Value Of 3D Printing Technology In The Surgical Treatment Of Skull Base Tumors

Objective:The skull base tumor is one of the difficult problems in the field of neurosurgery due to its deep location,complex anatomical structure and diverse nature.This study aims to explore the application value of 3D printing technology in the surgical treatment of skull base tumors by constructing a personalized 3D model.Materials and Methods:The experimental group(3D printing group)consisted of 48 patients with skull base tumors who were treated with 3D printing technology in neurosurgery of a hospital from September 2020 to November 2022.The control group was 51 patients with skull base tumor who had received surgical treatment in neurosurgery department of a hospital.The 3D printing group included 26 cases of pituitary adenoma,12 cases of skull base meningioma,and 10 cases of neurilemmoma.The3 D printing technology was used to build a personalized model containing tumor,important blood vessels around tumor and skull base bone before operation.The control group included 25 cases of pituitary adenoma,14 cases of skull base meningioma and 12 cases of schwannoma.The patients in both groups were operated under combined intravenous and inhalation anesthesia,and were followed up for 3 months after operation.Analyze the general data of the two groups of patients to determine whether there is comparability between the two groups.A total of 6 neurosurgeons scored 48 3D models(1-5 points)according to the Likert scale to obtain the average of the scores to analyze the accuracy of the patients’ 3D printing models.Compare and statistically analyze the intraoperative bleeding volume,operation time,postoperative hospitalization time,and GOS score of patients in the3 D printing group and the control group,and determine the application value of 3D printing technology in the surgical treatment of skull base tumors.Result:1.A total of 99 patients with skull base tumors in the 13 D printing group and the control group successfully completed the surgery,of which 48 patients with skull base tumors in the 3D printing group were successfully constructed.There is no statistical difference in the general data of the two groups of patients(p>0.05),which can be analyzed and compared.2.According to the Likert scale score of 48 3D models,the overall conformity between the model and the preoperative imaging of patients was 4.48 ± 0.342 points,the conformity between the model and the size and shape of the tumor in the operation was 4.21 ± 0.275 points,the conformity between the model and the relationship between the tumor and the surrounding structure in the operation was3.95 ± 0.632 points,the score for preoperative planning and surgical simulation was4.05 ± 0.455 points,and the score for resident training and patient education was4.52 ± 0.262 points.The results show that 3D printing technology can build accurate personalized models,which can well carry out preoperative planning,physician teaching and patient education,but 3D models need to be further improved in building brain nerves and microvessels.3.There were 26 patients in the pituitary adenoma group,26 in the 3D printing group,and 25 in the control group.The average intraoperative blood loss was 93.46± 13.01 m L in the 3D printing group and 156.80 ± 20.80 m L in the control group;The average operation time was 133.35 ± 8.78 min in the 3D printing group and165.20 ± 12.57 min in the control group;The average postoperative hospital stay was 5.62 ± 2.58 days in the 3D printing group and 9.68 ± 5.52 days in the control group.The GOS score of all 51 patients was 5 points 3 months after operation.The results showed that the pituitary adenoma 3D printing group had less intraoperative bleeding,shorter operative time and shorter postoperative hospital stay,and the difference was statistically significant(p<0.05).4.In the skull base meningioma group,there were 12 patients in the 3D printing group and 14 patients in the control group.The average intraoperative blood loss was 363.75 ± 35.21 m L in the 3D printing group and 385.71 ± 44.26 m L in the control group;The average operation time was 374.58 ± 38.43 min in the 3D printing group and 401.36 ± 37.42 min in the control group;The average postoperative hospital stay was 12.67 ± 5.86 days in the 3D printing group and 14.93± 6.49 days in the control group.The GOS score of all 26 patients was 5 points 3months after operation.The results showed that the amount of intraoperative bleeding,operation time and postoperative hospital stay in the 3D printing group of skull base meningioma were relatively small,but the difference was not statistically significant(p>0.05).5.There were 10 patients in the schwannoma group and 12 in the control group.The average intraoperative blood loss was 384.00 ± 39.73 m L in the 3D printing group and 417.50 ± 44.01 m L in the control group;The average operation time was390.50 ± 31.26 min in the 3D printing group and 424.58 ± 19.28 min in the control group;The average postoperative hospital stay was 12.40 ± 1.73 days in the 3D printing group and 14.17 ± 1.17 days in the control group.The GOS score of all 22 patients was 5 points 3 months after operation.The results showed that the amount of intraoperative bleeding,operation time and postoperative hospital stay in the 3D printing group were relatively small,but the difference was not statistically significant(p>0.05).Conclusion:1.The size,shape and position relationship between the tumor and surrounding structures in the 3D printing model are basically consistent with those seen during the operation,and can accurately reflect the structure and position relationship,which plays an important role in the clinical teaching and patient education of residents,can shorten the learning curve of residents,and improve the understanding of patients on disease surgery.2.3D printing technology can assist surgery planning in pituitary adenoma surgery,significantly reduce intraoperative bleeding,shorten operation time and hospital stay,improve the safety of surgery,and reduce the potential cost of patients.3.The application value of 3D printing technology in the operation of skull base meningioma and neurilemmoma has no significant statistical difference,but it still has certain guiding significance for the surgical treatment,and its application is worthy of further exploration.