Abstract:

Objective　To use the technology of three-dimensional （3D）reconstruction based on head CT for  preoperation  planning and postoperative  assessment in the nasal inverted papilloma surgery, and to provide reference value for clinical application.　Method　This study selected a male patient, who was 65 years old with a weight of 70 kg and height of 170 cm, and had  no head trauma history, surgery history and family history of brain disease. Head CT scans were performed to exclude organic brain diseases. Informed consent has been signed with the patient. The reverse engineering software Mimics 15.0 was used to create a 3D-reconstruction model, the model components were measured by 3-matic 7.0, and the preoperative planning and follow-up observation for the nasal inverted papilloma operation were designed.　Result　The 3D-models of head skull and sinus were established in accordance with the CT image measurement results;  a 3D model of simulated nasal passages and tumors that consistent with the surgical approach was established; the surgical design of complicated nasal tumor and assessment after eradication were further completed. Postoperative tumor measurements showed a maximum diameter of 64.78 mm on the X-axis, 71.21 mm on the Y-axis, 86.46 mm on the Z-axis, and a total volume of 58.88 ml. This was in accord with the preoperative measurement results in shape and size. According to the analysis, the size of the tumor tissue resected during the operation was basically the same as the size of the preoperative 3D-model reconstructed tumor, indicating that the tumor tissue was completely resected by the operation.　Conclusion　Through the data analyzed by the 3D model,  we can design pre-operation  planning and complete the operation successfully. It is of great significance to guide the clinical design of individualized surgical approach for sinus tumors.

Key words: Nasal inverted papilloma, 　Accessory nasal sinuses, 　Operation planning, 　Reverse engineering, 　3D reconstruction