利用人工智能评估下颌骨重建的美学效果。
Evaluation of aesthetic outcomes of mandibular reconstruction using artificial intelligence.
机构信息
Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Department of Plastic, Reconstructive and Aesthetic Surgery, Graduate School of Medicine, The University of Tokyo, Hongo, Japan.
出版信息
Head Neck. 2024 Nov;46(11):2699-2708. doi: 10.1002/hed.27797. Epub 2024 May 3.
BACKGROUND
Although vascularized bone graft (VBG) transfer is the current standard for mandibular reconstruction, reconstruction with a mandibular reconstruction plate (MRP) and with a soft-tissue flap (STF) alone remain crucial options for patients with poor general conditions. However, objective aesthetic outcome evaluations for these methods are limited.
METHODS
In a retrospective analysis of 65 patients (VBG, 33; MRP, 19; and STF, 13), mandibular asymmetry value was calculated for each patient's photograph using facial recognition AI, with a higher value indicating worse asymmetry.
RESULTS
The MRP group had a value comparable to the VBG group regardless of mandibular defect types. The STF group had a significantly higher value than the VBG group.
CONCLUSIONS
Regarding cosmesis, STF was inferior to VBG, whereas MRP was comparable to VBG, even for anterior defects for which rigid reconstruction is mandatory. However, MRP's risks of plate-related complications limit its use to cases where VBG is contraindicated or with poor prognosis.
背景
尽管带血管骨移植（VBG）是目前下颌骨重建的标准方法，但对于一般情况较差的患者，下颌骨重建板（MRP）和单独使用软组织瓣（STF）的重建仍然是重要的选择。然而，这些方法的客观美学效果评估有限。
方法
在对 65 名患者（VBG 组 33 名，MRP 组 19 名，STF 组 13 名）的回顾性分析中，使用面部识别人工智能计算每位患者照片的下颌不对称值，数值越高表示不对称越严重。
结果
无论下颌骨缺损类型如何，MRP 组的数值与 VBG 组相当。STF 组的数值明显高于 VBG 组。
结论
就美容效果而言，STF 不如 VBG，而 MRP 与 VBG 相当，即使对于需要刚性重建的前侧缺损也是如此。然而，MRP 与钢板相关的并发症风险限制了其在 VBG 禁忌或预后不良的情况下使用。
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