Shen Shunyao, Yang Chengshuai, Wu Jinyang, Zhang Lei, Wang Xudong, Shi Jun, Zhang Shilei
Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.
J Craniofac Surg. 2020 Mar/Apr;31(2):e126-e130. doi: 10.1097/SCS.0000000000006047.
The purpose of this study was to evaluate the use of a modified template system and double computed tomography scan procedure to maintain mandibular width in cases of mandibular reconstruction.
Ten patients who underwent mandibular reconstruction with a fibular flap were enrolled. The surgeries were planned with a computer-aided surgical simulation (CASS) planning method. Following double computed tomography scan procedure, the template system was designed in a computer and was fabricated using a three-dimensional printing technique. The cutting guides were designed with the holes of the conventional reconstruction plate on the remnant mandibular segments. After surgery, the outcome evaluation was compared by first superimposing the post-operative computed tomography model onto the planned model and then measuring the differences between the planned and actual outcomes.
All surgeries were completed successfully using the template system. With the use of the templates, the largest linear root-mean-square deviation (RMSD) between the planned and post-operative remnant segments was 1.01 mm, and the largest angular RMSD was 4.05°.
The authors conclude that this template system and double computed tomography scan procedure provides a reliable method to maintain mandibular width in mandibular reconstruction using a fibular flap.
本研究的目的是评估在进行下颌骨重建时，使用改良模板系统和双重计算机断层扫描程序来维持下颌骨宽度的效果。
纳入10例行腓骨瓣下颌骨重建的患者。手术采用计算机辅助手术模拟（CASS）规划方法进行规划。在双重计算机断层扫描程序之后，在计算机中设计模板系统，并使用三维打印技术制作。根据残余下颌骨段上传统重建板的孔设计切割导板。术后，通过首先将术后计算机断层扫描模型叠加到规划模型上，然后测量规划结果与实际结果之间的差异来进行结果评估。
使用模板系统，所有手术均成功完成。使用模板时，规划的残余段与术后残余段之间的最大线性均方根偏差（RMSD）为1.01毫米，最大角度RMSD为4.05°。
作者得出结论，这种模板系统和双重计算机断层扫描程序为使用腓骨瓣进行下颌骨重建时维持下颌骨宽度提供了一种可靠的方法。
