The Clinical Research Of Three-dimensional Printing And Neuronavigation In The Skull Base Meningioma Surgery

Objective:To study the experience about the application of three-dimensional printing combined with intraoperative neuronavigation in the treatment of skull base meningiomas,analyze its value comprehensively and evaluating its clinical application value.Methods:Collected 35 patients continuously,including 15 males and 20 females about 15 cases of sphenoid ridge and mid-lateral meningioma,3 cases of sellar meningioma,12 cases of CPA,3 cases of meningeal meningioma,and 2 cases of cavernous sinus meningioma(manifesto confirmed as meningioma)in the Department of Neurosurgery of the People's Hospital Affiliated Shanxi Medical University from April 2016 to December 2017.Those people who diagnosis meningioma patients completing 3D data or model and intraoperative neuronavigation surgical treatment.To retrospect comparison study the other total of 35 patients with previous skull base meningioma neuronavigation microsurgery,18 males and 17 females,including 12 cases of sphenoid ridge lateral meningioma,5 cases of sellar meningioma,10 cases of CPA area,olfactory meningioma 5 cases,3 cases of cavernous sinus meningioma(mandibular tumor confirmed by postoperative pathology).Clinical data analysis was included in the study from January 2015 to April 2016(microsurgery group).The CT and MRI images of the patient and some of the DTI tomographic data were perfected preoperatively.The 3D printing software output system was used to process the long-fiber bundles in the skull base,tumor,and intracranial region of the 3D model to establish a clear phase.The preoperative intraoperative surgical model further plans the precise design of the surgical approach and the preparation of surgical strategies for the treatment of important variant nerves and blood vessels during surgery.The preoperative CT and MRI dials are used to guide the backup data into navigation system fusion correction.Guidance,retrospective analysis of patients with surgical approach comparison,tumor resection degree,operation time,complications and prognosis,and collect relevant data for statistical analysis.Results:1.Of the 35 patients in the new technique group,22 were treated with total resection of tumors(Simpson ?,?),8 with subtotal resection(Simpson ?),and 5 with severe resection(Simpson ?);There were 3 cases with GOS prognostic score(3 scores),5 cases with mild complications(GOS prognosis score 4 points),27 cases without obvious complications(GOS prognostic score 5 points),no perioperative deaths;retrospective inclusion Only neurosurgical patients with total tumor resection(Simpson ?,?)in 23 cases,9 cases of subtotal tumor resection(Simpson ?),3 cases of subtotal tumor resection(Simpson ?);severe complications(GOS prognostic score)3 points)5 cases,7 cases of mild complications(GOS prognosis score 4 points),no obvious complications(GOS prognosis score 5 points)occurred in 23 cases,no perioperative deaths.There was no statistical difference between the two groups in the age distribution correction X2=0.668,p=0.716;gender distribution correction X2=0.516,,p=0.473,no statistical difference;growth site distribution correction X2=1.715,p=0.788 Statistical difference;the degree of tumor resection in the two groups was compared with X2 = 0.581,p = 0.784 without statistically significant difference;postoperative complications were compared X2= 6.275,p = 0.043,P ? 0.05,in reducing postoperative complications There are statistically significant differences;according to the surgical site,the mean operating time does not have to be shortened to varying degrees.The use of 3D printed brain tumor models combined with intraoperative navigation system showed good advantages for the protection of intraoperative functional areas,shortening of operation time,and postoperative complications.2.Through surveys and questionnaires,it is concluded that the young doctors generally subjectively believe that learning is more intuitive and easier to understand related issues.Conclusion:1.We can lean,discuss,and plan the surgery more intuitively preoperatively.Predicting that the surgical approach may encounter important structures in the course of surgery,formulate solutions in advance and increase the safety of the operation;2.Shorten the operation time and reduce the exposure time of the incision;3.Reduce postoperative complications;...