KR102649486B1 - Nose implants and how to make them - Google Patents

Abstract

A nasal prosthesis inserted between the nasal bone, nasal cartilage and nasal skin, comprising: a prosthesis body including an upper part covering the nasal bone and a lower part covering the nasal cartilage; and a vertical guide located between the upper and lower portions of the prosthesis body, wherein the vertical guide has a groove shape. The nasal prosthesis can be placed in an accurate position on the patient's nasal bone and nasal cartilage. .

Description

Nose implants and how to make them

The present invention relates to a method of manufacturing a nasal prosthesis, and more specifically, to a method of manufacturing a nasal prosthesis that can be used in rhinoplasty surgery to be customized to the patient.

Recently, along with the increase in interest in beauty, interest in plastic surgery is also increasing explosively. Among the facial areas, rhinoplasty has been widely popular since ancient times, and rhinoplasty is commonly used to improve the appearance of the nose by inserting artificial implants such as silicone into the nose.

Conventionally, in rhinoplasty surgery, the operator selects an implant that matches the shape of the patient's nose from a set of implants of various lengths and thicknesses, checks the curvature of the nasal bone and cartilage during the surgery, and personally sculpts the inner shape where the implant is seated. The production method was carried out in this way.

However, this method had the problem that it took a lot of time to carve and that it was not easy to produce an implant of the desired shape through manual carving. Additionally, if the implant is not seated closely to the nasal bone and cartilage and a space is formed between them, side effects such as infection and positional deformation may occur.

Public Patent Publication No. 10-2019-0131796 (2019.11.27.)

Therefore, the purpose of the present invention is to solve this conventional problem, and to model the cartilage shape, which is not confirmed from the medical image, based on the information identified from the medical image and the anatomical information between the cartilage. An implant is provided by reflecting the shape of the formed cartilage.

The purpose is to provide a nasal prosthesis that reduces the surgical time through patient-tailored modeling and can adhere closely to the nasal bone and cartilage, thus preventing side effects such as infection and positional deformation.

The problems to be solved by the present invention are not limited to the problems mentioned above, and other problems not mentioned will be clearly understood by those skilled in the art from the description below.

A nasal prosthesis inserted between the nasal bone, nasal cartilage and nasal skin, comprising: a prosthesis body including an upper part covering the nasal bone and a lower part covering the nasal cartilage; and a vertical guide located between an upper and lower part of the prosthesis body, wherein the vertical guide provides a nasal prosthesis having a groove shape.

The vertical guide may include a side groove recessed into at least one end of the left or right side of the prosthesis body.

The side groove may have a semicircular curve.

The semicircular curve may have a diameter of 1 to 1.5 mm.

The vertical guide may include a rear groove formed at a boundary between the bottom of the implant body and the implant on the back of the implant body.

It further includes a horizontal guide protruding from the back of the lower part of the prosthesis body, and may be located between the lower lateral cartilage divided into two sides among the nasal cartilages.

The width of the nose implant when viewed from the front may become narrower as it moves from the top of the prosthesis body to the bottom of the prosthesis body.

The upper end of the prosthesis body may further include a glabella extending in the left and right directions.

A method of manufacturing a nasal prosthesis inserted between the nasal bone, nasal cartilage and nasal skin according to another aspect of the present invention, comprising the steps of: (a) acquiring a three-dimensional image of the nasal bone and a three-dimensional image of the nasal cavity; (b) modeling the nasal cartilage by applying anatomical information between the nasal bone, the nasal cavity, and the nasal cartilage to the three-dimensional image of the nasal bone and the three-dimensional image of the nasal cavity; (c) modeling the inner shape of the prosthesis body including an upper part corresponding to the shape of the three-dimensional image of the nasal bone and a lower part corresponding to the modeled shape of the nasal cartilage; (d) modeling the nasal implant by modeling the external shape of the prosthesis body based on the target nasal external shape; and (e) determining the position of a vertical guide located between the top and bottom of the prosthesis body.

The vertical guide may include a side groove located in a lateral direction of the prosthesis body.

Determining the position of the vertical guide includes placing the modeled prosthesis body on the three-dimensional image of the nasal bone; Setting a location where the lower end of the nasal bone touches the lateral end of the prosthesis body as a cutting center point; And cutting the side groove with a plate-shaped cutter having a semicircular curved surface at an end, wherein the step of cutting the side groove can be performed by positioning the center of the semicircular curved surface of the cutter at the cutting center point. there is.

The plate-shaped cutter may be disposed perpendicular to the side end of the implant body in the lateral direction, and may be disposed in a direction inclined at a 45° angle to the center of the implant body in the forward direction.

According to the nasal prosthesis manufacturing method of the present invention as described above, there is an advantage in that a nasal prosthesis can be manufactured customized for each patient using 3D imaging technology.

