摘要
目的 探讨改进前颅底显微外科导航系统的技术 ,并评估其精确性及手术安全性。方法 对 4 2例同时侵犯脑颅和面颅的前颅底良恶性肿瘤 ,设计新型连接 ,以维持头架和参考框架术中持续稳定 ,并无红外信号发射障碍。 6个参考点布局在顶额、颧、上颌、乳突等区。应用STN导航系统和SMN导航手术显微镜的虚拟探针、虚拟手术入路和虚拟目标 (肿瘤 )轮廓线 ,在SMN手术显微镜下作立体导航手术。结果 新型设计的精度可使导航距离误差在 1～ 1.5mm ,安全导向手术 ,相比之下。原设计精度误差≥ 4 .0mm。结论 精良的虚拟技术和显微手术相结合提高前颅底显微外科的精确程度和安全性 。
Objective To investigate the accuracy and safety of the modified techniques in anterior skull base microsurgery with navigation system. Methods Operation was performed upon 42 patients with benign and malignant tumor of anterior skull base involving both cerebral cranium and visceral cranium with the help of modified navigation system. A new arrangement was designed for stable maintenance of the headset with dynamic reference frame to avoid disturbance during emission of encoded infrared signal. Six reference points were used, distributed in the parietal, frontal, zygomatic, maxillary, and mastoid regions. The STN navigation system and SMN surgical microscope navigator were used to provide virtual pointer, virtual approach route and virtual contour as an orientation for stereotaxic guidance during surgery. Results The modified technique could keep the accuracy of surgical guidance within 1～1.5 mm in comparison with the accuracy of 4 mm or more by the original design, thus guaranteeing the safety of surgery. Conclusion The modified techniques raise the accuracy and safety of anterior skull base microsurgery. However, the cost remains high.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第13期879-882,共4页
National Medical Journal of China
