际操作相同的模拟操作,对比真实手术,记录外耳道后上嵴、鼓环/鼓沟、听小骨、面神经、外半规管、乙状窦、脑板、圆窗龛等解剖结构以及病变组织在模拟手术中出现的情况。结果按病变类型分为软组织类型27例和骨性类型13例,耳科手术模拟系统中骨性类型中病变的显示率(100%,13/13)明显优于软组织类型(7.4%,2/27)(Fisher检验,P=0.000),其他结构显示率差异无统计学意义(P0.05)。按乳突气化程度分为气化型16例和非气化型24例,气化型乳突中病变的显示率(68.8%,11/16)显著性高于非气化型(16.7%,4/24)(Fisher检验,P=0.002)。按采用的乳突开放术式分为完壁式25例和开放式15例,完壁式病变显示率(48.0%,12/25)与开放术式(20.0%,3/15)差异无显著性(Fisher检验,P=0.101),其他结构显示率差异亦无统计学意义(P0.05)。结论利用耳科手术模拟器,在以骨性类型为主的病种及气化较好的乳突中,可以较好地模拟病变的情况。
[Abstract]:Objective to investigate the characteristics and application of Voxel-Man Tempo Surg (Voxel-Man Tempo Surg) in different types of middle ear surgery. Methods from June 2012 to March 2015, 40 cases of middle ear surgery were selected, including 21 cases of middle ear cholesteatoma, 6 cases of cholesterol granuloma, 4 cases of congenital deformity of external middle ear, 9 cases of multiple fracture of temporal bone. The surgical simulation system was used to perform the same simulation operation as the actual operation. The posterior superior ridge of the external auditory canal, tympanic ring / sulcus, auditory bone, facial nerve, external semicircular canal, sigmoid sinus, brain plate were recorded. Anatomic structures such as round window niches and the appearance of diseased tissues in simulated surgery. Results there were 27 cases of soft tissue type and 13 cases of bone type according to the type of lesion. The display rate of osteogenic type (100% 13 / 13) was significantly better than that of soft tissue type (7.4% 27) (Fisher test P0. 000), but there was no significant difference in other structures (P0.05). According to the degree of mastoid gasification, there were 16 cases of gasification type and 24 cases of non-gasification type. The demonstration rate of pathological changes in the mastoid process of gasification type (68.8% / 11 / 16) was significantly higher than that of non-gasification type (16.7% / 24) (Fisher test P0. 002). According to the open mastoid procedure, there were 25 cases of complete wall type and 15 cases of open type. The display rate of end wall lesion (48.0 / 25) was not significantly different from that of open procedure (20.0 / 15) (Fisher test P0.101), and there was no significant difference in other structures (P0.05). Conclusion the use of ear surgery simulator can simulate the pathological changes in osteogenic diseases and mastoid processes with good gasification.
【作者单位】：北京大学第三医院耳鼻咽喉头颈外科;
【基金】：首都卫生发展科研专项(首发-2016-2-4094)
【分类号】：R764.9

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