In addition, since the gap between the nasal cartilage and the implant can be minimized and adhered closely, side effects such as inflammation and positional deformation can be minimized.

Additionally, there is an advantage that the surgery time can be shortened because the operator does not need to sculpt the implant during the surgery.

In addition, since nose implants are manufactured based on 3D images, there is also the advantage of being able to more accurately predict the patient's surgical results.

In addition, the vertical guide and horizontal guide of the nasal implant can be used to place the nasal implant in an accurate position and prevent the nasal implant from being misaligned during recovery after surgery or due to subsequent shock.

The effects that can be obtained from the present invention are not limited to the effects mentioned above, and other effects not mentioned can be clearly understood by those skilled in the art from the description below. will be.

Figure 1 shows CT images from the side of the face and below the chin, respectively.
FIG. 2 shows three-dimensional images of skin, bone, and nasal cavity obtained by segmenting the CT image of FIG. 1.
Figure 3 shows part of the process of modeling the nasal bridge cartilage and lateral nasal cartilage according to one embodiment of the present invention.
Figure 4 is a diagram of an image comparing a 3D image of the nasal cavity enlarged by applying a first offset and whether the nasal cavity enlarged from the 3D image of the nasal bone matches the height of the nasal bone.
Figure 5 shows part of the process of modeling the alar cartilage and lateral nasal cartilage following Figure 3.
Figure 6 shows a comparison between the nasal bridge cartilage and lateral nasal cartilage modeled according to an embodiment of the present invention and a photograph of the actual nasal cartilage.
Figure 7 shows part of the process of modeling nasal septal cartilage according to one embodiment of the present invention.
FIG. 8 shows the nasal septum cartilage finally modeled by modeling the nasal bridge line after modeling both sides of the nasal septum cartilage according to FIG. 7 along with the modeled nasal bridge cartilage and lateral nasal cartilage.
Figure 9 shows part of the process of modeling the reference shape of the inner shape on which the implant is seated using modeled cartilage according to an embodiment of the present invention.
Figure 10 shows the before and after view of modifying the concave part between the lateral nasal cartilages to be convex after modeling the mucosa.
FIG. 11 is a diagram for explaining the process of FIG. 10.
FIG. 12 shows a process of modeling the inner shape of the implant according to the reference shape in FIG. 10.
Figure 13 is a drawing showing the three-dimensional appearance of the nose before plastic surgery and the three-dimensional appearance of the nose required after plastic surgery together with modeling.
Figure 14 is a diagram for explaining the process of modeling the external shape of a nose implant.
FIG. 15 is a diagram illustrating a finally modeled nasal prosthesis according to an embodiment of the present invention.
FIG. 16 is a diagram illustrating a mold modeled for manufacturing the nose prosthesis of FIG. 15. do.
Figure 17 is a view showing a conventional nose implant and a nose implant according to the present invention being placed on the nose.
Figure 18 is a diagram showing a nose prosthesis according to an embodiment of the present invention.
Figures 19 and 20 are diagrams showing the nose implant according to an embodiment of the present invention being placed on the nose.
Figures 21 and 22 are diagrams showing a method of manufacturing a locking protrusion of a nose implant according to an embodiment of the present invention.
Figure 23 is a diagram showing the nasal bone and nasal cartilage.
Figure 24 is a cross-sectional view of a nose prosthesis according to another embodiment of the present invention.
Figure 25 is a front view of a nose prosthesis according to another embodiment of the present invention.

Specific details of the embodiments are included in the detailed description and drawings.

The advantages and features of the present invention and methods for achieving them will become clear by referring to the embodiments described in detail below along with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below and may be implemented in various different forms. The present embodiments are merely provided to ensure that the disclosure of the present invention is complete and to be understood by those skilled in the art. It is provided to fully inform those who have the scope of the invention, and the present invention is only defined by the scope of the claims. Like reference numerals refer to like elements throughout the specification.

Hereinafter, the present invention will be described with reference to the drawings for explaining the method of manufacturing a nose prosthesis according to embodiments of the present invention.

A method of manufacturing a nasal prosthesis according to an embodiment of the present invention includes the steps of acquiring a 3D image of the nasal bone and a 3D image of the nasal cavity, modeling nasal cartilage using the 3D image of the nasal bone and the 3D image of the nasal cavity, and It may include the step of modeling the inner shape in which the implant is seated from a 3D image of the nasal bone and the modeled nasal cartilage. In addition, the steps of modeling the entire implant including the external shape of the implant, modeling a mold to produce the shape of the modeled implant, manufacturing the mold, and manufacturing the nose implant by injecting silicone into the mold. More can be included.

FIG. 1 shows CT images from the side of the face and below the chin, respectively, and FIG. 2 shows three-dimensional images of the skin, bones, and nasal cavity obtained by segmenting the CT image of FIG. 1.

