Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology.
J Craniofac Surg. 2021 May 1;32(3):896-901. doi: 10.1097/SCS.0000000000007258.
Pruzansky-Kaban III hemifacial microsomia (HFM) is a rare congenital facial deformity, and it is challenging to reconstruct the facial appearance. The aim of the present study was to describe a technique of application of virtual planning for three-dimensional (3D) guided maxillofacial reconstruction of Pruzansky-Kaban III HFM using custom made fixation plate.
With the help of 3D models, a preoperative virtual planning and surgical simulation were performed. Computer-aided design/computer-aided manufacture (CAD/CAM) patient customized guides and custom fixation plates were designed to reconstruct the maxillofacial skull intraoperatively. Assessment was achieved through evaluation of the postoperative effects, such as imaging, facial appearance recovery and operation time.
Five patients with Pruzansky-Kaban III HFM were enrolled into this study. The results showed an exceptional accuracy between the preoperative virtual planning and the outcomes actually achieved postoperatively. Intraoperative measurements were no longer needed and the different surgical steps became more simple and easier. The total time was distributed as: 160 minutes for the surgical time, 40 minutes for preoperative virtual plan, and 80 minutes for designing the patient specific cutting guides and custom fixation plates. The operating time and tissue damage were reduced. All cases underwent uneventful healing without any complications.
The technique of patient specific guides and custom fixation plates is a reliable method of conveying the virtual plan to the operative field with higher efficiency in patients with Pruzansky-Kaban III HFM.
普鲁赞斯基-卡班 III 型半侧颜面短小畸形（HFM）是一种罕见的先天性面部畸形，重建面部外观具有挑战性。本研究旨在描述一种应用虚拟规划的技术，通过定制固定板实现普鲁赞斯基-卡班 III 型 HFM 的三维（3D）引导颌面重建。
借助 3D 模型，进行术前虚拟规划和手术模拟。设计计算机辅助设计/计算机辅助制造（CAD/CAM）患者定制引导器和定制固定板，以在术中重建颌面颅骨。通过评估术后效果，如影像学、面部外观恢复和手术时间，进行评估。
本研究纳入了 5 例普鲁赞斯基-卡班 III 型 HFM 患者。结果显示，术前虚拟规划与术后实际效果之间具有极高的准确性。术中不再需要进行测量，不同的手术步骤变得更加简单和容易。总时间分配如下：手术时间 160 分钟，术前虚拟计划 40 分钟，设计患者专用切割引导器和定制固定板 80 分钟。手术时间和组织损伤减少。所有病例均愈合顺利，无任何并发症。
对于普鲁赞斯基-卡班 III 型 HFM 患者，患者特异性引导器和定制固定板技术是一种可靠的方法，可以将虚拟计划高效地传递到手术现场。
