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导航引导下治疗面部创伤后畸形(上海40例经验)

Navigation-guided correction of midfacial post-traumatic deformities (Shanghai experience with 40 cases).

作者信息

Zhang Shilei, Gui Haijun, Lin Yanping, Shen Guofang, Xu Bing

机构信息

Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

出版信息

J Oral Maxillofac Surg. 2012 Jun;70(6):1426-33. doi: 10.1016/j.joms.2011.03.068. Epub 2011 Jul 31.

Abstract

PURPOSE

To evaluate the effectiveness of navigation-guided surgical correction as the treatment of midfacial post-traumatic deformities.

PATIENTS AND METHODS

A total of 40 patients with midfacial post-traumatic deformities from 2007 to 2010 were involved in the present study. The preoperative planning and simulation data sets, including the generation of virtual models with the mirror tool, were used as a virtual template to guide surgical correction of those deformities by intraoperative instrument- and/or probe-based navigation. The outcome was checked by both superimposing the postoperative 3-dimensional computed tomography model on the preoperative planning model and clinical examination.

RESULTS

Through registration, an accurate match between the intraoperative actual position and 3-dimensional virtual model was achieved with a systematic error of 1 mm difference. With the guidance of the navigation system, the average deviation of the morphologic change after surgical correction was less than 1 mm according to the image comparison between the preplanned and postoperative computed tomography. The 1- to 2-year follow-up evaluation showed that the clinical complaint symptoms were alleviated, and the postoperative function and esthetics improved remarkably.

CONCLUSIONS

Navigation-guided correction in the treatment of midfacial post-traumatic deformities can be regarded as an ideal and valuable option for this potentially complicated procedure.

摘要

目的

评估导航引导下手术矫正治疗面中部创伤后畸形的有效性。

患者与方法

本研究纳入了2007年至2010年期间共40例面中部创伤后畸形患者。术前规划和模拟数据集,包括使用镜像工具生成虚拟模型,被用作虚拟模板,通过术中基于器械和/或探针的导航来引导这些畸形的手术矫正。通过将术后三维计算机断层扫描模型与术前规划模型叠加以及临床检查来检查结果。

结果

通过配准,术中实际位置与三维虚拟模型实现了精确匹配,系统误差相差1毫米。在导航系统的引导下,根据术前规划和术后计算机断层扫描的图像比较,手术矫正后形态变化的平均偏差小于1毫米。1至2年的随访评估表明,临床主诉症状得到缓解,术后功能和美观度显著改善。

结论

导航引导下矫正治疗面中部创伤后畸形可被视为这一潜在复杂手术的理想且有价值的选择。

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