Raveggi Elisa, Gerbino Giovanni, Autorino Umberto, Novaresio Andrea, Ramieri Guglielmo, Zavattero Emanuele
Division of Maxillofacial Surgery, Surgical Science Department, Maxillofacial Unit, University of Torino, Italy.
Department of Management and Production Engineering, Polytechnic University of Turin, Turin, Italy.
J Craniomaxillofac Surg. 2023 Feb;51(2):107-116. doi: 10.1016/j.jcms.2023.01.016. Epub 2023 Feb 2.
In this retrospective case series, patients undergoing surgery to treat isolated orbital floor fractures were morphometrically analyzed. Cloud Compare was used to compare mesh positioning with a virtual plan, using the distance-to-nearest-neighbor method. To assess the accuracy of mesh positioning, a mesh area percentage (MAP) parameter was introduced and three distance ranges were defined as the outcome measures: the 'high-accuracy range' included MAPs at a distance of 0-1 mm from the preoperative plan; the 'intermediate-accuracy range' included MAPs at a distance of 1.1-2 mm from the preoperative plan; the 'low-accuracy range' included MAPs at a distance of >2 mm from the preoperative plan. To complete the study, morphometric analysis of the results was combined with clinical judgment ('excellent', 'good', or 'poor') of mesh positioning by two independent blind observers. In total, 73 of 137 orbital fractures met the inclusion criteria. In the 'high-accuracy range' the mean, minimum, and maximum MAP values were 64%, 22%, and 90%, respectively. In the 'intermediate-accuracy range', the mean, minimum, and maximum values were 24%, 10%, and 42%, respectively. In the 'low-accuracy range', the values were 12%, 1%, and 48%, respectively. Both observers classified 24 cases of mesh positioning as 'excellent', 34 as 'good', and 12 as 'poor'. Within the limitations of the study, it seems that virtual surgical planning and intraoperative navigation has the potential to add quality to the repair of the orbital floor and, therefore, should be taken into consideration whenever appropriate.
在这个回顾性病例系列研究中，对接受手术治疗单纯眶底骨折的患者进行了形态学分析。使用Cloud Compare软件，采用最近邻距离法将网片定位与虚拟计划进行比较。为了评估网片定位的准确性，引入了网片面积百分比（MAP）参数，并定义了三个距离范围作为结果指标：“高精度范围”包括距离术前计划0 - 1毫米的MAP；“中等精度范围”包括距离术前计划1.1 - 2毫米的MAP；“低精度范围”包括距离术前计划大于2毫米的MAP。为完成该研究，将结果的形态学分析与两名独立的盲法观察者对网片定位的临床判断（“优秀”、“良好”或“差”）相结合。总共137例眶骨骨折中有73例符合纳入标准。在“高精度范围”中，MAP的均值、最小值和最大值分别为64%、22%和90%。在“中等精度范围”中，均值、最小值和最大值分别为24%、10%和42%。在“低精度范围”中，这些值分别为12%、1%和48%。两名观察者均将24例网片定位判定为“优秀”，34例为“良好”，12例为“差”。在本研究的局限性范围内，虚拟手术规划和术中导航似乎有可能提高眶底修复的质量，因此，在适当的时候应予以考虑。
