Qu Miao, Hou Yikang, Xu Yourong, Shen Congcong, Zhu Ming, Xie Le, Wang Hao, Zhang Yan, Chai Gang
Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Rd, Shanghai, 200011, China.
National Digital Manufacturing Technology Center, Shanghai Jiao Tong University, Shanghai, China.
J Craniomaxillofac Surg. 2015 Jan;43(1):106-12. doi: 10.1016/j.jcms.2014.10.019. Epub 2014 Oct 29.
Through three-dimensional real time imaging, augmented reality (AR) can provide an overlay of the anatomical structure, or visual cues for specific landmarks. In this study, an AR Toolkit was used for distraction osteogenesis with hemifacial microsomia to define the mandibular osteotomy line and assist with intraoral distractor placement.
20 patients with hemifacial microsomia were studied and were randomly assigned to experimental and control groups. Pre-operative computed tomography was used in both groups, whereas AR was used in the experimental group. Afterwards, pre- and post-operative computed tomographic scans of both groups were superimposed, and several measurements were made and analysed.
Both the conventional method and AR technique achieved proper positioning of the osteotomy planes, although the AR was more accurate. The difference in average vertical distance from the coronoid and condyle process to the pre- and post-operative cutting planes was significant (p < 0.01) between the two groups, whereas no significant difference (p > 0.05) was observed in the average angle between the two planes. The difference in deviations between the intersection points of the overlaid mandible across two cutting planes was also significant (p < 0.01).
This study reports on an efficient approach for guiding intraoperative distraction osteogenesis. Augmented reality tools such as the AR Toolkit may be helpful for precise positioning of intraoral distractors in patients with hemifacial microsomia in craniofacial surgery.
通过三维实时成像，增强现实（AR）可以提供解剖结构的叠加图，或特定地标的视觉线索。在本研究中，使用AR工具包辅助半侧颜面短小畸形患者的牵张成骨术，以确定下颌骨截骨线并协助放置口内牵张器。
对20例半侧颜面短小畸形患者进行研究，并随机分为实验组和对照组。两组均采用术前计算机断层扫描，实验组使用AR技术。之后，将两组患者术前和术后的计算机断层扫描图像进行叠加，并进行多项测量和分析。
传统方法和AR技术均能实现截骨平面的正确定位，不过AR技术更精确。两组之间，从冠突和髁突到术前和术后截骨平面的平均垂直距离差异显著（p < 0.01），而两个平面之间的平均角度无显著差异（p > 0.05）。两个截骨平面上重叠下颌骨交点之间的偏差差异也很显著（p < 0.01）。
本研究报告了一种指导术中牵张成骨的有效方法。诸如AR工具包之类的增强现实工具可能有助于在颅面外科手术中为半侧颜面短小畸形患者精确放置口内牵张器。
