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通过薄金属模板将颅骨重建计划转移至手术室:临床结果

Skull reconstruction planning transfer to the operation room by thin metallic templates: clinical results.

作者信息

Clijmans Tim, Mommaerts Maurice, Gelaude Frederik, Suetens Paul, Sloten Jos Vander

机构信息

Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Leuven, Belgium.

出版信息

J Craniomaxillofac Surg. 2008 Mar;36(2):66-74. doi: 10.1016/j.jcms.2007.08.003. Epub 2008 Feb 4.

Abstract

INTRODUCTION

Craniofacial malformations implicate a risk of medical complications and a negative psychological impact on the patient. In order to correct functional and aesthetic aspects of these malformations, skull reconstruction is required. Because of the complexity of the surgery, pre-operative planning is unavoidable. Current and previously developed planning environments often lack the opportunity to transfer the simulated surgery to the operation room on a cheap but accurate, and easy to handle basis.

MATERIALS AND METHODS

This study applies an automated filter procedure, implemented in Matlab, to generate a set of adapted contours from which a surface mesh can be directly deduced. Skull reconstruction planning is performed on the generated outer bone surface model. For each resected/osteotomized bone part, the presented semi-automatic Matlab procedure generates surface based bone cutting guides, also denoted bone segment templates. Autoclaved aluminium templates transfer the surgical plan to the operation room.

RESULTS

The clinical feasibility is demonstrated by the successful pre-operative planning and surgical correction of three skull reconstruction cases in which the proposed procedure leads to considerable reduction in surgery time and good results.

CONCLUSION

A cost-efficient and planning-environment-independent solution is generated for an accurate and fast transfer of a complex cranial surgery plan to the operation room.

摘要

引言

颅面畸形会带来医疗并发症风险,并对患者产生负面心理影响。为了矫正这些畸形的功能和美学方面,需要进行颅骨重建。由于手术的复杂性,术前规划是不可避免的。当前以及先前开发的规划环境往往缺乏将模拟手术以低成本、准确且易于操作的方式转移到手术室的机会。

材料与方法

本研究应用在Matlab中实现的自动过滤程序,以生成一组适配轮廓,可直接从中推导表面网格。颅骨重建规划在生成的外骨表面模型上进行。对于每个切除/截骨的骨部分,所呈现的半自动Matlab程序生成基于表面的骨切割引导线,也称为骨段模板。经高压灭菌的铝制模板将手术计划转移到手术室。

结果

通过对三例颅骨重建病例的成功术前规划和手术矫正证明了临床可行性,其中所提出的程序使手术时间大幅缩短且效果良好。

结论

生成了一种经济高效且与规划环境无关的解决方案,用于将复杂的颅骨手术计划准确快速地转移到手术室。

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