Marmulla Rüdiger, Mühling Joachim, Lüth Tim, Hassfeld Stefan
Department of Cranio-Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
Br J Oral Maxillofac Surg. 2006 Aug;44(4):273-8. doi: 10.1016/j.bjoms.2005.06.011. Epub 2005 Jul 15.
Methods of recording landmarks on the facial skin without the use of markers have become increasingly accepted in image-guided surgery. However, position or muscular activity may change the skin's geometry and generate a lack of agreement between the facial contours recorded before and those recorded during the operation. In the present study, we measured this physiological shift of facial skin and evaluated its influence on the accuracy of stereotactic recording. We made laser-scans of the skin of 20 conscious patients while they were sitting and lying, both at rest and when smiling. The laser-scans were referenced to the corresponding computed tomographic dataset, and the accuracy of the recording was calculated. Gravitational or muscular shifts of the skin reduced the mean (S.D.) accuracy of recording to 1.7 (0.3)mm. The loss of accuracy was significantly correlated with the dynamic and gravitational wrinkling of the facial skin and with the body mass index of each patient.
在图像引导手术中，不使用标记物记录面部皮肤标志点的方法越来越被广泛接受。然而，位置或肌肉活动可能会改变皮肤的几何形状，并导致术前记录的面部轮廓与手术期间记录的面部轮廓不一致。在本研究中，我们测量了面部皮肤的这种生理移位，并评估了其对立体定向记录准确性的影响。我们对20名清醒患者在坐着、躺着、休息和微笑时的皮肤进行了激光扫描。将激光扫描与相应的计算机断层扫描数据集进行参照，并计算记录的准确性。皮肤的重力或肌肉移位使记录的平均（标准差）准确性降低至1.7（0.3）毫米。准确性的损失与面部皮肤的动态和重力皱纹以及每位患者的体重指数显著相关。
