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应用带血管蒂双腓骨瓣修复下颌骨缺损包括髁突的三维虚拟技术。

Three-dimensional virtual technology in reconstruction of mandibular defect including condyle using double-barrel vascularized fibula flap.

机构信息

Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, No.193 Renmingxi Road, Kunming, Yunnan 650031, China.

出版信息

J Craniomaxillofac Surg. 2013 Jul;41(5):417-22. doi: 10.1016/j.jcms.2012.11.008. Epub 2012 Dec 5.

DOI:10.1016/j.jcms.2012.11.008
PMID:23218981
Abstract

OBJECTIVE

The aim of this study is to demonstrate the reconstruction of mandibular defects including the condyle using a double-barrel vascularized fibula flap aided by three-dimensional virtual technology.

METHODS

Ten patients with the type H mandibular defects, who had undergone mandibular reconstruction using a double-barrel vascularized fibula flap, were reviewed for this study. Prior to the surgery, the patients CT scan data were analyzed virtually using SimPlant Pro™ software (version 11.04). The simulation allowed construction of an individual mandibular model serving to guide the clinical operation.

RESULTS

The preoperative virtual surgery greatly benefitted the actual surgery. The vertical height of the neomandible and facial contour were precisely predicted. Some minor complications were encountered. Postoperative three-dimensional reconstruction revealed a close match with the simulated condyle.

CONCLUSION

A double-barrel vascularized fibula flap can provide sufficient bone, both in length and vertical height, for the reconstruction of a type H mandibular condylar defect. Combined virtual three-dimensional reconstruction and rapid prototyping can improve postoperative outcomes in mandibular reconstruction.

摘要

目的

本研究旨在展示使用双管血管化腓骨瓣结合三维虚拟技术重建包括髁突在内的下颌骨缺损。

方法

回顾性分析了 10 例行双管血管化腓骨瓣下颌骨重建术的 H 型下颌骨缺损患者的临床资料。术前,使用 SimPlant Pro™软件(版本 11.04)对患者的 CT 扫描数据进行虚拟分析。模拟允许构建用于指导临床操作的个体化下颌骨模型。

结果

术前虚拟手术对实际手术有很大帮助。精确预测了新下颌骨的垂直高度和面部轮廓。术后出现一些轻微并发症。术后三维重建显示与模拟髁突吻合良好。

结论

双管血管化腓骨瓣可为 H 型下颌骨髁突缺损的重建提供足够的长度和垂直高度的骨量。结合虚拟三维重建和快速成型技术可改善下颌骨重建术后的效果。

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