三维建模配准分析经口与经鼻开窗治疗上颌骨囊肿三维形态变化  

Effectiveness of transnasal and transoral fenestration in the treatment of maxillary bone cysts

作　　者：李晓宇 王彬晨 徐大朋 王艳华[2] 杜平功 张庆泉 LI Xiaoyu;WANG Binchen;XU Dapeng;WANG Yanhua;DU Pinggong;ZHANG Qingquan(Binzhou Medical College,Yantai 264003,Shandong,China;Yantai Stomatology Hospital Affiliated to Binzhou Medical College,Yantai 264001,Shandong,China)

机构地区：[1]滨州医学院,山东烟台264003 [2]滨州医学院附属烟台口腔医院,山东烟台264001

出　　处：《山东大学耳鼻喉眼学报》2025年第2期72-78,86,共8页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的 通过三维建模及模型配准,分析经口与经鼻内镜鼻内开窗治疗上颌骨囊肿的体积及三维方向变化,探讨经鼻内镜鼻内开窗治疗上颌骨囊肿与经口开窗治疗的囊肿体积缩小的差异及其各自三维方向收缩变化。方法 收集2019年6月至2022年6月滨州医学院附属烟台口腔医院确诊的上颌骨囊肿的患者资料,手术分为经口开窗、经鼻内镜鼻内开窗采用鼻底、下鼻道开窗两种方式,依据术前及术后拍摄的Cone-bean computed tomography,通过Materialise Mimics 21及3-matic软件三维重建,测量体积及近远中径、颊舌径、高度上的变化。结果 得到两组术式开窗术后体积百分比与时间的回归模型:V_(1)=-0.007×t^(3)+0.462×t^(2)-10.175×t+99.481(P<0.001,R=0.956, adjusted R^(2)=0.904);V_(2)=-0.018×t^(3)+0.872×t^(2)-13.834×t+99.978 (P<0.001,R=0.964, adjusted R^(2)=0.919),前6个月经鼻内镜鼻内开窗组体积收缩速度大于经口开窗组;22个月时经口开窗组囊腔体积基本保持稳定;囊腔变化稳定后两组体积相似。经口开窗组三维方向变化百分比与时间的回归模型:X_(1)=-2.23×10^(-4)×t^(3)+0.074×t^(2)-3.652×t+98.979 (P<0.001,R=0.91, adjusted R^(2)=0.811);Y_(1)=-0.005×t^(3)+0.288×t^(2)-5.638×t+100.028 (P<0.001,R=0871, adjusted R^(2)=0.734);Z_(1)=0.079×t^(2)-3.880×t+97.633 (P<0.001,R=0.917, adjusted R^(2)=0.830);经鼻开窗组三维方向变化百分比与时间的回归模型:X_(2)=0.072×t^(2)-3.346×t+98.80 (P<0.001,R=0.945, adjusted R^(2)=0.883);Y_(2)=-0.001×t^(3)+0.127×t^(2)-4.036×t+99.138(P<0.001,R=0.892, adjusted R^(2)=0.766);Z_(2)=0.074×t^(2)-3.758×t+99.209 (P<0.001,R=0.961, adjusted R^(2)=0.916)。经鼻内镜下鼻内开窗术后上颌骨囊肿以高度变化为主;经口开窗术后上颌骨囊肿以近远中径、高度变化为主。结论 经口行上颌骨囊肿开窗治疗与经鼻内镜下鼻内开窗治疗上颌骨根尖囊肿,在体积收缩方面两者有相似的临床疗效,经鼻内镜下鼻内开�Objective To analyse the volume and three-dimensional direction changes of maxillary bone cyst treated by endoscopic and transnasal fenestration through three-dimensional modelling and model registration,and to explore the difference in volume reduction and three-dimensional contraction of maxillary cyst treated by endoscopic and transnasal fenestration.Methods The data of patients with maxillary bone cyst diagnosed in Yantai Stomatological Hospital Affiliated to Binzhou Medical College from June 2019 to June 2022 were collected.The operation was divided into two methods:transoral fenestration,transnasal endoscopy intranasal fenestration with nasal base and inferior nasal canal fenestration.Materialise Mimics 21 and 3-matic software were used for 3D reconstruction to measure changes in volume,proximal and distal diameter,buccolingual diameter and height.Results The regression models of volume percentage and time of the two groups were obtained:V1=-0.007×t^(3)+0.462×t^(2)-10.175×t+99.481(P<0.001,R=0.956,adjusted R^(2)=0.904);V2=-0.018×t^(3)+0.872 t^(2)-13.834×t+99.978(P<0.001,R=0.964,adjusted R^(2)=0.919),the volume contraction rate of the endoscopic intranasal fenestration group was higher than that of the transoral fenestration group in the first 6 months.The capsule volume in the transoral window group remained stable at 22 months.The volume of the two groups was similar after stabilisation of the changes in the cystic cavity.The percentage change of the three-dimensional direction in the transoral fenestration group was adjusted by a regression model:X_(1)=-2.23×10^(-4)×t^(3)+0.074×t^(2)-3.652×t+98.979(P<0.001,R=0.91,adjusted R^(2)=0.811);Y_(1)=-0.005×t^(3)+0.288×t^(2)-5.638×t+100.028(P<0.001,R=0871,adjusted R^(2)=0.734);Z1=0.079×t^(2)-3.880×t+97.633(P<0.001,R=0.917,adjusted R^(2)=0.830);The regression model of percentage and time of 3D direction change of the nasal window group was as follows:X_(2)=0.072×t^(2)-3.346×t+98.80(P<0.001,R=0.945,adjusted R^(2)=0.883);Y_(2)=-0.001×t^(3)+0.127×t^(2)

关 键 词：上颌骨囊肿 经口开窗 鼻内镜下经鼻内开窗 三维建模及模型配准 回归模型 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]