Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
J Formos Med Assoc. 2019 Feb;118(2):588-599. doi: 10.1016/j.jfma.2018.12.011. Epub 2019 Jan 8.
This retrospective study evaluated the volume of blood loss and operative time associated with management of nongrowing patients with cleft lip and palate (CLP) using bimaxillary orthognathic surgery (OGS) designed by a three-dimensional (3D) computer-assisted simulation and navigation for orthognathic surgery (CASNOS) system.
This study included 53 skeletal Class III nongrowing patients with unilateral CLP who underwent bimaxillary OGS using either the CASNOS protocol (n = 30) or the traditional two-dimensional (2D) method (n = 23). The skeletal parameters of jaw-bone components, the levels of hemoglobin (Hb) and hematocrit (Hct) were measured before and after surgery. The estimated blood loss and actual blood loss (ABL) were also calculated.
The two groups did not differ significantly with regard to the demographic parameters (age, gender, and body mass index), the preoperative skeletal parameters and surgical changes of jaw-bone components. The mean ABL of the CASNOS group was significantly lower than that of the control group (915.6 ± 280.5 vs. 1204.9 ± 201.0 ml, p < 0.001), and the changes in Hb and Hct level also followed a similar pattern in both groups. The mean operative time was significantly shorter in the CASNOS group compared with the control group (384.2 ± 48.5 vs. 469.0 ± 94.9 min, p < 0.001).
This study demonstrated that the application of the 3D CASNOS approach in OGS for the management of complicated Class III nongrowing patients with CLP significantly shortened the operative time and reduced ABL in comparison with the traditional 2D methods.
本回顾性研究评估了使用三维（3D）计算机辅助模拟和导航正颌手术（CASNOS）系统设计的双颌正颌手术（OGS）治疗单侧唇腭裂（CLP）非生长患者的失血量和手术时间。
本研究纳入了 53 例单侧 CLP 伴骨骼 III 类非生长患者，他们接受了双颌 OGS，其中 30 例采用 CASNOS 方案，23 例采用传统二维（2D）方法。测量手术前后颌骨成分的骨骼参数、血红蛋白（Hb）和血细胞比容（Hct）水平。还计算了估计失血量和实际失血量（ABL）。
两组在人口统计学参数（年龄、性别和体重指数）、术前骨骼参数和颌骨成分的手术变化方面无显著差异。CASNOS 组的平均 ABL 明显低于对照组（915.6 ± 280.5 比 1204.9 ± 201.0 ml，p < 0.001），两组 Hb 和 Hct 水平的变化也呈现相似模式。CASNOS 组的平均手术时间明显短于对照组（384.2 ± 48.5 比 469.0 ± 94.9 min，p < 0.001）。
本研究表明，在治疗复杂的 III 类非生长单侧唇腭裂患者的 OGS 中应用 3D CASNOS 方法与传统 2D 方法相比，可显著缩短手术时间并减少 ABL。