Figure 1(a) shows a CT image taken from the side of the face, and Figure 1(b) shows a CT image taken from under the chin. Generally, bones, empty spaces in the body, and skin can be identified from a CT image, but cartilage cannot be identified. It doesn't work. For reference, the bone here refers to the tibia, which can be identified on CT, not cartilage. Therefore, in the present invention, as will be described later, the shape of the nasal cartilage, which cannot be confirmed in the CT image, is modeled by applying anatomical elements to the image identified from the CT image, and the seating surface of the nasal implant is based on the modeled nasal cartilage. Let’s model the endotype.

First, obtain a 3D image of the nasal bone and a 3D image of the nasal cavity. Furthermore, 3D images of the skin can be obtained to model the appearance of the nose implant. At this time, as shown in Figure 2, a 3D skin image around the nose (Figure 2(a)) and a 3D nasal bone image (Figure 2) are segmented by adjusting the HU (Housefield Unit) value in the CT image. (b)) and a three-dimensional nasal image ((c) of FIG. 2) can be obtained. The method of acquiring an image by adjusting the HU value uses a known technique, so a detailed description thereof will be omitted.

Next, the nasal cartilage is modeled by applying anatomical information to the 3D image of the nasal bone and the 3D image of the nasal cavity. The process of modeling nasal cartilage will be described in detail below with reference to FIGS. 3 to 8.

Figure 3 shows part of the process of modeling the nasal bridge cartilage and lateral nasal cartilage according to an embodiment of the present invention, and Figure 4 shows a three-dimensional image of the nasal cavity and a three-dimensional image of the nasal bone enlarged by applying the first offset. It is a diagram of an image comparing whether the nasal cavity enlarged from matches the height of the nasal bone, FIG. 5 shows a part of the process of modeling the nasal bridge cartilage and lateral nasal cartilage following FIG. 3, and FIG. 6 shows an embodiment of the present invention. A comparison is shown between the nasal bridge cartilage and lateral nasal cartilage modeled according to an example and a photograph of the actual nasal cartilage, FIG. 7 shows a part of the process of modeling the nasal septum cartilage according to an embodiment of the present invention, and FIG. 8 shows FIG. After modeling both sides of the nasal septum cartilage according to Fig. 7, the bridge line of the nose is modeled, and the final modeled nasal septum cartilage is shown together with the modeled nasal bridge cartilage and lateral nasal cartilage.

The nasal cartilage consists of the lower lateral cartilage or alar cartilage, the upper lateral cartilage, and the septal nasal cartilage. First, we will explain the process of modeling the alar cartilage and the lateral nasal cartilage. Do this.

In the present invention, nasal cartilage is modeled using a 3D image of the nasal cavity and a 3D image of the nasal bone obtained by segmenting a CT image. As shown in (a) of Figure 3, when the nasal cavity image obtained from the CT image is not symmetrical left and right, the nasal cavity image is made so that it is left and right symmetrical around the anatomically close to normal nasal cavity among the left and right nasal cavity images. It can be copied (Figure 3(b)). In Figure 3, since the shape of the right nasal cavity (corresponding to the patient's left nasal cavity) is anatomically close to normal, the left nasal cavity was replicated symmetrically to the right.

Next, an offset of an appropriate value is applied to the image in (b) of Figure 3 to enlarge the image of the nasal cavity at a constant ratio to enlarge the size of the nasal cavity (Figure 3 (c)). At this time, as shown in FIG. 4, a 3D image of the nasal bone and an image of the nasal cavity enlarged by applying an offset are overlapped to compare whether the enlarged nasal cavity matches the height of the nasal bone (circled portion in FIG. 4). Then, adjust the offset value so that the enlarged nasal cavity matches the height of the nasal bone (this may mean that the enlarged nasal cavity and the nasal bone are naturally connected without steps) and obtain an image of the enlarged nasal cavity.

Anatomically, the nasal bone and nasal cartilage are naturally extended, and the nasal cartilage is a thin membrane with a certain thickness (about 0.5 mm), similar to the edge of the nasal cavity. Therefore, the surface of the nasal cavity enlarged by applying the offset may include a modeling shape of the outer surface of the nasal cartilage.

At this time, the offset value can be around 1.5 mm. This is because, on average, clinical trials have confirmed that when an offset of 1.5 mm is applied to the nasal cavity image and the image is enlarged, the enlarged nasal cavity matches the height of the nasal bone. This is the result obtained. Therefore, it is possible to obtain an enlarged nasal cavity image under the above conditions by adjusting the offset value based on the 1.5 mm value. In the following description, the offset value applied when enlarging the image of the nasal cavity to match the height of the nasal bone and the nasal cavity will be referred to as the first offset and will be described below.

