Troulis M J, Perrott D H, Kaban L B
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, USA.
J Oral Maxillofac Surg. 1999 Sep;57(9):1110-3. doi: 10.1016/s0278-2391(99)90335-x.
The purpose of this study was to demonstrate the feasibility of endoscopic placement and activation of a semiburied distraction device in the porcine mandible.
Sixteen cadaver and two live anesthetized minipigs were used in this study. Access to the mandible was gained through two 1.0-cm submandibular incisions used for a working port and a visualization port. Under endoscopic visualization, dissection was carried sharply to the mandible and completed in the subperiosteal plane. Landmarks were identified through the endoscope, and a mandibular angle osteotomy was created. A semiburied distractor was then implanted, fixed to the mandible, and activated to create a bone gap. Finally, the site was explored through a submandibular incision to verify the accuracy of the endoscopic procedure.
Endoscopic exposure; accurate identification of landmarks; creation of an osteotomy; and placement, fixation, and activation of a semiburied distractor were achieved in all 18 specimens. The inferior alveolar nerve was identified as the bone gap was expanded.
The results of this study indicate that the endoscopic approach described here allows exposure and osteotomy of the mandible, and placement, fixation, and activation of a distractor. In the future, this technique will be used with totally buried, miniature distraction devices.
本研究的目的是证明在猪下颌骨中进行内镜下放置和激活半埋式牵张装置的可行性。
本研究使用了16具尸体和2只活体麻醉小猪。通过两个1.0厘米的下颌下切口进入下颌骨，分别作为操作端口和可视化端口。在内镜可视化下，锐性剥离至下颌骨，并在骨膜下平面完成操作。通过内镜识别标志点，并进行下颌角截骨术。然后植入半埋式牵张器，固定于下颌骨，并激活以形成骨间隙。最后，通过下颌下切口探查手术部位，以验证内镜手术的准确性。
在所有18个标本中均实现了内镜暴露、准确识别标志点、截骨术以及半埋式牵张器的放置、固定和激活。在扩大骨间隙时识别出了下牙槽神经。
本研究结果表明，此处描述的内镜方法可实现下颌骨的暴露和截骨术，以及牵张器的放置、固定和激活。未来，该技术将与完全埋入式微型牵张装置一起使用。
