本文選題：計(jì)算機(jī)模擬 + 耳外科手術(shù)��； 參考：《中國(guó)微創(chuàng)外科雜志》2017年03期

【摘要】：目的探討耳科手術(shù)模擬系統(tǒng)Voxel-Man Tempo Surg在不同類型中耳手術(shù)的模擬操作中的特點(diǎn)與應(yīng)用。方法選擇2012年6月~2015年3月中耳手術(shù)40例,包括中耳膽脂瘤21例,膽固醇肉芽腫6例,先天性外中耳畸形4例,顳骨多發(fā)骨折9例,留取手術(shù)錄像。利用耳科手術(shù)模擬系統(tǒng)對(duì)上述病例進(jìn)行與手術(shù)實(shí)際操作相同的模擬操作,對(duì)比真實(shí)手術(shù),記錄外耳道后上嵴、鼓環(huán)/鼓溝、聽(tīng)小骨、面神經(jīng)、外半規(guī)管、乙狀竇、腦板、圓窗龕等解剖結(jié)構(gòu)以及病變組織在模擬手術(shù)中出現(xiàn)的情況。結(jié)果按病變類型分為軟組織類型27例和骨性類型13例,耳科手術(shù)模擬系統(tǒng)中骨性類型中病變的顯示率(100%,13/13)明顯優(yōu)于軟組織類型(7.4%,2/27)(Fisher檢驗(yàn),P=0.000),其他結(jié)構(gòu)顯示率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。按乳突氣化程度分為氣化型16例和非氣化型24例,氣化型乳突中病變的顯示率(68.8%,11/16)顯著性高于非氣化型(16.7%,4/24)(Fisher檢驗(yàn),P=0.002)。按采用的乳突開(kāi)放術(shù)式分為完壁式25例和開(kāi)放式15例,完壁式病變顯示率(48.0%,12/25)與開(kāi)放術(shù)式(20.0%,3/15)差異無(wú)顯著性(Fisher檢驗(yàn),P=0.101),其他結(jié)構(gòu)顯示率差異亦無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論利用耳科手術(shù)模擬器,在以骨性類型為主的病種及氣化較好的乳突中,可以較好地模擬病變的情況。
[Abstract]:Objective to investigate the characteristics and application of Voxel-Man Tempo Surg (Voxel-Man Tempo Surg) in different types of middle ear surgery. Methods from June 2012 to March 2015, 40 cases of middle ear surgery were selected, including 21 cases of middle ear cholesteatoma, 6 cases of cholesterol granuloma, 4 cases of congenital deformity of external middle ear, 9 cases of multiple fracture of temporal bone. The surgical simulation system was used to perform the same simulation operation as the actual operation. The posterior superior ridge of the external auditory canal, tympanic ring / sulcus, auditory bone, facial nerve, external semicircular canal, sigmoid sinus, brain plate were recorded. Anatomic structures such as round window niches and the appearance of diseased tissues in simulated surgery. Results there were 27 cases of soft tissue type and 13 cases of bone type according to the type of lesion. The display rate of osteogenic type (100% 13 / 13) was significantly better than that of soft tissue type (7.4% 27) (Fisher test P0. 000), but there was no significant difference in other structures (P0.05). According to the degree of mastoid gasification, there were 16 cases of gasification type and 24 cases of non-gasification type. The demonstration rate of pathological changes in the mastoid process of gasification type (68.8% / 11 / 16) was significantly higher than that of non-gasification type (16.7% / 24) (Fisher test P0. 002). According to the open mastoid procedure, there were 25 cases of complete wall type and 15 cases of open type. The display rate of end wall lesion (48.0 / 25) was not significantly different from that of open procedure (20.0 / 15) (Fisher test P0.101), and there was no significant difference in other structures (P0.05). Conclusion the use of ear surgery simulator can simulate the pathological changes in osteogenic diseases and mastoid processes with good gasification.
【作者單位】： 北京大學(xué)第三醫(yī)院耳鼻咽喉頭頸外科;
【基金】：首都衛(wèi)生發(fā)展科研專項(xiàng)(首發(fā)-2016-2-4094)
【分類號(hào)】：R764.9

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