Establishment of electron beam computed tomography and rapid prototyping techniques for a cranial bone defect model in goat / 中华医学美学美容杂志

Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.

Effects of vacuum sealing drainage on the treatment of cranial bone-exposed wounds in rabbits

This study was designed to assess the efficacy of vacuum sealing drainage (VSD) on skull exposure wounds in rabbits and to investigate the underlying mechanism of the process. Full-thickness excisional circular wounds 2×2 cm with or without periosteum involvement were created in 88 New Zealand white rabbits (mean body weight: 3.0±0.65 kg). Animals were randomly divided into 4 groups: periosteum-intact wounds treated with traditional dressing (p+control), periosteum-intact wounds treated with VSD (p+VSD), periosteum-lacking wounds treated with traditional dressing (p-control) and periosteum-lacking wounds treated with VSD (p-VSD). The wounds treated with traditional dressing were covered with Vaseline gauze, while VSD treatment was accompanied with continuous -120 mmHg pressure. Finally, wound tissues were harvested for analysis of hydroxyproline content and histologic detection. VSD hastened the wound healing process significantly (P<0.05) compared to the corresponding control groups. VSD alleviated the inflammation reaction, accelerated re-epithelialization and facilitated the organization of collagen fibers into neat rows. During the wound healing process, the hydroxyproline content increased overtime [i.e., postoperative days (POD) 7, POD 10 and POD 15] in all four groups, and it peaked in the p+VSD group. VSD also promoted angiogenesis via increasing number and quality of collagen. We concluded that VSD can promote healing in bone-exposed wounds via increasing hydroxyproline content and vessel density, reducing inflammatory responses and generating ordered collagen arrangement.

Large cranial bone defect reconstructed by titanium implant of CAD/CAM / 中华医学美学美容杂志

Objective To explore a method of large cranial bone defect reconstructed by titanium implant with computer aided design(CAD)/computer aided manufacture(CAM)technique.Methods From April 2006 to June 2008,7 cases of cranial bone defect due to tumor and trauma were admitted.The data of skull bone defects were obtained by CT.The resin model was designed and manufactured with rapid prototyping technique.Results The CT data could be used by image software directly.The resin model was manufactured accurately by RP technique.The titanium implant design could be completed by CAD/CAM.7 patients achieved one stage healing.After a follow-up of 6 months to 1 year,cranial bone defect was reconstructed satisfactorily.Conclusion Individual design and repair of large cranial bone defect with CAD/CAM technique is worth extending application clinically.It is a quite ideal and very simple method for the surgical treatment of the cranial bone defect.

The Diagnosing Value of Diffusion-weighted Magnetic Resonance Imaging of the Cranial Bone in Pituitary Adenomas Patients with Different Prolactin Level / 中国医科大学学报

Objective To study the changes of apparent diffusion coefficient（ADC）values and the feature of the cranial bone in the pituitary adenomas patients with different levels of prolactin（PRL）.Methods A total of 37 patients with pituitary adenoma and 20 healthy volunteers（serum prolactin 7.5～21.7 ng/ml,as control group G1）underwent routine MR and axial EPI-DWI scan（b=0,500 s/mm2）.The patients were divided into group G2（PRL 26.72 ng/ml,n =7）,group G3（PRL 26.72~200 ng/ml,n =17）,and group G4（PRL200 ng/ml,n =13）.The signal intensity of the interested regions（ROIs）was measured on DWI maps containing frontal,parietal,occipital bone marrow.The averaged ADC values were calculated among the 4 groups and compared with case groups and control group.The correlation between prolactin levels in patients with pituitary adenomas and ADC values of their skull bone marrow was explored.Results All patients had a hyperintensity of skull bone marrow signal on DWI maps.The ADC values of frontal,parietal and occipital bone marrow were as follows：G1（1.11±0.21,1.18±0.18,1.16±0.15×10-3 mm2/s）,G2（0.95±0.20,0.86±0.12,1.09±0.11×10-3 mm2/s）,G3（0.99±0.16,0.83± 0.21,0.98±0.25×10-3 mm2/s）,G4（0.81±0.20,0.69±0.16,0.83±0.28×10-3 mm2/s）.The ADC values of G3 and G4 were lower than those of G1（P 0.05）.There was no significant difference（P 0.05）between G2 and G1.Conclusion The ADC values of skull bone marrow were negatively correlated with serum prolactin levels in patients with pituitary adenomas.DWI examination might be beneficial for the identification of pituitary adenomas.