Next, another enlarged nasal cavity image can be obtained by applying the second offset, which is obtained by subtracting a predetermined value corresponding to the thickness of the nasal cartilage from the first offset, to the image (b) in FIG. 3 (( in FIG. 3 d). At this time, 0.5mm can be set as the thickness value of the nasal cartilage, which is a value based on the clinically confirmed average thickness of the nasal cartilage and the lateral nasal cartilage. Therefore, the second offset is 0.5 mm from the first offset. It may be a value obtained by subtracting mm. For example, if the value of the first offset is 1.5mm, the value of the second offset may be 1mm.

Therefore, Figure 3(d) forms a reference surface on which the bottom surface of the nasal cartilage is located, and Figure 3(c), described above, forms a reference surface on which the upper surface of the nasal cartilage is located, and the modeled nose between the two reference surfaces Cartilage is located.

Figure 5(a) shows an image showing the nasal cavity enlarged by applying the second offset as in Figure 3(d). In this embodiment, a three-dimensional image of the nasal cavity is enlarged by applying the second offset. The shape of the nasal cavity can be corrected according to the anatomical structure of the nasal cavity (Figure 5(b)). At this time, compared to the generally known anatomical structure of the nasal cavity, parts that are excessively hollow or distorted can be corrected into a smooth shape by connecting the end points of the non-distorted parts and giving natural volume.

Next, from the corrected image, the outline lines of the nasal bridge cartilage and the lateral nasal cartilage are created based on the most prominently protruding area on the surface of the 3D image (Figure 5(c)).

Next, as described above, according to the clinical average, the thickness of cartilage is 0.5 mm, so the nasal bridge cartilage and lateral nasal cartilage can be finally modeled by applying a thickness of 0.5 mm to the outline line.

Figure 6 shows a comparison between the nasal bridge cartilage and lateral nasal cartilage modeled according to the present invention and the actual nasal cartilage. The nasal bridge cartilage and lateral nasal cartilage modeled according to the present invention are anatomically almost identical to the actual nasal cartilage. You can see that it is modeled well.

In this embodiment, the entire modeling process of the nasal bridge cartilage and the lateral nasal cartilage is explained with drawings. However, since the actual nose prosthesis is seated on the upper surface of the nasal bridge cartilage and the lateral nasal cartilage, the first offset is as shown in FIG. 4. Only the upper surface of the nasal cartilage can be modeled from the applied image and used to model the inner shape of the nasal implant as described later.

Hereinafter, the process of modeling nasal septal cartilage will be described.

Anatomically, most of the inner surface on which the nasal implant is seated is supported by the nasal bridge cartilage and the lateral nasal cartilage, but in this embodiment, a process of modeling the nasal septal cartilage may be further included to increase modeling accuracy of the nasal implant.

As shown in (a) of Figure 7, display the nasal bridge cartilage and lateral nasal cartilage previously modeled from the CT image, and select the area where the septal cartilage can be located between both nasal cavities (Figure 7 ( b)). Next, both sides of the septal cartilage can be modeled by applying a third offset to the edge lines of both nasal cavities (Figure 7(c)). At this time, since the septal cartilage has a thickness of 0.5 to 1 mm, the third offset can be set by taking this into consideration in the image. Even in the case of the septal cartilage located between both nasal cavities, both sides of the nasal cavity are modeled in this embodiment, reflecting the anatomical content that it almost coincides with the edge lines of both nasal cavities adjacent to the septal cartilage.

Next, as shown in Figure 8, the upper part of the nasal bridge line of the nasal septum cartilage is formed to slightly protrude at a predetermined height between the two lateral nasal cartilages, and the lower part of the nasal bridge line of the nasal septal cartilage is the position of the lower end point of the modeled lateral nasal cartilage. It can be modeled by cutting with a line connecting the end points of the nasal septum bone. Figure 8 shows the nasal septum cartilage finally modeled in the same manner as above, as well as the nasal bridge cartilage and lateral nasal cartilage previously modeled.

After modeling the nasal cartilage using the above-described method, the inner shape in which the implant is seated is modeled using the three-dimensional image of the nasal bone and the shape of the modeled nasal cartilage.

Figure 9 shows part of the process of modeling the reference shape of the inner shape on which the implant is seated using cartilage modeled according to an embodiment of the present invention, and Figure 10 shows the concave shape between the lateral nasal cartilages after modeling the mucosa. It shows the appearance before and after modifying the part to make it convex, FIG. 11 is a diagram for explaining the process of FIG. 10, FIG. 12 shows the process of modeling the inner shape of the implant according to the reference shape in FIG. 10, and FIG. 13 is a drawing showing the three-dimensional appearance of the nose before plastic surgery and the three-dimensional appearance of the nose required after plastic surgery together with modeling, Figure 14 is a drawing to explain the process of modeling the external shape of the nose implant, and Figure 15 is a drawing showing the three-dimensional shape of the nose required after plastic surgery. A final modeled nasal prosthesis is shown according to an embodiment of the invention, and FIG. 16 shows a modeled mold for manufacturing the nasal prosthesis of FIG. 15 .

