| Background:The appearance of the human face plays an important role in the individual's mind,and has an important influence on the personal development and interpersonal communication.With the development of the times,more and more people are familiar with facial plastic surgery,which is more common.In the field of plastic surgery,contouring is a complex procedure toalter tissue contents and restore facial appearance;however,it is difficult to determine the appropriate amount of change.Meanwhile,it demands the change and outcome to accord with the expectation of surgeon and patient.Historically,the surgeon mainly through personal experience to assess the possible postoperative effect,the lack of objective and effective tools to guide the operation.This may lead to uncertainty in the postoperative effect and patient satisfaction.With the development of imaging techniques,the application of three-dimensional reconstruction technique combined with computer aided preoperative evaluation and surgical planning of postoperative stroke,and can provide objective basis for auxiliary the operation,improve the operation plan,improve the surgery prognosis.However,a single application of three-dimensional digital simulation can not meet the needs of patients with complex surgery,and three-dimensional digital simulation is confined to the plane,the lack of three-dimensional visual sense.This study is to investigate and evaluate the accuracy and availability of combined application of preoperative computer simulation(DS)and three-dimensional(3D)rapid prototyping technology in facial contouring procedure to get a better expected outcome and patient satisfaction.Patients and Methods:Patients with defect or shortage in contouring were enrolled and divided into frontal and lateral contours.We chose the patients who had nasal root,short chin,prominent malar bone and mandibular angle hypertrophy as ours research objectives.The experimental group was divided into the experimental group who was treated with the combination of DS and rapid prototyping and the control group.Three-dimensional surface imaging(3DSI)and computed tomography imaging(CTI)were reconstructed into a three-dimensional structure.The digital 3D structure is then comprehensively studied,measured,and analyzed to make the diagnosis and plan toward problem-solving solutions.DS is conducted by the simulation of cutting?implanting?rotating and translation operation of the bone and soft tissue.DS were transferred to three-dimensional printing of custom templates to guide the treatment at the time of surgery.After surgery,DS and postoperative evaluation was completed by objective assessment via rating and measuring the differences between DS and actual outcomes by the cephalometric analyses,and then subjective assessing the satisfaction of post-operation.Results:According to the professional surgeon's rating,the total accuracy of DS of 3DSI and CTI respectively was 87.5%?83.4%.The average satisfaction of patients in the experimental group were more than 3.4,compared with the control group,there was statistical difference.Cephalometric analyses show the average of the differences between DS and actual postoperative outcomes were limited to 2.17mm.The difference between the change of actual and simulate is small,there was no significant difference.There was no significant difference in the comparison between preoperative and postoperative differences between the two digital simulation systems.Conclusions:Preoperative computer simulation is an accurate method for designing the plan in contouring and can be an efficient and reliable predictor to get an expected outcome with the guide of custom templates.Using two kinds of simulation system,it can effectively deal with the external soft tissue contour and internal bone tissue to fit the complex requirements about facial contouring.Moreover,it establishes a good doctor-patient education and then improve patient satisfaction though the communicate with patients to determine the operation plan. |
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