{"title":"通过三维打印颅骨成形术定制颞骨前部隆起以治疗颞骨前部凹陷（ATH）","authors":"Methee Wongsirisuwan","doi":"10.1016/j.neuchi.2023.101528","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Anterior temporal hollowing (ATH) leads to unattractive facial asymmetry and significant distress for the patient. This study aimed to correct ATH by a prefabricated cranioplasty using soft-tissue volume augmentation created by 3D printing and to evaluate the esthetic improvement.</p></div><div><h3>Methods</h3><p>This prospective study was conducted on 19 patients with ATH after brain surgery. Quantitative assessment used Materialized Mimics® and Images® to compare defect volume and quantitative measurement of the “defect value” pre- and post-PMMA implantation. Qualitative assessment was rated by patients on VAS pre- and 6 months post-surgery.</p></div><div><h3>Results</h3><p>The mean defect value decreased significantly with the innovative PMMA implant, from 2.42 ± 0.57 cm to 0.57 ± 0.45 cm (<em>p</em> < 0.01). There was a statistically significant reduction between pre- and postoperative defect value: 1.85 ± 0.48 (<em>p</em> < 0.01; 95% CI 2.08–1.61). After PMMA cranial implantation, 100% of patients reported esthetic improvement, 79% (15 out of 20) rating their esthetic improvement with the highest possible VAS score: mean VAS rating, 0.84 ± 1.2 preoperatively, and 4.63 ± 0.83 postoperatively, for a significant mean improvement of 3.789 ± 1.273 (<em>p</em> < 0.01; 95% CI 3.176–4.403).</p></div><div><h3>Conclusions</h3><p>The innovative PMMA cranial implants created by advanced customized 3D technology successfully managed ATH. This could be a therapeutic alternative for correcting ATH and can be routinely employed in clinical practice.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 1","pages":"Article 101528"},"PeriodicalIF":1.5000,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Customized anterior temporal augmentation for treating anterior temporal hollowing (ATH) by 3D-printed cranioplasty\",\"authors\":\"Methee Wongsirisuwan\",\"doi\":\"10.1016/j.neuchi.2023.101528\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Anterior temporal hollowing (ATH) leads to unattractive facial asymmetry and significant distress for the patient. This study aimed to correct ATH by a prefabricated cranioplasty using soft-tissue volume augmentation created by 3D printing and to evaluate the esthetic improvement.</p></div><div><h3>Methods</h3><p>This prospective study was conducted on 19 patients with ATH after brain surgery. Quantitative assessment used Materialized Mimics® and Images® to compare defect volume and quantitative measurement of the “defect value” pre- and post-PMMA implantation. Qualitative assessment was rated by patients on VAS pre- and 6 months post-surgery.</p></div><div><h3>Results</h3><p>The mean defect value decreased significantly with the innovative PMMA implant, from 2.42 ± 0.57 cm to 0.57 ± 0.45 cm (<em>p</em> < 0.01). There was a statistically significant reduction between pre- and postoperative defect value: 1.85 ± 0.48 (<em>p</em> < 0.01; 95% CI 2.08–1.61). After PMMA cranial implantation, 100% of patients reported esthetic improvement, 79% (15 out of 20) rating their esthetic improvement with the highest possible VAS score: mean VAS rating, 0.84 ± 1.2 preoperatively, and 4.63 ± 0.83 postoperatively, for a significant mean improvement of 3.789 ± 1.273 (<em>p</em> < 0.01; 95% CI 3.176–4.403).</p></div><div><h3>Conclusions</h3><p>The innovative PMMA cranial implants created by advanced customized 3D technology successfully managed ATH. 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引用次数: 0
摘要
背景颞前凹陷（ATH）会导致面部不对称，给患者带来极大困扰。本研究旨在通过预制颅骨成形术矫正 ATH，使用 3D 打印技术创建软组织体积增量，并评估其美学改善效果。方法本前瞻性研究针对 19 名脑部手术后的 ATH 患者。定量评估使用 Materialized Mimics® 和 Images® 对缺损体积进行比较，并对 PMMA 植入前后的 "缺损值 "进行定量测量。定性评估由患者在手术前和手术后 6 个月根据 VAS 进行评分。结果创新型 PMMA 植入物的平均缺损值显著降低，从 2.42 ± 0.57 厘米降至 0.57 ± 0.45 厘米（p < 0.01）。术前和术后的缺损值减少了 1.85 ± 0.48（p < 0.01; 95% CI 2.08-1.61），差异有统计学意义。PMMA颅骨植入术后，100%的患者报告其美观度得到改善，79%（20 人中有 15 人）的患者对其美观度的改善给予了尽可能高的 VAS 评分：术前平均 VAS 评分为 0.84 ± 1.2，术后为 4.63 ± 0.83，平均改善幅度为 3.789 ± 1.273（p < 0.01; 95% CI 3.176-4.403）。结论通过先进的定制三维技术制作的创新型 PMMA 颅骨植入物成功地控制了 ATH，可作为矫正 ATH 的一种治疗方法，并可在临床上常规使用。
Customized anterior temporal augmentation for treating anterior temporal hollowing (ATH) by 3D-printed cranioplasty
Background
Anterior temporal hollowing (ATH) leads to unattractive facial asymmetry and significant distress for the patient. This study aimed to correct ATH by a prefabricated cranioplasty using soft-tissue volume augmentation created by 3D printing and to evaluate the esthetic improvement.
Methods
This prospective study was conducted on 19 patients with ATH after brain surgery. Quantitative assessment used Materialized Mimics® and Images® to compare defect volume and quantitative measurement of the “defect value” pre- and post-PMMA implantation. Qualitative assessment was rated by patients on VAS pre- and 6 months post-surgery.
Results
The mean defect value decreased significantly with the innovative PMMA implant, from 2.42 ± 0.57 cm to 0.57 ± 0.45 cm (p < 0.01). There was a statistically significant reduction between pre- and postoperative defect value: 1.85 ± 0.48 (p < 0.01; 95% CI 2.08–1.61). After PMMA cranial implantation, 100% of patients reported esthetic improvement, 79% (15 out of 20) rating their esthetic improvement with the highest possible VAS score: mean VAS rating, 0.84 ± 1.2 preoperatively, and 4.63 ± 0.83 postoperatively, for a significant mean improvement of 3.789 ± 1.273 (p < 0.01; 95% CI 3.176–4.403).
Conclusions
The innovative PMMA cranial implants created by advanced customized 3D technology successfully managed ATH. This could be a therapeutic alternative for correcting ATH and can be routinely employed in clinical practice.
期刊介绍：
Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal.
With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published.
Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.
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