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分析在颌面外科手术中使用 ICBCT 进行术中叠加的电路的实现,并比较手术结果。

Analysis of the implementation of a circuit for intra-operative superposition and comparison of the surgical outcomes using ICBCT in maxillofacial surgery.

机构信息

Innovation Department, SJD Barcelona Children's Hospital, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.

Medicina i Recerca Translacional, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08007, Barcelona, Spain.

出版信息

Int J Comput Assist Radiol Surg. 2024 Dec;19(12):2463-2470. doi: 10.1007/s11548-024-03196-x. Epub 2024 Jun 3.

Abstract

PURPOSE

This paper describes a novel circuit for intraoperative analysis with ICBCT in maxillofacial surgery. The aim is to establish guidelines, define indications, and conduct an analysis of the implementation of the circuit for intraoperative comparison of surgical outcomes in relation to 3D virtual planning in maxillofacial surgery.

METHODS

The study included 150 maxillofacial surgical procedures. Intraoperative actions involved fluoroscopy localization, intraoperative CBCT acquisition, segmentation, and superimposition, among other steps. Surgical times due to intraoperative superposition were measured, including time required for ICBCT positioning and acquisition, image segmentation, and comparison of 3D surfaces from the surgical planning.

RESULTS

Successful intraoperative comparison was achieved in all 150 cases, enabling surgeons to detect and address modifications before concluding the surgery. Out of the total, 26 patients (17.33%) required intraoperative revisions, with 11 cases (7.33%) needing major surgical revisions. On average, the additional surgical time with this circuit implementation was 10.66 ± 3.03 min (n = 22).

CONCLUSION

The results of our research demonstrate the potential for performing intraoperative surgical revision, allowing for immediate evaluation, enhancing surgical outcomes, and reducing the need for re-interventions.

摘要

目的

本文介绍了一种用于颌面外科手术中 ICBCT 术中分析的新型电路。目的是建立指南,定义适应证,并分析在颌面外科手术中,相对于 3D 虚拟规划,实施该电路进行术中比较手术结果的情况。

方法

该研究纳入了 150 例颌面外科手术。术中操作包括荧光透视定位、术中 CBCT 获取、分割和叠加等步骤。测量了由于术中叠加而导致的手术时间,包括 ICBCT 定位和获取、图像分割以及手术规划中 3D 表面比较所需的时间。

结果

在所有 150 例病例中均成功实现了术中比较,使外科医生能够在手术结束前发现并解决修改问题。在总共 150 例病例中,有 26 例(17.33%)需要术中修正,其中 11 例(7.33%)需要进行重大手术修正。平均而言,使用该电路实施增加的手术时间为 10.66 ± 3.03 分钟(n = 22)。

结论

我们的研究结果表明,进行术中手术修正具有潜力,可以进行即时评估,提高手术结果,并减少再次干预的需求。

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