摘要
目的探讨数字化外科技术在创伤后继发畸形治疗中的作用，总结技术流程及临床操作常规。方法将2011年5月至2012年2月北京大学口腔医学院·口腔医院口腔颌面外科收治患者共54例纳入本研究，其中男性37例，女性17例，平均年龄32．4岁。术前三维CT扫描数据，应用BrainLabIplan或SurgicaseCMF5．0软件进行数据分割、三维重建、术前虚拟规划，术中采用BrainLabNavigation系统引导手术操作。术后48—72h复查头颅CT，术前、术后CT在BrainLabIplan系统中进行自动数据融合，采用二维测量和三维色谱分析法评估真实外科手术与虚拟设计的吻合度。结果54例手术均无明显并发症；所有患者均对手术效果满意。导航系统精度在颧骨颧弓骨折复位手术为0．2～3．5mm、单纯眶壁缺损重建手术为0．8—2．0mm、个性化假体植入手术为0．2～2．2mnl。结论计算机虚拟规划有利于提高术前规划的精确性、可控性；导航系统能够作为信息载体，将虚拟计划信息传达到外科手术中，保证后者按照设计精确执行。
Objective To investigate the value of computer aided navigation system （CANS） in the treatment of post traumatic maxillofacial deformation. Methods Fifty-four patients （ M = 37, F = 17 ） were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48-72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices. Results All the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was O. 2-3.5 mm, 0. 8-2. 0 mm and 0. 2-2. 2 mm respectively. Conclusions Computer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2012年第11期645-650,共6页
Chinese Journal of Stomatology
基金
基金项目：国家高技术研究发展计划（863计划）（2009AA045201,2012AA041606）
关键词
创伤和损伤
外科
整形
治疗
计算机辅助
Wounds and injuries
Surgery, plastic
Navigation system orbital reconstruction
