Digital technology assisted treatment of fronto-orbital fibrous dysplasia
10.3760/cma.j.cn114453-20210126-00040
- VernacularTitle:数字化技术辅助治疗额眶部骨纤维异常增殖症
- Author:
Gang AN
1
;
Yijia LIU
;
Kaiyong ZHANG
;
Peng WU
;
Lai GUI
;
Feng NIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院颅颌面外科，北京 100144
- Keywords:
Surgery, computer-assisted;
Frontal orbit;
Fibrous dysplasia of bone;
Skull defect
- From:
Chinese Journal of Plastic Surgery
2022;38(4):412-417
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of digital technology in the surgical treatment of patients with fronto-orbital fibrous dysplasia.Methods:The clinical data of 2 patients with fronto-orbital fibrous dysplasia admitted to the Plastic Surgery Hospital, Chinese Academy of Medical Sciences in February 2016 and February 2018 were retrospectively analyzed. The patients were both male, aged 18 and 16 years, respectively. Preoperative CT scan was performed on the patient to obtain imaging data, imported into Mimics 10.01 for three-dimensional(3D) reconstruction and image analysis of the skull, and the resection range of fibrous dysplasia lesions was designed. Then, the 3D skull defect model was 3D printed, and a personality covering the skull defect was made. Titanium prosthesis was used, and then the bone extraction range of the autologous skull outer plate was designed and simulated to repair the orbital bone defect. Surgery was performed according to the design plan. Postoperatively, the recovery and complications of the patients were observed, skull CT scan was performed, orbital volume, proptosis was measured, visual acuity was checked, and the surgical effect was evaluated.Results:The intraoperative macroscopic lesion boundary in 2 patients was consistent with the preoperative simulation design, and the intraoperative temporal bone was normal bone. One patient recovered well after the operation, and the other had cerebrospinal fluid rhinorrhea 1 day after the operation, without special treatment, and recovered spontaneously after 2 weeks. CT scans after the operation showed that the personalized prosthesis was well integrated with the skull, and the shape of the fronto-orbital area was satisfactory, which was close to the normal anatomical shape. The orbital volume of the affected side of 2 cases was enlarged after operation, which increased by 2.99 ml and 9.99 ml respectively compared with that before operation; the exophthalmos were improved after operation, and decreased by 3.32 mm and 5.11 mm respectively compared with that before operation. Directional movement is good. Patients and their families were satisfied with the morphology.Conclusions:The use of digital technology in the preoperative simulation design of fronto-orbital fibrous dysplasia is helpful for the operator to accurately formulate the surgical plan, improve the utilization efficiency of the grafted bone, and obtain satisfactory postoperative results.
