Wang Yu, Li Jingtao, Xu Yinglin, Huang Ning, Shi Bing, Li Jihua
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft of Lip and Plate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
J Plast Reconstr Aesthet Surg. 2020 Jan;73(1):134-140. doi: 10.1016/j.bjps.2019.07.003. Epub 2019 Aug 7.
Management of maxillary hypoplasia in patients with cleft lip and palate (CLP) remains a significant clinical challenge. The objective of this retrospective study is to evaluate the accuracy of virtual surgical planning (VSP) with different maxillary advancement techniques.
Ninety adult patients with cleft-related maxillary hypoplasia between April 2010 and April 2016 were enrolled in our study. Various surgical techniques including conventional orthognathic surgery, total maxillary distraction osteogenesis, and anterior maxillary segmental distraction were used according to the characteristics of patients. All the cases were aided with VSP and three-dimensional (3D)-printed surgical splints. The virtual surgical plan was compared with the postoperative surgical results by analyzing the positions of several landmarks and planes relative to reference planes.
Both the profile and occlusion were improved significantly in all the cases. VSP was successfully transferred to actual surgery with the help of 3D-printed surgical splints in different surgical techniques.
Management of cleft-related maxillary hypoplasia requires both comprehensive surgical planning and accurate execution. VSP serves as a viable alternative to conventional model surgery with high accuracy in patients with adult CLP.
唇腭裂（CLP）患者上颌骨发育不全的治疗仍然是一项重大的临床挑战。这项回顾性研究的目的是评估不同上颌骨前移技术的虚拟手术规划（VSP）的准确性。
2010年4月至2016年4月期间，90例患有与腭裂相关的上颌骨发育不全的成年患者纳入我们的研究。根据患者的特点，采用了包括传统正颌手术、全上颌骨牵张成骨术和上颌前部节段性牵张术等多种手术技术。所有病例均采用VSP和三维（3D）打印手术夹板辅助。通过分析几个标志点和平面相对于参考平面的位置，将虚拟手术计划与术后手术结果进行比较。
所有病例的侧貌和咬合均有显著改善。在不同的手术技术中，借助3D打印手术夹板，VSP成功地应用于实际手术。
腭裂相关上颌骨发育不全的治疗需要全面的手术规划和精确的执行。对于成年CLP患者，VSP是一种可行的替代传统模型手术的方法，具有较高的准确性。
