Zhao Ruiqi, Zhu Zhihui, Shao Long, Meng Fanhao, Lei Zhenghui, Li Xing, Zhang Tao
Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China.
J Stomatol Oral Maxillofac Surg. 2023 Apr;124(2):101318. doi: 10.1016/j.jormas.2022.10.017. Epub 2022 Oct 21.
Augmented reality (AR) navigation has been developed in recent years and can overcome some limitations of existing technologies. This study aimed to investigate a novel method of fibula free flap (FFF) osteotomy based on AR technology through a cadaver study.
One mandible, seven fibulas, and seven lower limb specimens underwent computed tomography (CT) examination. We used the professional software Proplan CMF 3.0 to design a defective mandible model and created fourteen virtual reconstruction plans using the fibulas and lower limb specimens. The AR-based intraoperative guidance software prototype was developed using the Unity Real-Time Development Platform, and virtual plans were transferred into this software prototype. We used AR-based surgical navigation to guide the FFF osteotomy and used these fibular segments to reconstruct the defective mandible model. After reconstruction, all segments were scanned by CT. Osteotomy accuracy was evaluated by measuring the length and angular deviation between the virtual plan and the final result. The reconstruction precision was reflected by the volume overlap rate and average surface distance between the planned and obtained reconstruction.
The length difference, angular deviation, volume overlap rate and average surface distance of the in vitro group were 1.03±0.68 mm, 5.04±2.61°, 95.35±1.81%, and 1.02±0.27 mm, respectively. Those of the in vivo group were 1.18±0.84 mm, 5.45±1.47°, 95.31±2.09%, and 1.22±0.12 mm.
Due to the ideal result of cadaver experiments, an AR-based FFF osteotomy guided system may become a novel approach to assist FFF osteotomy for the reconstruction of defective mandibles.
近年来，增强现实（AR）导航技术得以发展，且能克服现有技术的一些局限性。本研究旨在通过尸体研究，探究基于AR技术的游离腓骨瓣（FFF）截骨术的新方法。
对1例下颌骨、7根腓骨和7个下肢标本进行计算机断层扫描（CT）检查。我们使用专业软件Proplan CMF 3.0设计一个下颌骨缺损模型，并利用腓骨和下肢标本创建14个虚拟重建方案。基于AR的术中引导软件原型是使用Unity实时开发平台开发的，虚拟方案被导入到该软件原型中。我们使用基于AR的手术导航来指导FFF截骨术，并使用这些腓骨段重建下颌骨缺损模型。重建后，所有骨段均进行CT扫描。通过测量虚拟方案与最终结果之间的长度和角度偏差来评估截骨准确性。重建精度通过计划重建与实际重建之间的体积重叠率和平均表面距离来反映。
体外组的长度差异、角度偏差、体积重叠率和平均表面距离分别为1.03±0.68毫米、5.04±2.61°、95.35±1.81%和1.02±0.27毫米。体内组的分别为1.18±0.84毫米、5.45±1.47°、95.31±2.09%和1.22±0.12毫米。
由于尸体实验结果理想，基于AR的FFF截骨引导系统可能成为辅助FFF截骨术重建下颌骨缺损的一种新方法。
