三维打印+膜诱导技术修复重建下颌骨节段性缺损1例报道

doi:10.12439/kqhm.1005-4979.2023.06.013

《口腔颌面外科杂志》 ›› 2023, Vol. 33 ›› Issue (6): 418-423. doi: 10.12439/kqhm.1005-4979.2023.06.013

• 病例报告 • 上一篇

三维打印+膜诱导技术修复重建下颌骨节段性缺损1例报道

肖晨亮¹(), 孙丽君²(), 何晓清³, 徐路¹, 赵徐达¹

¹ 中国人民解放军联勤保障部队第920医院耳鼻咽喉头颈外科，昆明 650032
² 中国人民解放军联勤保障部队第920医院普通外科，昆明 650032
³ 中国人民解放军联勤保障部队第920医院骨科，昆明 650032

收稿日期:2022-04-28 接受日期:2022-11-15 出版日期:2023-12-28 发布日期:2023-12-26
通讯作者: 孙丽君，主管护师. E-mail：448928989@qq.com
作者简介:
肖晨亮，副主任医师. E-mail：525976649@qq.com
基金资助:
联勤保障部队第九二〇医院院内科技计划(2019YG-B03)

Three dimension printing and Masquelet's induced membrane technique in mandibular segmental defect reconstruction: A case report

XIAO Chenliang¹(), SUN Lijun²(), HE Xiaoqing³, XU Lu¹, ZHAO Xuda¹

¹ Department of Otolaryngology-Head and Neck Surgery, the 920th Hospital of Joint Logistics Support Force of PLA, Kunming 650032, China
² Department of General Surgery, the 920th Hospital of Joint Logistics Support Force of PLA, Kunming 650032, China
³ Department of Orthopedics, the 920th Hospital of Joint Logistics Support Force of PLA, Kunming 650032, China

Received:2022-04-28 Accepted:2022-11-15 Online:2023-12-28 Published:2023-12-26

摘要/Abstract

摘要：

目的：报道1例2021年2月就诊于我院的下颌骨右侧成釉细胞瘤，采用Masquelet膜诱导技术（Masquelet's induced membrane technique，MIMT）重建患者下颌骨节段性缺损。方法：依据MIMT原则，给予患者Ⅰ期下颌骨部分切除+骨水泥植入，Ⅱ期依托数字化技术三维打印模型预塑钛网，移植髂骨碎骨块，Ⅲ期拆除重建板及钛网。结果：根据影像学检查及术中所见，应用MIMT修复重建下颌骨节段性缺损效果良好。结论：三维打印与MIMT应用于下颌骨节段性缺损能取得良好的成骨效果，可进一步进行研究。

关键词: Masquelet膜诱导技术, 三维打印, 下颌骨节段性缺损, 下颌骨重建

Abstract:

Objective: To report a case of ameloblastoma of mandible in our hospital using Masquelet's induced membrane technique (MIMT) to reconstruct mandibular segment defect in February 2021. Methods: According to the principle of MIMT, partial resection and implantation of bone cement were given in the first stage; with the help of digital surgery, three dimension printing model and pre-fabricated titanium mesh were used to transplant the iliac bone in the second stage; the plate and titanium mesh were removed in the third stage. Results: According to the post-operation CT images and intraoperative findings, the bone regeneration shows a good result with MIMT. Conclusion: MIMT can be further studied in the reconstruction of mandibular segmental defect.

Key words: Masquelet's induced membrane technique, three dimension printing, mandibular segmental defect, mandibular reconstruction

中图分类号:

R782

肖晨亮, 孙丽君, 何晓清, 徐路, 赵徐达. 三维打印+膜诱导技术修复重建下颌骨节段性缺损1例报道[J]. 《口腔颌面外科杂志》, 2023, 33(6): 418-423.

XIAO Chenliang, SUN Lijun, HE Xiaoqing, XU Lu, ZHAO Xuda. Three dimension printing and Masquelet's induced membrane technique in mandibular segmental defect reconstruction: A case report[J]. 《Journal of Oral and Maxillofacial Surgery》, 2023, 33(6): 418-423.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2023/V33/I6/418

图/表 10

图1 术前CT影像示右下颌骨病变 A.颌骨CT三维重建；B.冠状位影像；C.轴位影像。

Figure 1 Pre-operation CT images showing the lesion of right mandible

图2 Ⅰ期术中所见，骨水泥植入后

Figure 2 StageⅠintraoperative view after cement spacer implantation

图3 病理活检切片示下颌骨右侧成釉细胞瘤 A. 肿瘤侵犯骨组织（×40）；B.肿瘤呈巢状、条索状分布（×40）；C. 肿瘤相互融合呈网状，部分区域伴鳞状分化（×100）；D.周边细胞栅栏状排列，中央细胞中见嗜酸性颗粒（×200）。

