使用单个钛植入物进行颅骨整形术的美容效果

S. V. Mishinov
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引用次数: 0

摘要

在评估颅骨缺损的手术重建结果时,使用单个植入物进行颅骨成形术的美容效果是一个重要组成部分。颞肌萎缩的发展会影响面部轮廓的协调性,在使用考虑到骨骼对称性而设计的患者特异性植入体(PSI)的情况下,可能会因美容效果不理想而使这项技术失去意义。在这方面,当务之急是找到通过改变单个植入体的形状来弥补视觉缺陷的可能性,以达到良好的美容效果。54 例颅骨成形术病例被分为两组:第一组(32 例)的植入物与完整一侧的颅骨对称;第二组(22 例)的植入物弧度有所改变,以补偿正在发育的颞肌萎缩。为了使可能导致颞肌萎缩的区域标准化,对克伦林-布赖乌索瓦方案进行了细化标记。为了确定最佳的结构元素,以提高钢板自由边缘区域的强度,我们在专门的计算机环境中进行了一系列负载实验。68.7%的病例在术后至少 6 个月内使用对称种植体和颞部局部缺损的情况下都能达到良好的美容效果,而使用改良种植体的病例则达到了 100%。数字建模的结果表明,自由边缘的圆角是增加骨板强度的最佳结构元素。在神经外科实践中,当对颞部矩形区域颅骨缺损的患者进行开颅手术时,所开发的方法具有很大的应用潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cosmetic outcomes of cranioplasty using individual titanium implants
The cosmetic outcome of cranioplasty performed with individual implants is an important component in assessing the results of surgical reconstructions of scull defects. Developing temporalis muscle atrophy affects the harmonic face contour and, in cases of using patient-specific implants (PSI), designed taking into account bone symmetry, may discredit this technique due to unsatisfactory cosmetic results. In this regard, an urgent task is to find the possibility of compensating for a visual defect by modifying the shape of individual implants in order to achieve good cosmetic results. 54 cases of performed cranioplasty were divided into two groups: in the first group (n=32), the implant was modeled symmetrically to the intact side of the skull; in the second group (n=22), the curvature of the plates was modified to compensate for the developing temporalis muscle atrophy. To standardize the zone potentially responsible for the temporal muscle atrophy, a refining marking of the KrÖnlein-Bryusova scheme was carried out. To determine the optimal structural element that increases the strength of the plates in the area of their free edge, a number of load experiments were carried out in a specialized computer environment. Good cosmetic efficacy for periods of at least 6 months after the operation using symmetrical implants and localization of defects in the temporal region was noted in 68.7 % of cases, while with the use of modified implants this figure amounted to 100 %. The results of digital modeling have established that the rounding of the free edge is the optimal structural element that increases the strength of the plates. The developed approaches have a high potential for implementation in neurosurgical practice when performing cranioplasty in patients with defects of the skull bones localized in the temporal rectangle zone.
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