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基于光学手术导航系统的经缝牵引骨延长术在矫正面中部发育不良中的应用。

Application of trans-sutural distraction osteogenesis based on an optical surgical navigation system to correct midfacial dysplasia.

机构信息

Department of Plastic Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.

School of Mechanical Engineering and Automation, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing, 100191, China.

出版信息

Sci Rep. 2022 Aug 1;12(1):13181. doi: 10.1038/s41598-022-16013-9.

Abstract

Midfacial hypoplasia is a common maxillofacial deformity in patients with cleft lip and palate, which requires surgical treatment. However, trans-sutural distraction osteogenesis (TSDO) remains some disadvantages, including difficulty in accurate location of surgical path, prolonged operation time, and excess surgical bleeding. This study aimed to evaluate the application of an optical surgical navigation system (OSNS) developed for TSDO. Six consecutive patients with midfacial hypoplasia who required TSDO were included in the study. Preoperatively, a head computed tomography was performed, and the data were imported into Mimics software (version: 20.0.0.691, Materialise Inc, Belgium) to design a three-dimensional simulation of the surgical approach. TSDO was performed with the use of OSNS. The accuracy and results of the procedure were initially evaluated by comparing the preoperative and postoperative periods. The patients included five boys and one girl, with an average age of 10 years; five with postoperative cleft lip and palate, and one without combined cleft lip and palate. The surgical procedure was successful, with a postoperative follow-up of 4-5 months. All patients demonstrated good treatment results without complications. In conclusioin, OSNS-assisted TSDO can noninvasively correct midfacial dysplasia, improve surgical precision, reduce bleeding and obtain better clinical results. OSNS can guide the TSDO safely and effectively.

摘要

面中部发育不全是唇腭裂患者常见的颌面部畸形,需要手术治疗。然而,经缝牵引成骨术(TSDO)仍然存在一些缺点,包括手术路径的准确定位困难、手术时间延长和手术出血过多。本研究旨在评估一种用于 TSDO 的光学手术导航系统(OSNS)的应用。纳入了 6 例需要 TSDO 的面中部发育不全的连续患者。术前进行头部 CT 检查,并将数据导入 Mimics 软件(版本:20.0.0.691,Materialise Inc,比利时)对面部手术入路进行三维模拟设计。使用 OSNS 进行 TSDO。通过比较术前和术后,初步评估手术的准确性和结果。患者包括 5 名男孩和 1 名女孩,平均年龄 10 岁;5 例术后唇腭裂,1 例无合并唇腭裂。手术过程成功,术后随访 4-5 个月。所有患者均无并发症,治疗效果良好。总之,OSNS 辅助 TSDO 可以非侵入性地矫正面中部发育不良,提高手术精度,减少出血,并获得更好的临床效果。OSNS 可以安全有效地指导 TSDO。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a5/9343408/38ac4dc6f14b/41598_2022_16013_Fig1_HTML.jpg

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