Objective To probe into the characteristics and application of the Voxel-Man TempoSurg in middle ear surgical procedures. Methods A total of 40 middle ear surgical procedures from June 2012 to March 2015 were selected, which included 21 cases of cholesteatoma , 6 cases of cholesterol granuloma , 4 cases of congenital external and middle ear malformation , and 9 cases of temporal fractures .The videos of these routine surgical procedures were reserved .Then simulated procedures same as real procedures in the operations were carriec out .The appearances of the important structures , such as the posterior crest of the external auditory canal, the tympanic sulcus, the ossicles, the facial never, the external semicircular canal , the sigmoid sinus, the cerebral plate and the round window niche were recorded in the simulated procedures while comparing with real procedures . Results In terms of types of lesion, there were 27 cases of soft issue structure lesions and 13 cases of bone structure lesions .In otologic surgery simulation system, the displaying rate of lesions in cases with bone structure lesions (100%, 13/13) was significantly higher than that with soft issue structure lesions (7.4%, 2/27).The difference was statistically significant (Fisher's Exact Test, P=0.000).However, the displaying rate was not statistically significant in other structures (P>0.05).In terms of mastoid pneumatization, there were 16 cases of pneumatic mastoids and 24 cases of non-pneumatic mastoids .The displaying rate of lesions in cases with pneumatic mastoids (68.8%, 11/16) was significantly higher than that with non-pneumatic mastoids (16.7%, 4/24).The difference was statistically significant (Fisher's Exact Test, P=0.002).In terms of surgical types of mastoidectomy, there were 25 cases with canal-wall-up mastoidectomy and 15 cases with canal-wall-down mastoidectomy . The displaying rate of lesions in cases with canal-wall-up mastoidectomy (48.0%, 12/25) was significantly higher than that with canal-wall-down mastoidectomy (20.0%, 3/15), without significant difference (Fisher's Exact Test, P=0.101).The displaying rate of other structures was not statistically significant (P>0.05). Conclusion Lesions can be simulated satisfactorily in cases with bone structure lesions and good pneumatic mastoid by using otologic simulator .%目的 探讨耳科手术模拟系统Voxel-Man TempoSurg在不同类型中耳手术的模拟操作中的特点与应用.方法 选择2012年6月~2015年3月中耳手术40例,包括中耳胆脂瘤21例,胆固醇肉芽肿6例,先天性外中耳畸形4例,颞骨多发骨折9例,留取手术录像.利用耳科手术模拟系统对上述病例进行与手术实际操作相同的模拟操作,对比真实手术,记录外耳道后上嵴、鼓环/鼓沟、听小骨、面神经、外半规管、乙状窦、脑板、圆窗龛等解剖结构以及病变组织在模拟手术中出现的情况.结果 按病变类型分为软组织类型27例和骨性类型13例,耳科手术模拟系统中骨性类型中病变的显示率(100%,13/13)明显优于软组织类型(7.4%,2/27)(Fisher检验,P=0.000),其他结构显示率差异无统计学意义(P>0.05).按乳突气化程度分为气化型16例和非气化型24例,气化型乳突中病变的显示率(68.8%,11/16)显著性高于非气化型(16.7%,4/24)(Fisher检验,P=0.002).按采用的乳突开放术式分为完壁式25例和开放式15例,完壁式病变显示率(48.0%,12/25)与开放术式(20.0%,3/15)差异无显著性(Fisher检验,P=0.101),其他结构显示率差异亦无统计学意义(P>0.05).结论利用耳科手术模拟器,在以骨性类型为主的病种及气化较好的乳突中,可以较好地模拟病变的情况.
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