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采用微血管腓骨移植进行原发性颌骨重建的加速工作流程。

Accelerated workflow for primary jaw reconstruction with microvascular fibula graft.

作者信息

Goetze Elisabeth, Gielisch Matthias, Moergel Maximilian, Al-Nawas Bilal

机构信息

Department of Oral and Maxillofacial Surgery, University of Mainz, Medical Center, Augustusplatz 2, D-55131 Mainz, Rheinland-Pfalz Germany.

出版信息

3D Print Med. 2017;3(1):3. doi: 10.1186/s41205-017-0010-7. Epub 2017 Feb 14.

Abstract

INTRODUCTION

Major facial defects due to cancer or deformities can be reconstructed through microvascular osteocutaneous flaps. Hereby CAD/CAM workflows offer a possibility to optimize reconstruct and reduce surgical time. We present a retrospectiv observational study regarding the developement of an in-house workflow allowing an accelerated CAD/CAM fibula reconstruction without outsourcing.

CASE DESCRIPTION

Workflow includes data acquisition through computertomography of head and legs, segmentation of the data and virtual surgery. The virtual surgery was transferred into surgical guides and prebent osteosynthesis plate. Those were sterilized and used in surgery.

EVALUATION

The workflow was used in 30 cases. Minimum planning period took 4 days from CT to surgery, average time was 8 days. Planning could be transferred to surgery every time. Intraoperative complications regarding osteotomy, assembly and fixation did not occur.

DISCUSSION/CONCLUSION: An in-house workflow for CAD/CAM fibula reconstruction is feasible within a few days providing an accelerated procedure even in urgent cases.

摘要

引言

因癌症或畸形导致的严重面部缺损可通过微血管骨皮瓣进行重建。在此,计算机辅助设计/计算机辅助制造(CAD/CAM)工作流程为优化重建和减少手术时间提供了一种可能。我们开展了一项回顾性观察研究,探讨一种内部工作流程的开发情况,该流程可在不外包的情况下加速CAD/CAM腓骨重建。

病例描述

工作流程包括通过头部和腿部的计算机断层扫描进行数据采集、数据分割和虚拟手术。虚拟手术被转化为手术导板和预弯接骨板。将其消毒后用于手术。

评估

该工作流程应用于30例患者。从CT扫描到手术的最短规划期为4天,平均时间为8天。每次规划都能转化为手术操作。术中未发生截骨、组装和固定方面的并发症。

讨论/结论:一种用于CAD/CAM腓骨重建的内部工作流程在几天内是可行的,即使在紧急情况下也能加快手术进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a4/6140762/8cad01a38878/41205_2017_10_Fig1_HTML.jpg

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