【摘要】：背景：耳顯微外科所涉及的解剖結(jié)構(gòu)基本都深藏于顳骨中，自身體積細小精微，形態(tài)多變而不規(guī)整。此外，許多顳骨內(nèi)的結(jié)構(gòu)，如：面神經(jīng)、頸內(nèi)動脈、頸內(nèi)靜脈、乙狀竇等，行程綿延曲折、空間跨度較大，且與顱底、顱內(nèi)、腮腺、上頸部等周圍區(qū)域內(nèi)的結(jié)構(gòu)或直接沿續(xù)、或位置關(guān)系密切。因而，人們對耳顯微外科所涉及的解剖結(jié)構(gòu)常常是觸之不及、窺之不見，難以建立直觀、形象而具體的空間感受，學(xué)習(xí)和熟練掌握的難度較大。此外，目前應(yīng)用于耳顯微外科臨床及解剖的圖片及視頻基本都是二維的，而在實際的臨床工作中，術(shù)者所看到的真實術(shù)野是具有豐富的立體信息的。相對于原始的立體術(shù)野，二維媒體丟失了許多關(guān)鍵的立體信息，這些立體信息在辨識解剖結(jié)構(gòu)、確定解剖方位等方面非常重要，當手術(shù)中遇到因出血或正常結(jié)構(gòu)被破壞而導(dǎo)致解剖標志不清時這些立體信息尤為重要。因此，如何以恰當?shù)姆绞奖４婧驮佻F(xiàn)原始術(shù)野的立體信息，如何以最佳的角度展示耳顯微外科涉及的解剖結(jié)構(gòu)和解剖操作過程，是本課題需要解決的兩個主要問題。 目的：探索將立體視覺技術(shù)應(yīng)用于耳顯微外科的方法；探索以立體的表現(xiàn)形式展示顳骨內(nèi)解剖結(jié)構(gòu)及解剖操作的方法。 方法：調(diào)查研究現(xiàn)有的多種立體視覺重建解決方案，并結(jié)合耳顯微外科臨床工作特點篩選可以應(yīng)用于耳顯微外科的立體視覺重建解決方案；在解剖及手術(shù)工作中驗證選定的立體視覺重建解決方案的可行性，并對最終選定的解決方案進行規(guī)范化、流程化處理；開展規(guī)范的、系統(tǒng)的顳骨解剖，并按規(guī)范化流程采集并制作顳骨解剖和顳骨三維重建的立體素材，并通過合適的方式重現(xiàn)原始術(shù)野的立體信息。 結(jié)果：我們成功的將立體視覺技術(shù)應(yīng)用于耳顯微外科，制定了適用于耳顯微外科、并可推廣至其他相關(guān)領(lǐng)域的立體視覺重建解決方案�；诖朔桨福覀儗Χ@微外科立體視覺重建系統(tǒng)所涉及的設(shè)備、軟件、采集及制作方法等各個部分都進行了規(guī)范化、系統(tǒng)化處理，，形成了與耳顯微外科立體視覺重建方案相匹配的軟、硬件系統(tǒng)。我們按規(guī)范化的流程采集了1.2萬余幅顳骨解剖及顳骨三維重建素材，制作了624幅高質(zhì)量的顳骨解剖和顳骨三維重建立體圖，而且這些立體圖可以源源不斷的增加并能保持持續(xù)更新，從而使耳顯微外科立體視覺重建系統(tǒng)具備了臨床實用價值。在現(xiàn)有技術(shù)手段基礎(chǔ)上，我們還進一步探索性的開發(fā)了耳顯微外科立體電視監(jiān)視系統(tǒng)，目前該系統(tǒng)已實現(xiàn)本地及局域網(wǎng)內(nèi)的立體實時監(jiān)控，初步顯現(xiàn)出其臨床實用價值。 結(jié)論：耳顯微外科立體視覺技術(shù)可以應(yīng)用于耳顯微外科。耳顯微外科立體視覺信息重建系統(tǒng)集成度高、操作簡單、并能夠很好的保存并重現(xiàn)原始術(shù)野的立體信息。耳顯微外科立體視覺重建解決方案具備相當?shù)呐R床實用價值。
[Abstract]:Background: the anatomical structures involved in ear microsurgery are mostly embedded in the temporal bone, small and delicate in size, variable in shape and irregular in shape. In addition, many structures in the temporal bone, such as the facial nerve, internal carotid artery, internal jugular vein, sigmoid sinus, etc., have a long and tortuous journey, and have a large spatial span and may be directly followed by the structures in the surrounding areas such as the skull base, the skull, the parotid gland, the upper neck, etc. Or location is closely related. Therefore, the anatomical structure involved in ear microsurgery is often not as close as touch, not to be seen, it is difficult to establish visual, image and specific spatial feeling, and it is difficult to learn and master skillfully. In addition, at present, the images and videos used in the clinical and anatomical analysis of ear microsurgery are basically two-dimensional, but in the actual clinical work, the true surgical field seen by the operator is rich in three-dimensional information. Compared with the original stereoscopic field, the two-dimensional media has lost a lot of key stereoscopic information, which is very important in identifying the anatomical structure, determining the anatomic orientation, and so on. The stereoscopic information is especially important when the anatomical signs are unclear due to bleeding or the destruction of normal structures. Therefore, how to preserve and reproduce the three-dimensional information of the original surgical field in a proper way, and how to display the anatomical structure and anatomic process involved in ear microsurgery from the best angle are two main problems to be solved in this paper. Objective: to explore the method of applying stereoscopic vision to the microsurgery of the ear, and to explore the method of displaying the anatomical structure and operation of the temporal bone in the form of stereoscopic presentation. Methods: a variety of existing stereo vision reconstruction solutions were investigated and selected according to the clinical features of ear microsurgery. To verify the feasibility of the selected stereo vision reconstruction solution in anatomy and surgery, and to standardize and process the final selected solution, to carry out standardized, systematic temporal bone anatomy, The three-dimensional materials of temporal bone anatomy and three-dimensional reconstruction of temporal bone were collected and made according to the standardized procedure, and the stereo information of the original surgical field was reproduced in a suitable way. Results: we successfully applied stereo vision technology to ear microsurgery and developed a stereo vision reconstruction solution which can be extended to other related fields. Based on this scheme, we have standardized and systematized the equipment, software, acquisition and manufacturing methods of the stereo vision reconstruction system for ear microsurgery. A software and hardware system is formed to match the stereo vision reconstruction scheme of ear microsurgery. According to the standard procedure, we collected more than 12000 temporal bone anatomy and three-dimensional reconstruction materials, and made 624 high-quality three-dimensional images of temporal bone anatomy and temporal bone three-dimensional reconstruction. Moreover, these stereoscopic images can be continuously increased and continuously updated, which makes the stereo vision reconstruction system of ear microsurgery have clinical practical value. On the basis of the existing techniques, we have further developed a stereoscopic television surveillance system for ear microsurgery. At present, this system has realized the stereoscopic real-time monitoring in local and local area networks, and has shown its clinical practical value. Conclusion: stereoscopic vision technique can be used in microsurgery. The stereo vision information reconstruction system of ear microsurgery is highly integrated, easy to operate, and can save and reproduce the stereo information of the original field well. The solution of stereoscopic vision reconstruction in ear microsurgery is of considerable clinical value.
【學(xué)位授予單位】：南開大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2012
【分類號】：R764

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