Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany.
Int J Oral Maxillofac Surg. 2012 Oct;41(10):1171-5. doi: 10.1016/j.ijom.2012.06.006. Epub 2012 Jul 9.
Computed tomography is currently the standard in preoperative evaluation of facial fractures, but cone beam computed tomography (CBCT) or digital volume tomography (DVT) offers potential advantages. Intraoperative imaging may facilitate adequate fracture reduction, optimising fracture repair. The aim of this article is to demonstrate the potential benefits of a new mobile CBCT system in a series of patients with complex facial fractures. Intraoperative imaging was performed with the xCAT ENT portable CBCT system. Images were provided in three planes and in a three-dimensional reconstruction. This system was used for intraoperative imaging of 46 consecutive facial trauma patients. The impact of intraoperative CBCT on the management of these cases is described and two select cases are presented to illustrate the potential benefits of this technique. Intraoperative CBCT was successfully performed in all patients and has led to immediate consequences in 12 (26%) cases. In 5 cases, fracture reduction turned out to be insufficient and was further optimized and in 5 other cases the titanium implant (orbital mesh) was not placed in the optimal position and the position was corrected. Bony fragments were detected and removed in 2 cases. Intraoperative imaging provides a number of advantages over post-therapeutic imaging in the management of facial fractures.
计算机断层扫描（CT）目前是面部骨折术前评估的标准方法，但锥形束 CT（CBCT）或数字体层摄影术（DVT）具有潜在优势。术中成像有助于实现充分的骨折复位，优化骨折修复。本文旨在通过一系列复杂面部骨折患者的病例展示新型移动 CBCT 系统的潜在优势。术中成像使用 xCAT ENT 便携式 CBCT 系统进行。图像提供了三个平面和三维重建。该系统用于 46 例连续面部创伤患者的术中成像。描述了术中 CBCT 对这些病例处理的影响，并呈现了两个精选病例来说明该技术的潜在优势。所有患者均成功进行了术中 CBCT，其中 12 例（26%）立即产生了影响。在 5 例中，骨折复位效果不理想，进一步进行了优化，在另外 5 例中，钛植入物（眶网）未置于最佳位置，并对其位置进行了纠正。在 2 例中发现并取出了骨碎片。与治疗后成像相比，术中成像在面部骨折的处理中有诸多优势。
