摘要
目的应用三维重建和快速成形技术，制备具有患者外耳形态特点的个性化人工耳廓置入体，并探讨其应用于外耳再造的可行性。方法应用螺旋CT扫描数据和图像处理技术重构患者耳廓三维立体模型，设计支撑结构、引流结构，生成耳支架的数字模型，采用数控快速成形设备，医用级聚氨酯为材料，以热熔喷丝工艺制备耳支架，并进行了疲劳性能和弹性模量的测试。同时，将多孔聚氨酯人工耳支架置入大鼠皮下，分别于置入后第1、2、4、8、12周观察再造外耳的外形及组织学变化。结果制备的聚氨酯人工耳支架与原型耳外形高度一致，其抗疲劳性明显优于聚乙烯，具备优良的弹性。再造耳外形逼真、细节清晰；2周后周围组织长人置入体孔隙，与多孔聚氨酯的网孔形成较为紧密的粘附，且随时间延长而逐渐牢固，4周时有包膜结构形成；12周时外形保持良好，硬度略有增加。病理切片显示4周后可形成完整的包膜结构，未见淋巴细胞浸润。结论三维重构与快速成形技术制备的聚氨酯人工耳支架，具备原型外耳的轮廓和特征，具有优异的抗疲劳性和良好的弹性，可为替代自体肋软骨耳支架提供一个新的途径。
Objective To manufacture the individual polyurethane（PUR） auricular framework using the rapid prototyping （RP） technique and to evaluate its feasibility in ear reconstruction. Methods 3-D models of the patient＇s auricle were reconstructed according to the computed tomography （CT） data. The supporting and drainage structures were created. Then the individual PUR auricular frameworks were manufactured using RP technique. The frameworks were tested for the fatigue strength and elasticity. The frameworks were also put at the subcutaneous layer of rat. At 1, 2, 4, 8, 12 weeks after operation, the shape of the reconstructed ears was observed and the histological examination was performed. Results The PUR framework had good elasticity and a much better fatigue strength than high density polyethylane（HDPE）framework. The shape of reconstructed ear matched the prototype very well. The around tissue grew into the implant pore and adhered tightly to the framework 2 weeks after implantation. Histologic examination showed integrated capsule four weeks later without lymphocytes infiltration. The shape kept very well twelve weeks later. Conclusions PUR auricular framework manufactured by the 3D reconstruction and RP techniques has very good shape, intensity and elasticity. It can be selected to replace the autograft of rib cartilage framework.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2008年第2期101-104,共4页
Chinese Journal of Plastic Surgery
关键词
支架
成像
三维
耳廓再造术
Stents
Imaging, three-dimensional
Reconstruction of auricle