First, as shown in (a) of Figure 9, the three-dimensional image of the nasal bone and the modeled cartilage are overlapped and positioned, and the lines of the nasal bone and cartilage are connected and integrated to merge, as shown in (b) of Figure 9. Creates the inner shape line of the implant.

As described above, the image enlarged by the first offset forms the upper surface of the nasal cartilage and the lateral nasal cartilage where the implant is seated, so the image enlarged by the first offset and the image of the bone are connected and integrated to integrate. This can create the inner shape line of the implant.

Next, the fourth offset corresponding to the thickness of the mucous membrane is applied to the image in (b) of Figure 9 and enlarged to the maintenance ratio in the same manner as described above (Figure 9 (c)). This is to take into account the fact that a mucous membrane of a certain thickness is formed over the nasal bone and cartilage. According to clinical averages, the thickness of the mucous membrane may be 0.3 mm.

Therefore, the three-dimensional images of the nasal bone and the modeled cartilage are connected and integrated, and the enlarged image (FIG. 9(c)) is applied by applying the fourth offset to ultimately become the reference surface for the inner shape of the nasal prosthesis.

Preferably, the concave portion between the modeled lateral nasal cartilages as shown in Figures 10 and 11 is naturally extended along the line of the surrounding mucosa (lateral nasal cartilage) as shown in Figure 11, making it convex. It can be corrected so that it sticks out.

Next, as shown in FIG. 12, a method of creating an implant base 100 extending from the root of the nose to the tip of the nose, overlapping the reference plane of the final modeled inner shape of the implant considering the thickness of the mucous membrane, and removing the overlapping portion. You can model the inner shape of the implant.

After the internal shape of the implant is modeled, the external shape of the implant is modeled. The external shape of the nose implant determines the external shape of the nose after plastic surgery and can be designed to reflect the patient's requirements and/or the operator's opinion.

At this time, a predetermined thickness (for example, a thickness of about 4 mm) is created based on the inner shape of the implant whose inner shape has been modeled, and the external shape of the implant that reflects the patient's requirements and/or the operator's opinion is derived. This can be modeled. In this process, it is desirable to design the appearance of the implant so that the volume difference between the nose before nose surgery and the nose modeled after nose surgery is calculated and the increased volume has a value similar to the volume of the implant.

As an example of modeling the appearance of a nose implant, first, as shown in FIG. 13, a 3D image before plastic surgery and a 3D image after plastic surgery that reflect the patient's requirements and/or the operator's opinion are modeled and overlapped. It can be displayed.

Next, the outline line of the implant is modeled for each cross section perpendicular to the nose length direction of the implant. Figure 14 shows a cross section of the skin before plastic surgery, the skin after plastic surgery, and the implant whose inner shape was modeled by the above-described method to transform from the skin before plastic surgery to the skin after plastic surgery is seated on the mucous membrane, between before and after plastic surgery with respect to the bridge of the nose. The height difference can be obtained, and from this, the height of the implant corresponding to the bridge of the nose can be obtained. Next, the outer line of the nasal implant can be modeled by free curve modeling between the bridge of the nose of the implant obtained by the above method and the inner edge of the implant modeled by the above method based on the shape of the skin after plastic surgery. In this way, the outer shape of the nose implant can be finally modeled by modeling the outer line for each cross section and smoothly extending the outer lies obtained for each cross section.

Figure 15 shows an example of the shape of the nasal implant 200 finally modeled using the above method.

Next, the mold 300 for manufacturing the nose implant in the form of the modeled nose implant 200 is modeled as shown in FIG. 16. An inlet 310 and an outlet 320 may be formed at the upper and lower positions of the prosthesis mold 300 to inject and discharge silicone for manufacturing a nose prosthesis, respectively. Depending on the embodiment, the injection port 310 is formed between the eyebrows of the implant, but it is not limited to this and can also be formed at the tip of the nose. The mold 300 modeled as described above can be manufactured using a 3D printer, but is not limited thereto.

Figure 17 shows a conventional nose prosthesis and a nose prosthesis according to the present invention being placed on the nose. Figure 17 (a) shows a nose prosthesis selected from a conventional nose prosthesis set being placed on the nose, and Figure 17 (b) shows a nose prosthesis custom-made for a patient according to the present invention being placed on the nose. The figure is shown. In the conventional case, the nose prosthesis does not adhere closely to the cartilage, forming a space between them. However, in the case of the present invention, the nasal prosthesis custom-made for the patient can be adhered to the cartilage, preventing side effects such as inflammation or positional deformation. It can be minimized.