Inferior Orbital Wall Reconstruction with Vascularized Partial Thickness Calvarial Bone Flap in Three Cases of Maxillary Tumor

PURPOSE: Inevitably, Maxillary structural defect follows maxillary cancer extirpation. Maxillary reconstruction is over every surgeon's head. Every physician tried to overcome limited donor site of craniofacial defect. We considered to suggest optimal method of inferior orbital wall defect in functional point as well as esthetic point. METHODS: We performed wide excision of maxilla and vascularized partial thickness calvarial bone flap to reconstruct the defect from cancer extirpation in three cases. We select ipsilateral superficial temporal artery, vein and outer cortex of parietal bone flap as donor. And we applied bone flap as inferior orbital wall structure. The bony surface was wrapped with fascia to prevent direct contact between orbital contents and rough bony flap surface. Computed tomography image was checked during follolw up period. RESULTS: We can observe these patients for over two years. In all three cases, We can get fair inferior orbital wall structure. Even though they got radiation therapy, there was no limitation of extraocular movements, no diplopia. no enophthalmos. Also there was minimal donor site morbidity. CONCLUSION: We suggest vascularized calvarial bone flap is practically excellent strategy for inferior orbital wall reconstruction

The effect of prp on the bone regeneration of beta-tcp grafted in rabbit cranial bone defect

Contribution of the Dura & the Pericranium in Absorption of Cranial Bone

Many craniofacial and neurosurgical procedures rely on cranial bone as a bone graft. In the majority of instances, the bone heals and gives good results. But we found that if either the dura or the pericranium were missing adjacent to the cranial bone, bone absorption would be increased. We studied a single animal model, investigating the contribution of the dura and the pericranium in the process of cranial bone absorption. The animals were divided into four groups of each five animals depending on the differential blockade of the dura and/or the pericranium by silastic sheet. Bilateral 100-mm2, parietal bone flaps were harvested from mature rabbits. Animals were humanely killed after 12 weeks, and histomorphometric analysis was performed. The volume maintenance is as follows; Group I; 89.0%, Group II; 80.0%, Group III; 63.3%, Group IV; 52.4%. The weight maintenance; Group I; 87.1%, Group II; 79.4%, Group III; 61.6%, Group IV; 51.1%. The histological contribution of living bone; Group I; 92.9%, Group II; 85.6%, Group III; 71.1%, Group IV; 56.2%. Significantly increased bone absorption occurred in Group II, III, IV compared with Group I. Conclusions are: 1. Cranial bone absorption is effected by both the dura and the pericranium. 2. The dura is more important than the pericranium in preventing cranial bone absorption. 3. The dura to be the source of central cranial bone and the pericranium to be the source of peripheral cranial bone.

The experimental study of the bone regeneration on beta-TCP in rabbit cranial bone

Pure-phase beta-tricalcium phosphate(beta-TCP) proved to be a bone regeneration material, providing the patient with vital bone at the defect site in a reasonable time, making a second surgical procedure for bone harvesting unnecessary. This study compares bone healing and BMP 2/4 expression in cranial defects in rabbits grafted with autogenous bone and beta-TCP. Thirty New Zealand White rabbits was divided into 3 group of 10 animals each. Bilateral calvarial defects were made in the parietal bones of each animal. beta-TCP placed in one defect and the other defects was filled with autogenous bone. The animal were sacrificed at 4, 8 and 12 weeks. Immunohistochemical analysis was used to investigate the expression of BMP 2/4. 1. The new bone formation around autogenous bone from 4 weeks and beta-TCP from 8 weeks. 2. In autogenous bone graft, BMP 2/4 expression was decreased from 4 to 12 weeks. 3. In beta-TCP graft, BMP 4 expression was increased from 8 to 12 weeks. But, BMP 2 was observed from 12 weeks. This study showed that bone healing, regeneration and, BMP 2/4 expression are delayed in grafted beta-TCP than autogenous bone.

A Case of Metastatic Small Hepatocellular Carcinoma to Cranial Bone with Left Eyelid Ptosis / 대한간학회지

Hepatocellular carcinoma (HCC) usually spreads to lung, regional lymph node, bone and the other organs by hematogenous, lymphatic route and direct extention at the advanced stage. Extrahepatic metastases from small HCC are, however, rare events. The frequent involving bony metastases are spine, rib and long bone. These are rare in cranial bone. Therefore, a case of small HCC diagnosed by first manifestation of cranial bone metastasis is very rare. We report a case of cranial bone metastasis with left eyelid ptosis from small HCC and review the literature pertaining to this condition.

Thickness of cranial bone: preliminary study