Liu Xiao-Jing, He Yang, Gong Xi, An Jin-Gang, Guo Chuan-Bin, Zhang Yi
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2012 Nov;47(11):645-50. doi: 10.3760/cma.j.issn.1002-0098.2012.11.002.
To investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.
Fifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.
All the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.
Computer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.
探讨计算机辅助导航系统(CANS)在创伤后颌面部畸形治疗中的价值。
本研究纳入54例患者(男性37例,女性17例),包括31例颧骨骨折、7例单纯眶骨折、11例颞下颌关节强直、1例异物及4例定制植入物缺损重建。通过CT扫描进行数据采集,并将DICOM数据传输至工作站。使用Surgicase CMF和Brain Lab Iplan系统进行计算机辅助设计,包括截骨、复位、腓骨瓣设计、眶植入物构建。将虚拟设计传输至Brain Lab导航系统,在导航引导下进行截骨、复位、植骨及定制植入物定位。术后48 - 72小时需进行CT扫描。术前和术后CT图像在BrainLab Iplan系统中自动叠加,并在三维物体和二维切片上进行比较。
所有病例均取得良好效果,无严重并发症。颧骨骨折复位、眶重建及缺损重建中重要对应点的误差分别为0.2 - 3.5毫米、0.8 - 2.0毫米和0.2 - 2.2毫米。
计算机辅助设计对于复杂创伤后畸形的系统和精确规划具有重要价值。在CANS的辅助下可准确进行虚拟规划。