FIG. 18 is a view showing the nose prosthesis 200 according to an embodiment of the present invention, and FIGS. 19 and 20 show the nose prosthesis 200 according to an embodiment of the present invention being seated on the nose. It is a drawing.

Figure 18 is a perspective view of the nose implant 200 and Figure 19 is a front view of the nose implant.

The nose implant 200 includes an implant body 210 made of a soft material such as silicone and extending in the vertical direction. The prosthesis body 210 may be composed of an upper body 211 covering the nasal bone 10 and a lower body 212 covering the nasal cartilage 20.

The nose prosthesis 200 has a shape extending vertically from the front and can be configured to have a curve when viewed from the side according to the shape of the nasal bone 10 and nasal cartilage 20 and the desired shape of the nose.

The nasal prosthesis 200 designed and manufactured by the above-described method is inserted by making an incision at the bottom of the columella of the nose and lifting the skin, as shown in FIG. 6(b). It can be opened up to the root of the nose (radix, nasion), but it can also be placed by pushing in from the bottom while leaving the root of the nose covered.

The prosthesis body 210 has the upper body 211 and the lower body 212 forming a continuous surface, so that when the implant is inserted into the incision site during surgery, the prosthesis is placed on the patient's nasal bone 10 and nasal cartilage 20. It is difficult to determine the exact location of the main body 210. In some cases, the position may be biased more upward or downward from the accurately designed position, so the operator needs a guide that can serve as a reference for the insertion position of the nasal implant 200. In other words, if the implant is pushed further upward, the tip of the implant between the eyebrows may curl or fold after surgery, and if the dead space in the middle does not fit properly, it may cause sequelae or reoperation. Alternatively, if it is pushed in less and the lower part remains longer, and the dead space in the middle does not fit properly, it may cause sequelae or reoperation.

If the top and bottom positions of the implant are not inserted properly, the bottom surface of the implant does not match the shape of the bone, so while the implant is being seated in the nasal tissue after surgery, the implant may be pushed to either the left or right side of the nose and may change its appearance. Ultimately, it can result in a crooked nose shape and cause aftereffects or reoperation.

Referring to FIG. 19, the human nose consists of a rigid nasal bone 10 as part of the skull at the top and soft nasal cartilage 20 that is connected to the lower end of the nasal bone 10 and can be bent. Since the upper part of the nasal cartilage body 211 and the lower body 212 cover different parts (nasal bone/nasal cartilage), there is a difference in shape and thickness.

Therefore, if the upper part of the main body 211 is located on the nasal cartilage 20 or the lower main body 212 is located on the nasal bone 10, a result different from the designed nose shape can be obtained, and the position in the vertical direction is accurately positioned. It is important to do.

A vertical guide 230 may be provided between the upper body 211 and the lower body 212 so that the upper body 211 is located on the nasal bone 10 and the lower body 212 is located on the nasal cartilage 20.

The vertical guide 230 is a groove formed in the prosthesis body 210 so that it can be caught on the lower end 30 of the nasal bone. The vertical guide 230 in the embodiment shown in FIG. 18 is located at the lateral end of the prosthesis body 210. It may include formed side grooves 230 and 231.

The lower part 30 of the nasal bone 10 includes a nasal point 31 (rhinion), and the lower part 30 of the nasal bone 10 has an inverted V shape extending downward in the left and right directions from the nasal bone 10. there is. The nasal point 31 is the part between the nasal bone 10 and the nasal cartilage 20, and is also called the beak, and may generally have a slightly protruding shape from the bridge of the nose.

Since the lower part 30 of the nasal bone 10 is in an inverted V shape, the side grooves 230 and 231 formed on the left and right sides are located at the upper and lower sides slightly deviated around the nasal peak 31 and are not on the same line. can be located next to each other.

Referring to Figure 19, the side grooves 230 and 231 illustrate an embodiment in which the side grooves 230 and 231 are located on both left and right sides.

If the side grooves 230 and 231 are located on the left and right, they can be placed in more accurate positions.

However, it is not necessary to form the side grooves 230 and 231 on both sides, and even if they are formed on only one side of the left and right sides, it is possible to prevent the position in the vertical direction from being greatly misaligned.

Figures 21 and 22 are diagrams showing a method of manufacturing the vertical guide 230 of the nose implant 200 according to an embodiment of the present invention. After manufacturing the implant body 210 by the above-described method, the designed implant body 210 can be placed on the nasal bone modeling.

The cutter shown in FIGS. 21 and 22 is a virtual tool for forming vertical guides 230 and 231 in the implant body 210 designed on modeling, and has a plate shape with a cutting blade at one end. The shape of the side grooves 230 and 231 of the cutter is determined according to the shape of the cutting blade, and in this embodiment, the cutting surface of the cutter may have a semicircular curve in the cross-section in the thickness direction.

