Abstract: Objective To explore the application value of 3D printed nasal skull base tumor model in the clinical and teaching of neurosurgery. Methods Total of 13 patients with skull base tumor were selected,the virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed according to the image data before surgery.40 students who participated in the standardized training of residents in the neurosurgery department were selected as teaching objects,and they were randomly divided into the traditional teaching group and the 3D printing model teaching group.The teaching effect of the two teaching modes was evaluated from the examination of theoretical knowledge and clinical skills,the satisfaction of teaching methods,the increase of understanding of neuroanatomical structure,the improvement of three-dimensional space imagination and the stimulation of active learning interest.Before surgery,the surgeon evaluated the spatial location of the tumor,preoperative talk,preoperative planning,intraoperative reference and postoperative anastomosis according to the 3D printed tumor model and traditional image data. Results The virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed before operation in all the 13 patients with skull base tumor.The 3D model clearly showed the tumor and its adjacent skull,blood vessels and nerves.We found that students in the 3D printed model teaching group had better scores in the assessment of theoretical knowledge and clinical skills than those in the traditional teaching group,and the difference between the two groups was statistically significant (P＜0.05).Moreover,the 3D printed model teaching group was higher than the traditional teaching group in terms of satisfaction with teaching methods,increasing understanding of neuroanatomical structure,improving three-dimensional space imagination and stimulating active learning interest.We also found that,in addition to preoperative planning,the 3D printed model group scored higher than the traditional image group on tumor spatial display,preoperative talk,intraoperative reference,and postoperative anastomosis.The difference between the two groups was statistically significant (P＜0.05). Conclusion Compared with the traditional surgical planning and clinical teaching based on two-dimensional image data,3D printed tumor model has better surgical planning and clinical teaching value.

Key words: 3D printing, Tumor model, Clinical, Teaching

摘要： 目的 探讨3D打印鼻颅底肿瘤模型在神经外科临床与教学中的应用价值。方法 选取13例颅底肿瘤患者,术前根据影像数据重建虚拟三维模型并3D打印等比例肿瘤模型,选择40名在神经外科参加住院医师规范化培训的学员作为教学对象,将其随机分为传统教学组和3D打印模型教学组,分别从理论知识和临床技能考核、教学方式满意度、增加对神经解剖结构理解、提高三维空间想象力和激发主动学习兴趣来评价两种教学模式的教学效果;手术前术者分别依据3D打印肿瘤模型和传统影像资料来评价肿瘤空间位置、术前谈话、术前规划、术中参考和术后吻合的效果。结果 本组13例颅底肿瘤患者术前均重建了虚拟三维模型并3D打印等比例肿瘤模型,3D模型清晰地显示了肿瘤与其毗邻的颅骨、血管和神经。我们发现,3D打印模型教学组的学员在理论知识和临床技能考核中的成绩均优于传统教学组,两组之间的差异有统计学意义(P＜0.05);不仅如此,3D打印模型教学组在教学方式满意度、增加对神经解剖结构理解、提高三维空间想象力和激发主动学习兴趣方面高于传统教学组。我们还发现,除了术前规划,3D打印模型组在肿瘤空间显示、术前谈话、术中参考和术后吻合方面的分值高于传统影像资料组。两组之间的差异有统计学意义(P＜0.05)。结论 与传统的根据二维影像资料来进行手术规划和临床带教相比,3D打印肿瘤模型具有更好的手术规划和临床带教价值。

关键词: 3D打印, 肿瘤模型, 临床, 教学