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肿瘤手术后下颌骨节段性重建的计算机辅助手术利弊

The Pros and Cons of Computer-Aided Surgery for Segmental Mandibular Reconstruction after Oncological Surgery.

作者信息

Han Hyun Ho, Kim Hak Young, Lee Jun Yong

机构信息

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Arch Craniofac Surg. 2017 Sep;18(3):149-154. doi: 10.7181/acfs.2017.18.3.149. Epub 2017 Sep 26.

Abstract

Computer-aided surgery (CAS) started being used for head and neck reconstruction in the late 2000s. Its use represented a paradigm shift, changing the concept of head and neck reconstruction as well as mandible reconstruction. Reconstruction using CAS proceeds through 4 phases: planning, modeling, surgery, and evaluation. Thus, it can overcome a number of trial-and-error issues which may occur in the operative field and reduce surgical time. However, if it is used for oncologic surgery, it is difficult to evaluate tumor margins during tumor surgery, thereby restricting pre-surgical planning. Therefore, it is dangerous to predetermine the resection margins during the pre-surgical phase and the variability of the resection margins must be taken into consideration. However, it allows for the preparation of a prebending plate and planning of an osteotomy site before an operation, which are of great help. If the current problems are resolved, its applications can be greatly extended.

摘要

计算机辅助手术(CAS)于21世纪末开始用于头颈部重建。它的应用代表了一种范式转变,改变了头颈部重建以及下颌骨重建的概念。使用CAS进行重建包括四个阶段:规划、建模、手术和评估。因此,它可以克服手术区域可能出现的一些反复试验问题,并减少手术时间。然而,如果将其用于肿瘤手术,在肿瘤手术过程中很难评估肿瘤边缘,从而限制了术前规划。因此,在术前阶段预先确定切除边缘是危险的,必须考虑切除边缘的变异性。然而,它允许在手术前制备预弯板并规划截骨部位,这非常有帮助。如果当前问题得到解决,其应用可以大大扩展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9160/5647851/abde1b201ee1/acfs-18-149-g001.jpg

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