Application Of Digtal Technology Aimed Auricle Locating And Personalized Framework Design In Auricle Reconstruction For Microtia With Craniomaxillofacial Asymmetry

Objective To seek a method that could improve postoperative symmetry of auricles through using digital technology to locate the reconstructed auricle and design framework for microtia with craniomaxillofacial asymmetry. Subject and Method 1.Subject:Between September 2014 and March 2015,50 patients with microtia combined with craniomaxillofacial asymmetry and scheduled for auricle reconstruction were included in the study. Of 50 patients, there were 36 males and 14 females with a mean age of 8.28 years (range,5 years to 20 years). Evenly divided all of the patients into two groups:experimental and control.2. Method:(1) Scanned the auricles and heads of the patients in experimental group with 3D photogrammetric scanning technology, and built digital models with scan data. Located the reconstructed auricles and measure the morphological parameters and correcting parameters with digital technology on those digital models. (2) A CT machine was used to scan costal cartilages of those patients, digital models were built with image reconstruction technique, and morphological parameters of morphological parameters were measured on the models to estimate costal cartilage volume. (3) Fabricated the personalized frameworks and reconstructed auricles for patients in experimental group, according to the locating information, parameters and costal cartilage volume. And the control group take operation in common method. (4) Followed up all the two groups patients 1 month after the operation, and marked allthe reconstructed auricles into A, B,C by the surgeons, the independent plastic surgeons, the families of patients and the independent personnel. At last made a statistical analysis(the rate of A&B), the available data were analyzed by K-test (Kappa-test).Result 1.The digital models of auricles and heads built by 3D photogrammetric scanning got fine sharpness, verisimilitude, and stereoscopic impressions. 2.Gap existed between the skulls and the mirrored auricles, after the auricles on normal sides were mirrored.3.Fine locating information, accurate morphological parameters and correcting parameters of the reconstructed auricle were achieved from the digital models.4.The one month postoperative following up shown that the marking results of experimental group by the surgeons, the independent plastic surgeons, the families of patients and the independent personnel were better than control group. And the difference between marking results of the two groups from the independent plastic surgeons, the families of patients and the independent personnel were statistically significant.Conclusion 1. The digital models of auricles and heads built by 3D photogrammetric scanning could guide the clinical operation.2. Through analyzing the digital models could achieve the locating information, accurate morphological parameters and correcting parameters for the auricle reconstructions.3.Comparing with taking the traditional method, better following up results of auricle asymmetry were achieved when the information and parameters were included.