个体化三维数字模型在内镜经鼻颞骨岩部解剖中的应用  

The application of individual three-dimensional digital manikin on transnasal endoscopic approach of petrous bone

作　　者：何海勇[1] 李文胜[1] 王辉[1] 蔡梅钦[1] 罗伦[1] 张保豫[1] 郭英[1] 

机构地区：[1]中山大学附属第三医院神经外科,广州510630

出　　处：《中国临床解剖学杂志》2012年第5期498-502,共5页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(30672152)

摘　　要：目的研究个体化三维数字模型(three-dimension digital manikin,3D-DM)在内镜经鼻颞骨岩部解剖中的应用,探讨其临床应用价值。方法 10例(20侧)成人头部标本灌注后经CT扫描,将图像导入3Dview软件,重建出个体化3D-DM,运用"逆向骨窗形成"技术设计并模拟颞骨岩部骨窗形成。然后在3D-DM辅助下对颞骨岩部进行内镜解剖,对头部标本解剖与个体化3D-DM视野及相关测量进行比较。结果通过逆向骨窗形成技术可术前模拟颞骨岩部磨除,头部标本解剖与个体化3D-DM下视野高度一致,相关测量间比较无统计学差异。结论个体化3D-DM为内镜下经鼻入路暴露颞骨岩部提供详尽解剖数据,可以术前模拟颞骨岩部磨除,提高术中颞骨岩部磨除的准确性和安全性,对该手术入路的临床应用具重要指导意义。Objective To investigate clinical value of individual three-dimensional digital manikin （3D-DM） on the transnasal endoscopic approach to petrous bone. Methods Ten adult cadaveric heads （20 sides） fixed with formalin were dyed through the artery with silicone rubber （RTV3110） and 12.5% Iopromide. Then specimens were scanned by 320-detector-row spiral CT with coronal, axial and sagittal positions. The images were stored in DICOM format, imported into 3D view software and reconstructed individual 3D-DM, on which the technology of ＂reverse bone window formed＂ were used to design and simulate the bone window formation of petrous bone. The anatomic marks of skull base related to the transnasal endoscopic approach to petrous bone in individual 3D-DM were observed and the distances between the related anatomic marks were measured. The endoscopic images were recorded, and the relationships of the surgical marks were observed and measured. Finally,The consistency between anatomy and 3D-DM data were explored. Results Individual 3D-DM of the samples was well reconstructed. The vision of individual 3D-DM was similar to that of endoscopic anatomy, as well the correlated parameters. Conclusions Individual 3D-DM can be used to simulate bone window formation of petrous bone preoperatively, which can improve the accuracy and security of the surgery. Individual 3D-DM can provide detailed information of bony structures, arteries supply and approach-related critical anatomical data, which had important clinical significance for transnasal endoscopic approach to petrous bone.

关 键 词：颞骨岩部 逆向骨窗形成 个体化三维数字模型 内镜解剖 

分 类 号：R651.1[医药卫生—外科学]