论文部分内容阅读
目的探讨复合性眼眶骨折的三维实体模型的构建方法和眼眶骨折修复重建手术的计算机辅助设计和辅助制造(CAD/CAM)。方法选择2003年8月至2004年3月在上海第九人民医院眼科就诊的12例复合性眼眶骨折患者,进行眼眶螺旋CT检查。首先将CT数据资料输入计算机进行三维实体建模,并通过自行开发的计算机辅助手术导航软件进行骨折骨块的移动、旋转及复位,记录骨块在各个轴位的移动量,为手术导航。其次计算眼眶容积,对比两侧眼眶容积的差异,为手术中所需植入材料的体积提供参考。最后制作快速原型,实际模拟手术。所有患者均施行眼眶重建眼球功能性复位手术,术后随访3～9个月,评估疗效。结果眼眶骨折修复重建手术的计算机辅助设计和制造系统整体运行良好,系统应用软件的功能达到设计要求,交互式操作方便实用,测量结果稳定可靠,实现了眼眶骨折手术的计算机辅助设计和制造。12例患者在手术后均达到满意的疗效:骨折眼眶复位良好,眼球内陷和下移得到矫正,复视和眼球运动受限明显改善,未发生视力下降或丧失。结论眼眶骨折修复重建手术的计算机辅助设计和制造系统能够为眼眶手术提供重要参考,提高手术疗效、降低风险。
Objective To investigate the method of constructing three-dimensional solid models of complex orbital fractures and computer aided design and manufacturing (CAD / CAM) of reconstructive orbital fractures. Methods From August 2003 to March 2004, 12 patients with complex orbital fracture treated by ophthalmology of the 9th People ’s Hospital of Shanghai were examined by orbital spiral CT. Firstly, the CT data was input into the computer for 3D solid modeling. The computerized surgical navigation software developed by ourselves was used to move, rotate and reset the fractured bone. The displacement of the bone in each axial position was recorded for surgical navigation. Second, calculate the orbital volume, comparing the difference of the orbital volume on both sides, providing the reference for the volume of implant material needed in the operation. The final production of rapid prototyping, the actual simulation surgery. All patients were undergone orbital reconstruction eye surgery, postoperative follow-up of 3 to 9 months to assess the efficacy. Results The computer aided design and manufacturing system of orbital fracture repair and reconstruction operation performed well. The function of the system application software met the design requirements. The interactive operation was convenient and practical, and the measurement results were stable and reliable. Computer-aided design and manufacturing of orbital fracture surgery was realized. Twelve patients achieved satisfactory results after operation: the fracture of the orbit was well repaired, the retraction and correction of the eyeball were corrected, the diplopia and ocular motility were limited, and no visual loss or loss of vision occurred. Conclusions Computer-aided design and manufacturing system for orbital fracture repair and reconstruction surgery can provide important reference for orbital surgery to improve the curative effect and reduce the risk.