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[面部和颅部区域的复杂重建]

[Complex reconstructions in the facial and cranial regions].

作者信息

Gellrich Nils-Claudius, Eckstein Fabian Matthias, Lentge Fritjof, Zeller Alexander-Nicolai, Korn Philippe

机构信息

Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

出版信息

Unfallchirurg. 2021 Oct;124(10):807-816. doi: 10.1007/s00113-021-01076-6. Epub 2021 Sep 9.

DOI:10.1007/s00113-021-01076-6
PMID:34499183
Abstract

Posttraumatic reconstruction of the neurocranium and viscerocranium is an essential part of modern oral and maxillofacial surgery, in addition to oncological surgery, surgery of congenital craniofacial deformities and dental surgery. Due to the complex anatomy of the facial skull and significant esthetic and functional demands on its reconstruction, reconstructive trauma surgery in this area places the highest demands on the surgeon. This is all the more true if definitive craniomaxillofacial surgical treatment can sometimes only be performed with considerable delays for the benefit of other life-threatening injuries. In order to take these prerequisites into account, achievements of modern biomedical technology, such as intraoperative real-time navigation, computer-assisted planning and computer-assisted manufacturing (CAD/CAM) of patient-specific biomodels and implants, came up early for use in oral and maxillofacial surgery. In combination with intraoperative three-dimensional imaging, these methods result in a treatment pathway tailored to the individual patient, which is directly checked for quality at every step and thus ensures the best possible result for the patient. The use of these technologies extends far beyond the original indications in the area of orbital reconstruction and restoration of bony defects with simple geometry, such as skull defects. Nowadays, even the most complex pan-facial fractures can be restored esthetically and functionally by means of digitalized preliminary planning and individualized skull, orbital and zygomatic implants as well as total temporomandibular joint prostheses.

摘要

除了肿瘤手术、先天性颅面畸形手术和牙科手术外,创伤后颅盖骨和面颅骨重建是现代口腔颌面外科的重要组成部分。由于面颅骨解剖结构复杂,对其重建有很高的美学和功能要求,该领域的重建创伤手术对外科医生的要求极高。如果有时为了处理其他危及生命的损伤而不得不延迟进行确定性的颅颌面外科治疗,情况更是如此。为了考虑到这些前提条件,现代生物医学技术的成果,如术中实时导航、计算机辅助规划以及针对患者的生物模型和植入物的计算机辅助制造(CAD/CAM),很早就开始应用于口腔颌面外科。这些方法与术中三维成像相结合,形成了一条针对个体患者的治疗路径,该路径在每一步都能直接检查质量,从而为患者确保最佳可能的结果。这些技术的应用远远超出了最初在眼眶重建和修复简单几何形状的骨缺损(如颅骨缺损)方面的适应症。如今,即使是最复杂的全颜面骨折,也可以通过数字化的初步规划、个性化的颅骨、眼眶和颧骨植入物以及全颞下颌关节假体,在美学和功能上得到修复。

相似文献

1
[Complex reconstructions in the facial and cranial regions].[面部和颅部区域的复杂重建]
Unfallchirurg. 2021 Oct;124(10):807-816. doi: 10.1007/s00113-021-01076-6. Epub 2021 Sep 9.
2
Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art.颅颌面外科中的计算机辅助设计与制造:最新技术水平
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The indication and application of computer-assisted navigation in oral and maxillofacial surgery-Shanghai's experience based on 104 cases.计算机辅助导航在口腔颌面外科中的适应证及应用——以上海地区 104 例病例为基础的经验总结
J Craniomaxillofac Surg. 2013 Dec;41(8):770-4. doi: 10.1016/j.jcms.2013.01.016. Epub 2013 Feb 23.
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Computer planning and intraoperative navigation in cranio-maxillofacial surgery.颅颌面外科手术中的计算机规划与术中导航
Oral Maxillofac Surg Clin North Am. 2010 Feb;22(1):135-56. doi: 10.1016/j.coms.2009.10.010.
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Verification of clinical precision after computer-aided reconstruction in craniomaxillofacial surgery.颅颌面外科计算机辅助重建后临床精度的验证
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):e1-10. doi: 10.1016/j.tripleo.2007.04.015. Epub 2007 Jul 26.
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Applications of navigation for orthognathic surgery.导航在正颌外科手术中的应用。
Oral Maxillofac Surg Clin North Am. 2014 Nov;26(4):587-98. doi: 10.1016/j.coms.2014.08.003. Epub 2014 Sep 16.
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Computer modeling and intraoperative navigation in maxillofacial surgery.颌面外科中的计算机建模与术中导航
Otolaryngol Head Neck Surg. 2007 Oct;137(4):624-31. doi: 10.1016/j.otohns.2007.06.719.
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Complex skull defects reconstruction with САD/САМ titanium and polyetheretherketone (PEEK) implants.使用计算机辅助设计/计算机辅助制造(CAD/CAM)钛和聚醚醚酮(PEEK)植入物进行复杂颅骨缺损修复。
Zh Vopr Neirokhir Im N N Burdenko. 2014;78(4):3-13.
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Surgical planning, three-dimensional model surgery and preshaped implants in treatment of bilateral craniomaxillofacial post-traumatic deformities.手术规划、三维模型手术及预成型植入物治疗双侧颅颌面创伤后畸形
J Oral Maxillofac Surg. 2014 Jun;72(6):1138.e1-14. doi: 10.1016/j.joms.2014.02.023. Epub 2014 Feb 20.
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Advanced Three-Dimensional Technologies in Craniofacial Reconstruction.颅面重建中的高级三维技术。
Plast Reconstr Surg. 2021 Jul 1;148(1):94e-108e. doi: 10.1097/PRS.0000000000008212.

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Polymers (Basel). 2022 Sep 15;14(18):3862. doi: 10.3390/polym14183862.
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[Current developments in primary and secondary surgical treatment of midface and periorbital trauma].[面中部及眶周创伤一期和二期外科治疗的当前进展]
HNO. 2022 Oct;70(10):756-764. doi: 10.1007/s00106-022-01226-1. Epub 2022 Aug 31.

本文引用的文献

1
Materials used for reconstruction after orbital floor fracture.眶底骨折后重建所用材料。
J Craniofac Surg. 2012 Nov;23(7 Suppl 1):1991-7. doi: 10.1097/SCS.0b013e31825aada1.