| Objective:The study designed to apply the digital three-dimensional technique to reconstruct the 3D model of the anterolateral femoral region. We focus on explorating the vascular distribution, the blood vessel diameter and position of perforator, determining the advantages of perforator and donor area before surgery, designing the perforator flap.Discussing the effectiveness of digital technology in repairing detect after the surgery in oral and maxillofacial tumors with anterolateral thigh perforator flap.Methods:1 Between February 2015 and March 2016, Department of Oral and Maxillofacial Surgery had treated nine cases of oral cancer patients, Prior to surgery, Department of radiology, first affiliated hospital, KMU, help us using Siemens Definifion flash CT scan and obtain CTA DICOM datasets. The data were exported in DICOM format, and imported to Mimics17.0 workstation software. Reconstructing the 3D visualization model of each tissue in the bilateral thigh by graphic reconstruction and segmentation tool in software. The keys are the reconstruction of the lateral femoral circumflex artery branches.The reconstructed images of muscles, blood vessels, bones and skin which could be multiply exhibited to show other adjacent structures by rotation and understand the relationships of organizations. Studying the digital clinical anatomy of anterolateral thigh perforator flap.2 The postion and quantity of anterolateral thigh perforator vessel could be measured and recorded by tools of software. Selective advantage for the region and perforators, and in the operation the flap was dissected on basis of preoperative design.3 The feasibility of digital three-dimensional reconstruction in former anterolateral thigh perforator flap surgery aided design for verification, by comparing whether the observation in the process of clinical surgery matching with preoperative markers and the result of detection.Results:This experiment include 9 cases of patients with a total of 18 sides samples found circumflex femoral artery, lateral descending branch of the perforating artery a total of 33 branches, averagely there were cutaneous 1.83 perforators in each side.33 perforators were identified, including 7 septocutaneous vessels and 26 masculocutaneous perforators One perforators were observed on 6 low limbs, two perforators were observed on 9 low limbs, three perforators were observed on low limbs, The mean distance of a given perforator from the ASIS was calculated as 45.18 ± 2.74cm. each branch to the superior border of patella distance averaged 18.6 ±3.35cm, each branch to the superior border of patella distance accounted for anterior on the spine to the lateral patellar edge distance ratio average 41.02%±6.6%. The 33 branches of the average diameter perforator was 2.15 ±0.46mm (1.19～3.12mm),which has 3 expenditure is more than lmm less than 1.5mm, 10greater than 1.5 mm less than 2.0mm,20 is larger than 2.0 mm, the superior perforator has 28, the mean outer diameter of the superior perforator for 2.28±0.37mm.Conclusions:1 Doing CTA examination and collecting data before Anterolateral thigh perforator flap transplantation, three-dimensional reconstruction with Mimics software.It’s precise to choose and locate optimal donor site and perforators, which makes flap dissection easier, decreases the injuries caused during operation and donor site morbidity. Compared with the traditional method, it can improve the success rate of flap.2 Image modeling and measurement statistics were used to do digital virtual dissection of femoral anterolateral area, study the interrelationship between the areas of the skin, muscle, blood vessels bone and other tissue by Separating and combinating them, which proved the feasibility of clinical application of digitized three-dimensional reconstruction of the anterolateral thigh perforator the in the design of the front flap surgery assistance. |
PDF Full Text Request