As shown in (a) of FIG. 21, the cutter can be arranged at an angle of 45° to the left and right based on the center of the left and right sides of the human nasal bone. The cutter on the left and the cutter on the right can be connected to form a V-shaped integrated form by connecting them at 90°.

However, as shown in (b) of FIG. 21, the nasal bone 10 of the human body may be left and right asymmetric, so the left and right cutters may be separated and configured in an independent form. As shown in (b) of FIG. 21, the vertical guides 230 and 231 of the nasal prosthesis 200 applied to the left and right nasal bones 10 may be formed left and right asymmetric.

As shown in FIG. 22, the direction of the cutter viewed from the side may be arranged perpendicular to the side end of the implant body 210.

The prosthesis 200 can be formed to have a semicircular curved surface with the center C at the point where the side end of the prosthesis 200 overlaps with the lower part of the nasal bone 30. The semicircular diameter of the side groove 230 may be approximately 1-1.5 mm, and the depth of the side grooves 230 and 231 may be 0.5 to 0.75 mm.

If the depth of the side grooves 230, 231 is less than 0.5 mm, it is difficult for the side grooves 230, 231 to be caught in the lower part of the nasal bone 30, and if they are cut deeper than 0.75 mm, the thick part of the prosthesis body 210 is cut to cut into the nose. Since the side grooves 230 of the nose implant 200 may be exposed in the direction of the skin, the depth of the side grooves 230 and 231 is preferably in the range of 0.5 to 0.75 mm.

The side grooves 230 and 231 are divided into a portion to be located on the nasal bone 10 and a portion to be located on the lower nasal cartilage 20 not only in the patient-customized nasal implant 200 but also in the ready-made nasal implant 200. Therefore, it can be formed at the boundary between the upper body 211 and the lower body 212. The ready-made nasal implant 200 can also be manufactured in various shapes such as symmetrical, asymmetrical, and unilateral so that it can be applied to various shapes of the nasal bone 10.

Figure 23 is a vertical cross-sectional view of the central portion of the nose implant 200 according to another embodiment of the present invention. The vertical guide 233 of this embodiment is formed in the rear direction of the nasal implant 200 and may include a rear groove 233 that catches the lower end of the nasal bone 30 through the formed rear groove 233.

Since the patient-tailored implant according to the embodiment is an implant that can be seated by filling the dead space, there is little possibility of the implant being pushed to either the left or right side of the nose while the implant is seated in the nasal tissue after surgery. In the case of making it, it is difficult to fit the entire body closely and fix it, so there is a high possibility that the implant will be pushed to either the left or right side of the nose. In such cases, the external appearance of the nose may be crooked, which may cause aftereffects or reoperation. In order to prevent this, a horizontal guide 220 is formed to slightly fix the implant to the human body, and the implant can be set to fit slightly into a groove in the human body tissue, thereby ensuring that the implant is well fixed. Depending on the embodiment, the same horizontal guide 220 may be formed on a patient-specific implant to further secure the implant to the human body.

The vertical guide 233 of this embodiment includes a rear groove 233 formed on the rear surface between the upper body 211 and the lower body 212. .

The back groove 233 may be formed to correspond to the V-shape at the bottom of the nasal bone 10 and continue along the boundary between the upper body 211 and the lower body 212, but minimize the effect on the overall shape of the nasal implant 200. To do this, a back groove 233 may be formed to be located at a point of the lower part of the nasal bone 30.

Figure 24 is a diagram showing the nasal bone 10 and nasal cartilage 20. The nasal cartilage (20) consists of the nasal septum (23, septum), the upper lateral cartilage (21, upper lateral cartilage) located on the left and right sides of the nasal septum (23), and the lower lateral cartilage (22, lower lateral cartilage) located in the nasal bridge. It can be configured.

The aforementioned back groove 233 may be arranged to be located between the upper lateral cartilage 21 and the nasal septum 23.

In addition to the vertical guides 230 and 233 that guide the vertical positions of the nasal implant 200, the device may further include a horizontal guide 220 that aligns the left and right positions of the nasal implant 200 in the left and right directions.

The horizontal guide 220 may be inserted into the supratip breakpoint between the lower lateral cartilage 22 and protrude from the back of the nasal implant 200.

The horizontal guide 220 fills the dead space between the upper lateral cartilage 21 and the lower lateral cartilage 22 and is located between a pair of lower lateral cartilage 22, so that the left and right positions are misaligned. can be prevented.

Figure 25 is a front view of a nose prosthesis 200 according to another embodiment of the present invention. The nose prosthesis 200 of the present invention can be configured to have a narrower left and right width at the bottom than at the top, as shown in (a) of FIG. 25, for a slim nose shape.

