基于模板的微创 TMJ 手术（MITMJS）中颞下颌关节穿刺和入路 - 技术说明和初步临床结果。
Template-based temporomandibular joint puncturing and access in minimally invasive TMJ surgery (MITMJS) - a technical note and first clinical results.
机构信息
Department of Oral & Maxillofacial Plastic Surgery, Leipzig University, Liebigstr. 12, 04103, Leipzig, Germany.
Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl-Liebknecht Str. 145, 04277, Leipzig, Germany.
出版信息
Head Face Med. 2019 Apr 2;15(1):10. doi: 10.1186/s13005-019-0194-8.
BACKGROUND
Minimally invasive temporomandibular joint surgery (MITMJS) is an option for patients suffering from severe internal derangement or adhesions. To improve TMJ access, a workflow to create surgical templates is introduced.
METHODS
A workflow to generate a dividable patient specific template based on CBCT and optical scanning to access the joint is introduced. In a first clinical trial 3 patients (6 joints) were treated by way of template-guided endoscopically-assisted TMJ therapy (3 arthrocenteses and 3 arthroscopies).
RESULTS
Generation and clinical use of the templates was as planned. All templates showed perfect fit and permitted instant access to the TMJ. All surgeries were performed without complications.
CONCLUSIONS
Template-guidance could improve the feasibility of endoscopically-assisted TMJ therapy. An important issue is the capability to dis- and remount the template during surgery. Using in-house production, costs are affordable.
TRIAL REGISTRATION
This study was registered at the Ethic Committee of the Berlin Medical Chamber ( Eth-30/17 , 12/06/2017).
背景
对于患有严重内部紊乱或粘连的患者，微创颞下颌关节手术（MITMJS）是一种选择。为了改善 TMJ 的进入，引入了创建手术模板的工作流程。
方法
介绍了一种基于 CBCT 和光学扫描生成可分割的患者特定模板以进入关节的工作流程。在首次临床试验中，通过模板引导的内窥镜辅助 TMJ 治疗（3 次关节穿刺和 3 次关节镜检查）治疗了 3 名患者（6 个关节）。
结果
模板的生成和临床应用按计划进行。所有模板均完美贴合，可立即进入 TMJ。所有手术均无并发症。
结论
模板引导可以提高内窥镜辅助 TMJ 治疗的可行性。一个重要的问题是在手术过程中能够拆卸和重新安装模板的能力。使用内部生产，成本是可以承受的。
试验注册
本研究已在柏林医疗协会伦理委员会注册（Eth-30/17，2017 年 6 月 12 日）。
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