Explorate The Role Of 3D Printing Combined With Image Guided Technology In Skull Base Resection

Objective: In this study,3D printing technology and IGS technology in3D-Slicer software were used to create solid model combined with image guidance technology to assist neurosurgeons in tumor evaluation,preoperative localization and simulation of skull base tumor resection,so as to explore the value of 3D printing combined with image guidance technology in skull base tumor resection.Methods: Patients admitted to Neurosurgery Department of Yunnan Cancer Hospital from October 2021 to May 2022 who were diagnosed with skull base tumor by CT or MRI examination were selected.Inclusion criteria: patients aged 20-85 years who were identified by CT or MRI as having skull base tumors;It can be combined with CT and magnetic resonance examination of the brain and sellar region,and there are no contraindications for enhanced examination.Exclusion criteria: Patients with cerebral hemorrhage and brain surgery;Have a history of serious mental illness;Patients with cognitive dysfunction,aphasia and inability to cooperate with tests;Complicated with serious diseases such as liver and kidney;Patients with poor image quality,unable to perform image post-processing and clinical diagnosis.Results: According to the exclusion criteria,20 patients with skull base tumor were eventually included,including 10 patients in the control group,consisting of 6 males and 4 females.Pathological types: pituitary tumor in 3 cases,Rathke cyst in 2 cases,metastatic tumor in 1 case,meningioma in 1 case,ependymoma in 1 case,glioma in 1 case.In the experimental group,10 patients were enrolled,including 5 males and 5 females.Pathological types: Pituitary tumor in 7 cases,craniopharyngioma in 1 case,cerebellar metastatic tumor in 1case,poorly differentiated carcinoma in 1 case.The subjective evaluation results showed that: the degree of tumor display,the degree of spatial relationship between tumor and surrounding structures,and the effectiveness of preoperative planning in the three kinds of image subjective quality evaluation score differences were statistically significant,and the score of the control group was better than that of the experimental group.The image quality evaluation of the two groups of research objects is also consistent.In terms of objective evaluation,the difference analysis showed that there was no difference between the experimental group and the control group in the type of surgery(Fisher,P=0.582)and operation method(Fisher,P=0.170).The rate of no complications(cerebral hemorrhage,intracranial infection,pituitary dysfunction,coagulation disorder and cerebrospinal fluid rhinorrhea)in the experimental group(Fisher,P=0.020)was higher than that in the control group,and the length of hospital stay(t=-2.381,P=0.029)was lower than that in the control group.The operation duration(Z=-2.658,P=0.008)and hospital stay(Z=-2.698,P=0.007)of the experimental group were less than those of the control group.The Barthel index self-care ability level of the experimental group(Z=-2.359,P=0.018)was significantly different from that of the control group,and the mild dependence of the experimental group was higher than that of the control group.Conclusion(s): In this study,3D printing combined with image guidance technology was used to display the spatial location of skull base tumor and the surrounding invasion situation in stereo,which assisted operators to evaluate the tumor before surgery,develop the preoperative plan and simulate the surgical approach.After two physicians’ subjective evaluation of image quality and objective evaluation of various surgical indicators,It is proved that 3D printing combined with image guidance technology has a certain value in guiding the resection of skull base tumors.