In addition, in order to naturally form the left and right curves between the eyebrows, a glabellar part 213 extending in the left and right directions may be further provided. When the upper end of the implant body 210 is expanded, the peeling area between the skin and the nasal bone 10 must be widened to insert the nose implant 200, and if the end of the glabella 213 is sharp, a wider area is cut. Should be. Therefore, for convenience during surgery, the end of the glabellar region 213 may be configured to have a curve as shown in (b) of FIG. 25.

According to the method of manufacturing the nasal prosthesis 200 of the present invention as described above, there is an advantage that the nasal prosthesis 200 can be manufactured customized for each patient using three-dimensional imaging technology.

In addition, since the gap between the nasal cartilage 20 and the nasal implant 200 can be minimized and brought into close contact, there is also the advantage of minimizing side effects such as inflammation and positional deformation.

In addition, there is an advantage that the surgery time can be shortened because the operator does not need to sculpt the nose implant 200 during the surgery.

In addition, since the nose prosthesis 200 is manufactured based on a 3D image, there is also the advantage of being able to more accurately predict the patient's surgical results.

In addition, the nose implant 200 can be placed in an accurate position through the vertical guide 230 and the horizontal guide 220 of the nose implant, and the position of the nose implant 200 is prevented from being misaligned during recovery after surgery or after impact. can do.

The scope of the present invention is not limited to the above-described embodiments, but may be implemented in various forms of embodiments within the scope of the appended claims. It is considered to be within the scope of the claims of the present invention to the extent that anyone skilled in the art can make modifications without departing from the gist of the invention as claimed in the claims.

Claims (12)

In the nasal implant inserted between the nasal bone, nasal cartilage and nasal skin,
an implant body including an upper part covering the nasal bone and a lower part covering the nasal cartilage; and
It includes a vertical guide located at the boundary between the upper and lower parts of the prosthesis body,
The vertical guide is a nasal prosthesis having a groove shape that engages the lower end of the nasal bone covered by the upper part of the main body. According to claim 1,
The vertical guide is,
A nasal prosthesis comprising a side groove recessed into at least one end of the left or right side of the prosthesis body. According to claim 2,
The side groove is
A nose implant characterized by having a semicircular curve. According to paragraph 3,
A nose prosthesis, characterized in that the semicircular curve has a diameter of 1 to 1.5 mm. According to claim 1,
The vertical guide is,
A nose prosthesis comprising a back groove formed on the back of the prosthesis body at a boundary between the bottom of the prosthesis body and the prosthesis. According to claim 1,
A nasal prosthesis further comprising a horizontal guide protruding from a lower surface of the prosthesis body, and positioned between lower lateral cartilages divided into two sides among the nasal cartilages. According to claim 1,
The width seen from the front of the nose implant is
A nasal implant that becomes narrower as it moves from the top of the implant body to the bottom of the implant body. According to claim 1,
A nose prosthesis, characterized in that the upper end of the prosthesis body further includes a glabellar region expanded in the left and right directions. In the method of manufacturing a nasal prosthesis inserted between the nasal bone, nasal cartilage and nasal skin,
(a) acquiring a 3D image of the nasal bone and a 3D image of the nasal cavity;
(b) modeling the shape of the nasal cartilage by applying anatomical information between the nasal bone, the nasal cavity, and the nasal cartilage to the three-dimensional image of the nasal bone and the three-dimensional image of the nasal cavity;
(c) modeling the inner shape of the prosthesis body including an upper prosthesis corresponding to the shape of the three-dimensional image of the nasal bone and a lower prosthesis corresponding to the modeled nasal cartilage shape;
(d) modeling the nasal implant by modeling the external shape of the prosthesis body based on the target nasal external shape; and
(e) modeling a vertical guide located at the boundary between the upper part of the implant and the lower part of the implant body,
The step of modeling the vertical guide is,
Seating the modeled prosthesis body on the three-dimensional image of the nasal bone and the modeled nasal cartilage shape; and
A method of manufacturing a nasal prosthesis comprising forming the vertical guide in the prosthesis body at a position corresponding to a point where the lower portion of the nasal bone of the three-dimensional image of the nasal bone and the upper portion of the nasal cartilage of the modeled nasal cartilage shape meet. According to clause 9,
The vertical guide is
A method of manufacturing a nasal prosthesis, comprising a side groove located in a lateral direction of the prosthesis body. According to claim 10,
The step of modeling the vertical guide is,
Setting the position where the lower end of the nasal bone and the lateral end of the prosthesis body contact as the cutting center point; and
It includes cutting the side groove with a plate-shaped cutter having a semicircular curved surface at the end,
The method of cutting the side groove is characterized in that cutting is performed by positioning the center of the semicircular shape of the cutter at the cutting center point. According to claim 11,
The plate-shaped cutter is
A method of manufacturing a nasal prosthesis, characterized in that it is disposed in a direction perpendicular to the side end of the prosthesis body in the lateral direction, and disposed in a direction inclined 45° to the center of the prosthesis body in the normal direction.

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