Wang P, Zhang Z, Wang Y, Li X, Ye B, Li J
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Int J Oral Maxillofac Surg. 2019 Mar;48(3):341-346. doi: 10.1016/j.ijom.2018.07.026. Epub 2018 Sep 7.
Hemifacial microsomia (HFM) is a common congenital craniofacial deformity with a high prevalence. Orthognathic surgery and distraction osteogenesis are two conventionally used treatments of HFM. The main objective of this retrospective study was to evaluate the accuracy of two treatments with the help of virtual surgical planning in adult HFM patients. Sixty-eight adult patients with unilateral HFM were enrolled in this study. Preoperative surgical planning and simulation were performed on three-dimensional computed tomography models. Orthognathic surgery or distraction osteogenesis was performed under the guidance of three-dimensional surgical templates. Postoperative evaluation of the intervention was performed by comparison of the affected ramus height, chin deviation and the occlusal cant in surgical planning and actual result. Outcome and feedback information (an average of 14 months) showed that virtual surgical planning was accurately transferred to actual surgery in both surgical approaches. There were no statistical differences between the accuracy of affected ramus height and the occlusal cant in two surgical approaches. The orthognathic group showed significantly higher accuracy in chin deviation. In conclusion, virtual surgical planning and three-dimensional surgical templates were proved to facilitate treatment planning and offer an accurate surgical result in the treatment of adult HFM patients.
半侧颜面短小畸形（HFM）是一种常见的先天性颅面畸形，发病率很高。正颌手术和牵张成骨术是两种传统的HFM治疗方法。这项回顾性研究的主要目的是借助虚拟手术规划评估成人HFM患者两种治疗方法的准确性。本研究纳入了68例单侧HFM成年患者。在三维计算机断层扫描模型上进行术前手术规划和模拟。在三维手术模板的引导下进行正颌手术或牵张成骨术。通过比较手术规划和实际结果中患侧下颌升支高度、颏部偏斜和咬合斜面来进行干预的术后评估。结果及反馈信息（平均14个月）显示，在两种手术方法中虚拟手术规划均准确地应用于实际手术。两种手术方法在患侧下颌升支高度和咬合斜面准确性方面无统计学差异。正颌组在颏部偏斜方面显示出显著更高的准确性。总之，虚拟手术规划和三维手术模板被证明有助于治疗规划，并在成人HFM患者的治疗中提供准确的手术结果。
