Yu Hongbo, Shen Guofang, Wang Xudong, Zhang Shilei
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
J Oral Maxillofac Surg. 2010 Jan;68(1):28-34. doi: 10.1016/j.joms.2009.07.058.
To evaluate the effectiveness of image-guided navigation on open reduction and orbital floor reconstruction as treatment for zygomatic-orbital-maxillary complex fractures.
Six patients with zygomatic-orbital-maxillary complex fractures were enrolled in the present study. With preoperative planning and 3-dimensional simulation, the normal anatomic structures of the deformed area were recreated by superimposing and comparing the unaffected side with the affected side. The position of dislocated bone for reduction was defined, and surgical simulation was performed. All patients underwent open reduction and orbital floor reconstruction under the guidance of the navigation system.
A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration, with a systematic error of 1-mm difference. With guidance of the navigation system, open reduction of zygomatic-orbital-maxillary complex fractures and orbital floor reconstruction were performed in all cases. The reduction was checked by postoperative computed tomography scans, with a good match with preoperative planning noted. The maximal deviation between the reduction and preoperative planning was less than 2 mm. The symptoms associated with the orbital floor defects were eliminated, and the postoperative facial appearance of the patients was clearly improved.
Navigation-guided open reduction of zygomatic-orbital-maxillary complex fractures with orbital floor reconstruction can be regarded as a valuable treatment option for this potentially complicated procedure.
评估影像引导导航在颧眶上颌复合体骨折切开复位及眶底重建治疗中的有效性。
本研究纳入6例颧眶上颌复合体骨折患者。通过术前规划和三维模拟，将患侧与健侧进行叠加和对比，重建变形区域的正常解剖结构。确定用于复位的脱位骨位置，并进行手术模拟。所有患者均在导航系统引导下进行切开复位及眶底重建。
通过配准实现了术中解剖结构与计算机断层扫描图像的相当精确匹配，系统误差为1毫米差异。在导航系统引导下，所有病例均进行了颧眶上颌复合体骨折切开复位及眶底重建。术后计算机断层扫描检查复位情况，发现与术前规划匹配良好。复位与术前规划的最大偏差小于2毫米。眶底缺损相关症状消除，患者术后面部外观明显改善。
导航引导下颧眶上颌复合体骨折切开复位及眶底重建可被视为这种潜在复杂手术的一种有价值的治疗选择。
