Pohlenz Philipp, Blessmann Marco, Blake Felix, Gbara Ali, Schmelzle Rainer, Heiland Max
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Oral Maxillofac Surg. 2008 Feb;66(2):324-9. doi: 10.1016/j.joms.2007.03.032.
This study investigated 3-dimensional (3D) imaging with intraoperative cone beam computed tomography (CBCT) in major mandibular reconstruction procedures.
The study group was comprised of 125 patients (83 males, 42 females) admitted for surgical treatment of the mandible. The patients ranged in age from 3 months to 91 years (average age, 40.72 +/- 22.843 years). Surgical procedures of the mandible were subdivided into repair of body fractures (17 patients), angle fractures (21 patients), condylar fractures (14 patients), and multiple fractures (30 patient). In addition, the study group included 21 patients undergoing orthognatic surgery and 22 undergoing reconstructive surgery on the mandible. Intraoperatively, 3D images were generated with a mobile CBCT scanner (Arcadis Orbic 3D; Siemens Medical Solutions, Erlangen, Germany).
During open reduction of mandibular fractures, not all fracture sites can be readily exposed for direct visual control. For example, the lingual cortical bone of the mandible is difficult to assess intraoperatively. This structure and others can be effectively visualized using the 3D mode of CBCT. Furthermore, screw placement can be evaluated, specifically in insertions near the alveolar nerve. The intraoperative acquisition of the data sets is uncomplicated, and the image quality is sufficient to allow evaluation of the postoperative result in all cases.
Intraoperative CBCT has proven to be a reliable imaging technique for providing visual control during major mandibular procedures.
本研究调查了术中锥形束计算机断层扫描（CBCT）在主要下颌骨重建手术中的三维（3D）成像情况。
研究组由125例因下颌骨手术治疗入院的患者组成（男性83例，女性42例）。患者年龄范围为3个月至91岁（平均年龄40.72±22.843岁）。下颌骨手术程序细分为体部骨折修复（17例患者）、角部骨折修复（21例患者）、髁突骨折修复（14例患者）和多发骨折修复（30例患者）。此外，研究组包括21例接受正颌手术的患者和22例接受下颌骨重建手术的患者。术中，使用移动CBCT扫描仪（Arcadis Orbic 3D；西门子医疗解决方案公司，德国埃尔兰根）生成3D图像。
在下颌骨骨折切开复位过程中，并非所有骨折部位都能轻易暴露以进行直接视觉控制。例如，下颌骨的舌侧皮质骨在术中难以评估。使用CBCT的3D模式可以有效地显示该结构及其他结构。此外，可以评估螺钉放置情况，特别是在靠近牙槽神经处的植入。术中采集数据集并不复杂，图像质量足以在所有病例中评估术后结果。
术中CBCT已被证明是一种可靠的成像技术，可在主要下颌骨手术中提供视觉控制。