Figure 3 Histopathology of ameloblastoma of right mandible

图4 骨水泥植入后复查CT A.颌骨CT三维重建；B.冠状位影像；C.轴位影像。

Figure 4 Post-operation CT images after cement spacer implantation

图5 Ⅱ期术中所见 A. 三维打印颌骨镜像模型；B.预塑形钛网；C. 钛网放入颌骨缺隙后。

Figure 5 StageⅡintraoperative view

图6 植入碎骨块 A. 髂骨皮质骨粉碎后与松质骨混合；B. 髂骨碎骨块植入后。

Figure 6 Implant bone frament

图7 Ⅱ期术后复查CT A.颌骨CT三维重建；B.冠状位影像；C.轴位影像。

Figure 7 StageⅡpost-operation CT images showing three dimension reconstruction

图8 Ⅱ期术后6个月 A.患者术后正面照；B.术后咬合照。

Figure 8 Clinical photos showing 6 months after stageⅡoperation

图9 Ⅱ期术后6个月 A.颌骨CT三维重建；B.冠状位影像；C.轴位影像。

Figure 9 CT images showing 6 months after stageⅡoperation

图10 钛板拆除术后9个月 A.颌骨CT三维重建；B.冠状位影像；C.轴位影像。

Figure 10 CT images showing 9 months after removal of plates

参考文献 19

[1]	周训银, 李研, 吴殿源, 等. 吻合血管的自体骨移植修复下颌骨缺损76例回顾分析[J]. 中国口腔颌面外科杂志, 2003, 1(2): 120-123.
[2]	Hidalgo DA. Fibula free flap: A new method of mandible reconstruction[J]. Plast Reconstr Surg, 1989, 84(1): 71-79. pmid: 2734406
[3]	刘宝林. 肿瘤术后颌骨缺损的功能重建[J]. 中华口腔医学杂志, 2003, 38(1): 9-11, I002.
[4]	廖贵清, 苏宇雄. 牙源性肿瘤术后颌骨缺损的修复重建[J]. 中国实用口腔科杂志, 2009, 2(2): 79-81.
[5]	Pitak-Arnnop P, Hemprich A, Dhanuthai K, et al. Fibular flap for mandibular reconstruction: Are there old tricks for an old dog?[J]. Rev Stomatol Chir Maxillofac Chir Orale, 2013, 114(1): 15-18. doi: 10.1016/j.stomax.2012.05.001 pmid: 23714213
[6]	杨辛. 牵张成骨在下颌骨缺损修复中的应用和进展[J]. 国外医学口腔医学分册, 2004, 31(2): 141-143.
[7]	Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft[J]. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
[8]	Masquelet AC. Induced membrane technique: Pearls and pitfalls[J]. J Orthop Trauma, 2017, 31(Suppl 5): S36-S38.
[9]	Pelissier P, Bollecker V, Martin D, et al. Foot reconstruction with the “bi-Masquelet” procedure[J]. Ann Chir Plast Esthet, 2002, 47(4): 304-307. doi: 10.1016/S0294-1260(02)00123-1 URL
[10]	Taylor BC, Zink T, McGowan S. Masquelet technique for chest wall reconstruction: A case report[J]. JBJS Case Connect, 2020, 10(1): e0011. doi: 10.2106/JBJS.CC.19.00011 URL
[11]	Micev AJ, Kalainov DM, Soneru AP. Masquelet technique for treatment of segmental bone loss in the upper extremity[J]. J Hand Surg Am, 2015, 40(3): 593-598. doi: 10.1016/j.jhsa.2014.12.007 pmid: 25648786
[12]	Zhang LF, Lu CY, Lv YQ, et al. Three-dimensional printing-assisted masquelet technique in the treatment of calcaneal defects[J]. Orthop Surg, 2021, 13(3): 876-883. doi: 10.1111/os.v13.3 URL
[13]	中华口腔医学会口腔颌面修复专业委员会. 下颌骨缺损修复重建治疗专家共识[J]. 中华口腔医学杂志, 2019, 54(7): 433-439.
[14]	Alford AI, Nicolaou D, Hake M, et al. Masquelet's induced membrane technique: Review of current concepts and future directions[J]. J Orthop Res, 2021, 39(4): 707-718. doi: 10.1002/jor.24978 pmid: 33382115
[15]	Xie J, Wang W, Fan XL, et al. Effects of PMMA spacer loaded with varying vancomycin concentrations on bone regeneration in the Masquelet technique[J]. Sci Rep, 2022, 12(1): 4255. doi: 10.1038/s41598-022-08381-z pmid: 35277575
[16]	Viateau V, Bensidhoum M, Guillemin G, et al. Use of the induced membrane technique for bone tissue engineering purposes: Animal studies[J]. Orthop Clin North Am, 2010, 41(1): 49-56. doi: 10.1016/j.ocl.2009.07.010 URL
[17]	刘华蔚, 李永锋, 母晓丹, 等. 口腔颌面外科手术三维打印系列导板的设计制作和临床应用[J]. 中华口腔医学杂志, 2021, 56(11): 1085-1091.
[18]	Khonsari RH, Adam J, Benassarou M, et al. In-house 3D printing: Why, when, and how? Overview of the national French good practice guidelines for in-house 3D-printing in maxillo-facial surgery, stomatology, and oral surgery[J]. J Stomatol Oral Maxillofac Surg, 2021, 122(4): 458-461. doi: 10.1016/j.jormas.2021.08.002 pmid: 34400375
[19]	谭新颖, 胡敏, 陶冶, 等. 计算机辅助外科在颅颌面部骨纤维异常增殖手术中的应用[J]. 上海口腔医学, 2014, 23(1): 62-65.

选择文件类型/文献管理软件名称

选择包含的内容

三维打印+膜诱导技术修复重建下颌骨节段性缺损1例报道

Three dimension printing and Masquelet's induced membrane technique in mandibular segmental defect reconstruction: A case report

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

图/表 10

参考文献 19

相关文章 2

编辑推荐

Metrics

本文评价

[1]	王艳艳, 康非吾. 数字化技术在牙槽外科中的应用及进展[J]. 《口腔颌面外科杂志》, 2023, 33(2): 116-118.
[2]	龙洁，鞠锐. 数字导板在颌面外科临床应用的实践与思考[J]. 《口腔颌面外科杂志》, 2019, 29(6): 301-.

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

三维打印+膜诱导技术修复重建下颌骨节段性缺损1例报道

Three dimension printing and Masquelet's induced membrane technique in mandibular segmental defect reconstruction: A case report

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

图/表 10

参考文献 19

相关文章 2

编辑推荐

Metrics

本文评价