Eufinger H, Wittkampf A R, Wehmöller M, Zonneveld F W
Department of Oral and Maxillofacial Surgery, Ruhr-University, Bochum, Germany.
J Craniomaxillofac Surg. 1998 Dec;26(6):373-8. doi: 10.1016/s1010-5182(98)80070-x.
In the cranio-maxillofacial field, computer-aided surgery based on computed tomography (CT) data is becoming more and more important. Navigation systems, which allow the precise intraoperative orientation of surgical instruments, can be used for greater accuracy in determining resection margins of tumours. These techniques support ablative procedures very well, but defect reconstruction still remains a problem. In contrast, computer-aided design (CAD) and computer-aided manufacturing (CAM) systems allow the construction and fabrication of individual templates for bone resection based on coherent numerical 3-D models. The template determines the exact pathway of an oscillating saw so that the planned extent of the resection and, if necessary, also the orientation of the cutting plane are verified. An individual titanium implant is prefabricated with a geometry fitting to that of the template. This implant closes the bone defect so that the contour is reconstructed precisely and individually. This new method was used for the first time for a single-step resection of a meningioma and defect-reconstruction. The tumour which had infiltrated the frontal bone resulting in a protrusion. Fronto-orbital resection and insertion of the titanium implant worked precisely as planned, so that this method offers promising new applications in the field of computer-aided surgery.
在颅颌面领域，基于计算机断层扫描（CT）数据的计算机辅助手术正变得越来越重要。导航系统可使手术器械在术中实现精确的定位，有助于更准确地确定肿瘤切除边缘。这些技术能很好地辅助切除手术，但缺损重建仍是个问题。相比之下，计算机辅助设计（CAD）和计算机辅助制造（CAM）系统可基于连贯的三维数字模型构建并制造用于骨切除的个性化模板。该模板确定摆动锯的精确路径，从而验证计划的切除范围以及必要时切割平面的方向。根据模板的几何形状预制一个个性化的钛植入物。该植入物可闭合骨缺损，从而精确且个性化地重建轮廓。这种新方法首次用于单步切除脑膜瘤及缺损重建。肿瘤已浸润额骨并导致突出。额眶切除及钛植入物的植入按计划精确进行，因此该方法在计算机辅助手术领域提供了有前景的新应用。
