Department of Oral and Maxillofacial Surgery Peking University School of Stomatology 22 Zhongguancun South Avenue Beijing 100081, People's Republic of China
Med Oral Patol Oral Cir Bucal. 2024 Nov 1;29(6):e806-e814. doi: 10.4317/medoral.26762.
Accurate mandibular reconstruction following tumor ablation is important yet challenging. While computer-assisted surgery and surgical navigation have been applied widely in maxillofacial reconstruction, the accuracy and the efficacy remain debatable due to the native mobile nature. This study aimed to evaluate the surgical outcomes and accuracy of mandibular reconstruction aided by different types of adjunctive computer-assisted techniques with or without intraoperative navigation.
Patients with anterior and/or lateral mandibular defects who underwent microvascular mandibular reconstruction aided by adjunct computer-assisted techniques, with or without intraoperative navigation were assessed. The deviations in spatial alignment of the bony segments between the pre-operative and post-operative datasets were measured to evaluate the overall surgical outcomes and accuracy. Independent t-test was performed and p-value less than 0.05 was statistically significant.
A total of 93 patients with L/LC or LCL defects who underwent microvascular mandibular reconstruction aided by adjunct computer-assisted techniques with or without surgical navigation were assessed. No significant difference was observed when comparing the mean differences between the preoperative and postoperative intercondylar and intergonial distance in both navigation-assisted and computer-aided design/computer-aided manufacturing (CAD/CAM) groups. There were also no significant differences noted among the different mandibular defects, osteosynthesis plates and types of free flap.
Accurate mandibular reconstruction following tumor resection can be achieved by incorporating intraoperative navigation and adjunctive methods such as computer-assisted techniques and our innovative device, mandibular fixation device.
肿瘤消融术后精确的下颌骨重建非常重要，但具有挑战性。虽然计算机辅助手术和手术导航已广泛应用于颌面重建，但由于下颌骨的固有活动特性，其准确性和疗效仍存在争议。本研究旨在评估不同类型的辅助计算机辅助技术在术中导航辅助下或不辅助下进行下颌骨重建的手术结果和准确性。
评估了接受微血管下颌骨重建辅助的辅助计算机辅助技术，术中导航或不辅助的前下颌和/或外侧下颌骨缺损患者。测量术前和术后数据集之间骨段空间对准的偏差，以评估整体手术结果和准确性。进行了独立 t 检验，p 值小于 0.05 具有统计学意义。
共评估了 93 例接受辅助计算机辅助技术辅助的微血管下颌骨重建的 L/LC 或 LCL 缺损患者，其中包括手术导航和 CAD/CAM 组。在导航辅助组和计算机辅助设计/计算机辅助制造 (CAD/CAM) 组中，术前和术后髁间和下颌角间距离的平均差异比较时，无显著差异。不同的下颌骨缺损、骨愈合板和游离皮瓣类型之间也没有显著差异。
通过术中导航和辅助方法（如计算机辅助技术和我们的创新设备，下颌骨固定装置），可以实现肿瘤切除后精确的下颌骨重建。
