Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China.
J Plast Reconstr Aesthet Surg. 2022 Jun;75(6):1971-1978. doi: 10.1016/j.bjps.2022.01.032. Epub 2022 Jan 23.
Accurate reconstruction of orbital and midfacial defects following extensive globe-sparing maxillectomy is challenging, due to the complex anatomy of facial skeleton. The aim of this study is to evaluate the outcomes of individually bent titanium mesh in navigation-assisted reconstruction of post-ablative orbits in comparison with that without intraoperative navigation. Forty-one patients undergone globe-sparing maxillectomy and orbital floor reconstruction using individually bent titanium mesh with or without intraoperative navigation were assessed. Pre- and postoperative orbital projection and volume measurements were performed on both orbits. The unaffected orbit was used as a control for comparison. True-to-original orbital reconstruction was achieved in this study. The average difference of globe projection and orbital volume between unaffected and reconstructed orbits was 0.8 ± 0.5 mm and 0.9 ± 1.2cm, respectively, in navigation-assisted group. In non-navigation-assisted group, the average difference of globe projection and orbital volume of unaffected and reconstructed orbit was 0.7 ± 0.5 mm and 1.3 ± 1.3cm, respectively. There was no statistical significance in mean differences between unaffected and affected globe projection (P = 0.744) and orbital volume (P = 0.677) in both groups. There was also no significant difference observed when comparing the mean differences between pre- and postoperative globe projection (P = 0.659) and orbital volume (P = 0.582) in both groups. While intraoperative navigation system was shown to be effective in orbital reconstruction in the past decade, equal satisfactory post-ablative orbital reconstruction can be achieved with individually bent titanium mesh with or without intraoperative navigation.
准确重建广泛眶内容保全上颌骨切除术后的眶及面中部缺损极具挑战性，这是由于面颅骨解剖结构复杂所致。本研究旨在评估个体化预弯钛网在导航辅助下与无术中导航的眶成形术的疗效比较。41 例患者接受了眶内容保全上颌骨切除术和个体化预弯钛网眶底重建术，其中 21 例采用术中导航。对所有患者的双侧眶进行术前和术后的眶突度和容积测量。正常对侧眶作为对照进行比较。本研究中实现了与原始眶的准确重建。导航辅助组中，正常对侧眶和重建眶之间的眼球突出度和眶容积的平均差异分别为 0.8±0.5mm 和 0.9±1.2cm。在无导航辅助组中，正常对侧眶和重建眶之间的眼球突出度和眶容积的平均差异分别为 0.7±0.5mm 和 1.3±1.3cm。两组之间正常对侧眶和患侧眶的眼球突出度（P=0.744）和眶容积（P=0.677）的平均差异均无统计学意义。两组之间术前和术后眼球突出度（P=0.659）和眶容积（P=0.582）的平均差异也无显著差异。虽然过去十年术中导航系统在眶重建中显示出有效性，但个体化预弯钛网在有或无术中导航的情况下均可实现满意的眶成形术效果。
