个体化三维数字模型辅助翼腭窝及颞下窝内镜解剖

Application of individual threedimensional digital manikin in anatomic study of pterygopalatine fossa and infratemporal fossa via transnasal endoscopic approach

摘要:

目的研究个体化三维数字模型（threedimension digital manikin，3DDM）在内镜经鼻翼腭窝、颞下窝解剖中的应用。方法12例（24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3DDM，然后在3DDM辅助下对翼腭窝、颞下窝进行内镜解剖，对头部标本解剖与3DDM视野及相关测量进行比较。结果头部标本解剖与个体化3DDM下视野高度一致，相关测量间比较差异无统计学意义（P>0.05）。结论个体化3DDM为内镜下经鼻入路暴露翼腭窝、颞下窝提供详尽解剖数据，可以术前模拟翼腭窝、颞下窝解剖，对该手术入路的临床应用具重要指导意义。

Abstract:

ObjectiveTo investigate the application of individual threedimensional digital manikin (3DDM) in anatomic study of pterygopalatine fossa and infratemporal fossa via transnasal endoscopic approach.Methods12 adult cadaveric heads (24 sides) fixed by formalin were dyed through the artery with silicone rubber (RTV3110) and 12.5% iopromide, and then scanned by 320detectorrow spiral CT. The images were stored in DICOM format and imported to 3D view software to reconstruct individual 3DDM.The anatomic marks of skull base related to pterygopalatine fossa and infratemporal fossa via transnasal endoscopic approach were observed and the distances among the related anatomic marks were measured in individual 3DDM. The endoscopic images were recorded, and the relationships of the surgical marks were observed and measured. Finally, the consistencies of visions and data between obtained by the two methods were analyzed.ResultsThe reconstruction of the individual 3DDM of all the samples was satisfactory. The visions obtained via individual 3DDM and endoscope were highly consistent and the differences of measurement data of correlated surgical marks between individual 3DDM and endoscopes were statistically insignificant (all P>0.05). ConclusionIndividual 3DDM can provide detailed information of bony structures, arterial supply and approachrelated critical anatomical data, which have important clinical significance for transnasal endoscopic approach to pterygopalatine fossa and infratemporal fossa.