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A hybrid simulation model for pre-operative planning of transsphenoidal encephalocele.
Neurosurgical Review ( IF 2.5 ) Pub Date : 2020-08-08 , DOI: 10.1007/s10143-020-01361-9
Giselle Coelho 1, 2, 3 , Nicollas Nunes Rabelo 3 , Eduardo Varjão 1 , Thailane Marie 1 , Daniella Brito 1 , Emilio C Del Massa 1 , Henrique Zuppani 1 , Belmiro Matos 1 , Maurício Yoshida 1 , João Paulo Mota Telles 3 , Manoel Jacobsen Teixeira 3 , Eberval Gadelha Figueiredo 3, 4
Affiliation  

Congenital transsphenoidal encephalocele (CTE) surgical correction is a challenging procedure. Although rare, this anomaly, characterized with neural herniation elements, including the pituitary gland or optic pathway through the sphenoid bone with anatomical alteration, can be presented in many different ways and should be individually analyzed. Significant advances in medical technology and the 3D models may simulate the complex anatomical relations of the human body. Nowadays, medical education relies on the availability of standardized materials that can reliably emulate human anatomy. Therefore, realistic anatomical models have become an alternative for cadavers or animal specimens. In this technical note, the authors present a new technique to create personalized models that combine 3D printing, molding, and casting to create an anatomically and tactilely realistic model based on magnetic resonance and computerized tomography images. Produced from different silicon types, the model recreated the anatomic alterations precisely, allowing a multidisciplinary team to determine the adequate surgical approach for this patient. We describe a case of congenital transsphenoidal encephalocele of a 3-year-old boy, whose surgical correction was planned using a hybrid model. The technical description of the model is given in detail. This new hybrid model allowed a detailed discussion of the surgical approach aspects by having tissues of different consistencies and resistances and a very high prediction rate. This approach may allow a reduction in surgery time and possible complications after operative procedures.



中文翻译:


经蝶脑膨出术前规划的混合仿真模型。



先天性经蝶脑膨出(CTE)手术矫正是一项具有挑战性的手术。尽管罕见,但这种异常以神经突出元素为特征,包括垂体或通过蝶骨的视神经通路发生解剖改变,可以以多种不同的方式呈现,应单独分析。医疗技术和 3D 模型的重大进步可以模拟人体复杂的解剖关系。如今,医学教育依赖于能够可靠地模拟人体解剖学的标准化材料的可用性。因此,逼真的解剖模型已成为尸体或动物标本的替代品。在本技术说明中,作者提出了一种创建个性化模型的新技术,该技术结合了 3D 打印、成型和铸造,基于磁共振和计算机断层扫描图像创建解剖学和触觉逼真的模型。该模型由不同类型的硅制成,精确地再现了解剖结构的变化,使多学科团队能够为该患者确定适当的手术方法。我们描述了一名 3 岁男孩先天性经蝶脑膨出的病例,计划使用混合模型对其进行手术矫正。详细给出了该模型的技术描述。这种新的混合模型通过具有不同稠度和阻力的组织以及非常高的预测率,可以详细讨论手术方法方面。这种方法可以减少手术时间和手术后可能出现的并发症。

更新日期:2020-08-09
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