Peacock Zachary S, Magill John C, Tricomi Brad J, Murphy Brian A, Nikonovskiy Vladimir, Hata Nobuhiko, Chauvin Laurent, Troulis Maria J
Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
Principle Research Scientist, Physical Sciences, Inc, Andover, MA.
J Oral Maxillofac Surg. 2015 Oct;73(10):2005-16. doi: 10.1016/j.joms.2015.03.017. Epub 2015 Mar 19.
To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model.
We tested an electromagnetic tracking system (OsteoMark-Navigation) that uses simple sensors to determine the position and orientation of a hand-held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the resection margins of a tumor on bone. The accuracy of the OsteoMark-Navigation system in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In group 1 (n = 3, 6 sides), OsteoMark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans. In group 2 (n = 3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared with those performed using fabricated guide stents. Three metrics were used to document the precision and accuracy. In group 3 (n = 1), the system was tested in a standard operating room environment.
For group 1, the mean error between the points was 0.7 mm (horizontal) and 1.7 mm (vertical). Compared with the posterior and inferior mandibular border, the mean error was 1.2 and 1.7 mm, respectively. For group 2, the mean discrepancy between the points marked using the OsteoMark-Navigation system and the surgical guides was 1.9 mm (range 0 to 4.1). The system maintained accuracy on a live minipig in a standard operating room environment.
Based on this research OsteoMark-Navigation is a potentially powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to that of existing clinical applications.
使用人体尸体和小型猪活体模型评估一种新型颌面外科导航系统的准确性。
我们测试了一种电磁跟踪系统（OsteoMark导航系统），该系统使用简单的传感器来确定手持式铅笔状标记设备的位置和方向。该设备可在术中转换三维计算机断层扫描数据，使外科医生能够在骨头上定位并绘制拟行的截骨线或肿瘤切除边缘。评估了OsteoMark导航系统在人体尸体头部定位和标记截骨线及螺钉位置的准确性。在第1组（n = 3，6侧）中，将OsteoMark导航系统标记的截骨线和螺钉位置与虚拟治疗计划进行比较。在第2组（n = 3，6侧）中，将牵引成骨装置标记的截骨线和螺钉位置与使用定制导向支架进行的操作结果进行比较。使用三个指标来记录精度和准确性。在第3组（n = 1）中，该系统在标准手术室环境中进行测试。
对于第1组，点之间的平均误差为0.7毫米（水平）和1.7毫米（垂直）。与下颌后缘和下缘相比，平均误差分别为1.2毫米和1.7毫米。对于第2组，使用OsteoMark导航系统标记的点与手术导板之间的平均差异为1.9毫米（范围0至4.1）。该系统在标准手术室环境中的小型猪活体上保持了准确性。
基于本研究，OsteoMark导航系统是颌面外科临床应用中一种潜在的强大工具。它具有与现有临床应用相当的准确性和精度。
