DeLong Michael R, Gandolfi Brad M, Barr Meaghan L, Datta Neha, Willson Thomas D, Jarrahy Reza
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California - Los Angeles Medical Center, Los Angeles, CA.
The Robert Zubowski Center for Plastic and Reconstructive Surgery, Paramus, NJ.
J Craniofac Surg. 2019 Mar/Apr;30(2):465-472. doi: 10.1097/SCS.0000000000005130.
Image-guided navigation has existed for nearly 3 decades, but its adoption to craniofacial surgery has been slow. A systematic review of the literature was performed to assess the current status of navigation in craniofacial surgery.
A Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) systematic review of the Medline and Web of Science databases was performed using a series of search terms related to Image-Guided Navigation and Craniofacial Surgery. Titles were then filtered for relevance and abstracts were reviewed for content. Single case reports were excluded as were animal, cadaver, and virtual data. Studies were categorized based on the type of study performed and graded using the Jadad scale and the Newcastle-Ottawa scales, when appropriate.
A total of 2030 titles were returned by our search criteria. Of these, 518 abstracts were reviewed, 208 full papers were evaluated, and 104 manuscripts were ultimately included in the study. A single randomized controlled trial was identified (Jadad score 3), and 12 studies were identified as being case control or case cohort studies (Average Newcastle-Ottawa score 6.8) The most common application of intraoperative surgical navigation cited was orbital surgery (n = 36), followed by maxillary surgery (n = 19). Higher quality studies more commonly pertained to the orbit (6/13), and consistently show improved results.
Image guided surgical navigation improves outcomes in orbital reconstruction. Although image guided navigation has promise in many aspects of craniofacial surgery, current literature is lacking and future studies addressing this paucity of data are needed before universal adoption can be recommended.
图像引导导航技术已经存在了近30年，但在颅面外科手术中的应用进展缓慢。我们进行了一项文献系统综述，以评估导航技术在颅面外科手术中的现状。
使用一系列与图像引导导航和颅面外科手术相关的搜索词，对Medline和Web of Science数据库进行了系统综述，并遵循系统评价和Meta分析的首选报告项目（PRISMA）。然后筛选标题的相关性，并审查摘要内容。排除单病例报告、动物、尸体和虚拟数据研究。根据所进行的研究类型对研究进行分类，并在适当时使用Jadad量表和纽卡斯尔-渥太华量表进行分级。
根据我们的搜索标准共检索到2030个标题。其中，审查了518篇摘要，评估了208篇全文，最终104篇手稿被纳入研究。确定了一项随机对照试验（Jadad评分为3），12项研究被确定为病例对照或病例队列研究（纽卡斯尔-渥太华平均评分为6.8）。术中手术导航最常见的应用是眼眶手术（n = 36），其次是上颌手术（n = 19）。高质量的研究更常见于眼眶手术（6/13），并始终显示出更好的结果。
图像引导手术导航可改善眼眶重建的效果。虽然图像引导导航在颅面外科手术的许多方面都有前景，但目前的文献不足，在推荐普遍采用之前，需要进一步的研究来解决数据匮乏的问题。
