目的探讨数字化技术辅助设计、制作个性化鼻假体支架的临床应用效果。方法自2018年11月至2019年8月,应用数字模拟技术重建14例患者的鼻部三维形态,测量、比较术前及术后预测的鼻部三维形态,预估手术需要的假体体积并设计鼻假体。通过三维打印技术预制鼻假体模型,指导术中硅胶鼻假体支架的制作。利用数字化技术测量术前术后鼻三维形态结构的变化情况。结果术后平均随访7个月,12例患者及家属对鼻外形表示满意,2例认为鼻尖形态轮廓一般,未见明显鼻部形态及功能异常。鼻根点与鼻尖点距离手术前后存在统计学差异(P=0.04);鼻根点与鼻小柱点的距离、鼻唇角角度手术前后无统计学差异(P=0.74;P=0.56)。结论数字化技术可以实现鼻假体的精确设计和个性化制备,为鼻假体支架的制作提供精确指导,并为整形术后的鼻三维结构提供客观评价。

Objective To explore the efficacy of designing and fabricating personalized nasal framework with digital technology. Methods From November 2018 to August 2019, the three-dimensional nasal morphology of 14 patients was reconstructed by digital simulation technology, the preoperative and postoperative predicted three-dimensional nasal morphology was measured and compared, the volume of prosthesis needed for surgery was estimated, and the nasal prosthesis was designed. The nasal framework model was fabricated by three-dimensional printing technology to guide the fabrication of silicone framework. The changes of three-dimensional nasal morphology were measured by digital technique. Results The average follow-up period was 7 months. 12 patients and their parents were satisfied with the nasal shape, 2 cases thought that the shape of the nasal tip was general, and there was no obvious abnormal nasal shape and function. There was statistical difference in the distance between the nasion and nasal tip before and after operation(P =0.04). There was no significant difference in the distance between the nasion and the columella point and the nasolabial angle before and after operation(P=0.74; P=0.56). Conclusion Digital technology can realize the precise design and personalized preparation of nasal prosthesis, provide accurate guidance for the fabrication of nasal prosthesis scaffold, and provide objective evaluation for the three-dimensional structure of nose after plastic surgery.