Tang Z N, Hu L H, Liu S, Yu Y, Zhang W B, Peng X
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2024 Nov 9;59(11):1107-1113. doi: 10.3760/cma.j.cn112144-20240711-00266.
To assess the feasibility and application of mixed reality combined with surgical navigation technology in parapharyngeal space tumor surgery, and to provide a reference for the development and promotion of this technology. In this study, retrospective data collection was conducted on 16 patients with parapharyngeal space tumors who were treated at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June 2020 to June 2023. The patient's age was (39.6±17.8) years, with 4 males and 12 females. Mixed reality combined with surgical navigation technology was utilized to assist physicians in the treatment of these patients. Mixed reality combined with surgical navigation technology was used to assist physicians in treatment of these patients. The application steps included acquisition of image data, processing of image data [three-dimensional (3D) reconstruction, image fusion, and virtual surgical design], development of surgical navigation plan, connection of mixed reality and navigation system, automatic registration and intraoperative guidance and validation. In the preoperative plan, landmark points were placed on the virtual tumor and surrounding important structures reconstructed using digital software, serving to guide the localization of crucial anatomical structures. Intraoperative positioning deviation, surgical time, intraoperative blood loss, and postoperative complications were recorded and analyzed to evaluate the clinical application effectiveness of mixed reality combined with surgical navigation technology. With the assistance of mixed reality combined with surgical navigation technology, 16 patients successfully underwent tumor resection. All patients were accurately diagnosed preoperatively by 3D reconstruction and image fusion technology, and a comprehensive preoperative plan was formulated; intraoperatively, mixed reality combined with surgical navigation technology was utilized for the localization of important structures. The average localization deviation of 38 landmark points during the operation were (4.43±1.96) mm, with 62% (26/42) of the points having a deviation of ≥0 and<5 mm. The average duration of the operation was (149.6±53.9) min and the blood loss was 70 (45, 150) ml. The average postoperative follow-up was 16 months, and five patients experienced postoperative complications involving facial paralysis, hoarseness, and choking. Mixed reality combined with surgical navigation technology can achieve the three-dimensional visualization of oral and maxillofacial anatomical structures to achieve precise preoperative diagnosis. During surgery, the technology can real-time display the relationship between soft tissue tumors and the surrounding important anatomical structures, guide surgical operation, and enhance the safety of surgery.
评估混合现实结合手术导航技术在咽旁间隙肿瘤手术中的可行性及应用情况，为该技术的发展与推广提供参考。本研究回顾性收集了2020年6月至2023年6月在北京大学口腔医学院口腔颌面外科接受治疗的16例咽旁间隙肿瘤患者的数据。患者年龄为（39.6±17.8）岁，男性4例，女性12例。采用混合现实结合手术导航技术辅助医师对这些患者进行治疗。混合现实结合手术导航技术用于辅助医师对这些患者进行治疗。应用步骤包括图像数据采集、图像数据处理（三维（3D）重建、图像融合及虚拟手术设计）、制定手术导航计划、连接混合现实与导航系统、自动注册及术中引导与验证。在术前计划中，使用数字软件在虚拟肿瘤及重建的周围重要结构上放置地标点，以指导关键解剖结构的定位。记录并分析术中定位偏差、手术时间、术中出血量及术后并发症，以评估混合现实结合手术导航技术的临床应用效果。在混合现实结合手术导航技术的辅助下，16例患者成功接受肿瘤切除。所有患者术前均通过3D重建和图像融合技术准确诊断，并制定了全面的术前计划；术中，利用混合现实结合手术导航技术对重要结构进行定位。术中38个地标点的平均定位偏差为（4.43±1.96）mm，其中62%（26/42）的点偏差≥0且<5mm。平均手术时长为（149.6±53.9）分钟，出血量为70（45，150）ml。术后平均随访16个月，5例患者出现术后并发症，包括面瘫、声音嘶哑和呛咳。混合现实结合手术导航技术可实现口腔颌面解剖结构的三维可视化，以实现精确的术前诊断。手术过程中，该技术可实时显示软组织肿瘤与周围重要解剖结构的关系，指导手术操作，提高手术安全性。
