State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
State Key Laboratory of Military Stomatology, National Clinical Research Center of Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
Chin J Traumatol. 2021 Feb;24(1):11-17. doi: 10.1016/j.cjtee.2020.10.002. Epub 2020 Nov 17.
To evaluate the outcomes with and without aid of a computer-assisted surgical navigation system (CASNS) for treatment of unilateral orbital wall fracture (OWF).
Patients who came to our hospital for repairing unilateral traumatic OWF from 2014 to 2017 were included in this study. The patients were divided into the navigation group who accepted orbital wall reconstruction aided by CASNS and the conventional group. We evaluated the surgical precision in the navigation group by analyzing the difference between actual postoperative computed tomography data and preoperative virtual surgical plan through color order ratios. We also compared the duration of surgery, enophthalmos correction, restoration of orbital volumes, and improvement of clinical symptoms in both groups systemically. Quantitative data were presented as mean ± SD. Significance was determined by the two-sample t-test using SPSS Version 19.0 A p < 0.05 was considered statistically significant.
Seventy patients with unilateral OWF were included in the study cohort. The mean difference between preoperative virtual planning and actual reconstruction outcome was (0.869 ± 0.472) mm, which means the reconstruction result could match the navigation planning accurately. The mean duration of surgery in the navigation group was shorter than it is in the control group, but not significantly. Discrepancies between the reconstructed and unaffected orbital-cavity volume and eyeball projection in the navigation group were significantly less than that in the conventional group. One patient had remnant diplopia and two patients had enophthalmos after surgery in the navigation group; two patients had postoperative diplopia and four patients had postoperative enophthalmos in the conventional group.
Compare with the conventional treatment for OWF, the use of CASNS can provide a significantly better surgical precision, greater improvements in orbital-cavity volume and eyeball projection, and better clinical results, without increasing the duration of surgery.
评估计算机辅助手术导航系统（CASNS）辅助治疗单侧眼眶壁骨折（OWF）的效果。
本研究纳入 2014 年至 2017 年因单侧外伤性 OWF 来我院就诊的患者。将患者分为接受 CASNS 辅助眼眶壁重建的导航组和常规组。通过颜色顺序比分析实际术后 CT 数据与术前虚拟手术计划之间的差异，评估导航组的手术精度。我们还系统地比较了两组的手术时间、眼球内陷矫正、眼眶容积恢复和临床症状改善情况。定量数据以均数±标准差表示。使用 SPSS 版本 19.0 进行两样本 t 检验，p<0.05 为有统计学意义。
本研究纳入了 70 例单侧 OWF 患者。术前虚拟规划与实际重建结果的平均差值为（0.869±0.472）mm，这意味着重建结果可以准确匹配导航规划。导航组的手术时间平均比对照组短，但差异无统计学意义。导航组重建眼眶腔容积和眼球投影与未受影响侧的差异明显小于对照组。导航组有 1 例患者术后仍有复视，2 例患者术后有眼球内陷；常规组有 2 例患者术后有复视，4 例患者术后有眼球内陷。
与传统的 OWF 治疗方法相比，CASNS 的使用可以显著提高手术精度，更好地改善眼眶腔容积和眼球投影，临床效果更好，且不会增加手术时间。
