组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2018, Vol. 14 ›› Issue (3): 127-131.doi: 10.3969/j.issn.1673-0364.2018.03.003

• 论著 • 上一篇    下一篇

基于数字医学的下颌骨重建系统：模块化手术方案和标准化评估

周知航，赵昊明，陈旭卓，张善勇，郑吉驷，杨驰   

  1. 上海交通大学医学院附属第九人民医院口腔外科上海口腔医学重点实验室；山东大学口腔医学院·山东大学口腔医院
  • 收稿日期:2018-04-08 发布日期:2020-07-23
  • 作者简介:张善勇（E-mail：zhangshanyong@126．com）。

Mandibular Reconstruction Based on Digital Medicine:Modularized Protocol and Standardization Evaluation

ZHOU Zhihang,ZHAO Haoming,CHEN Xuzhuo,ZHANG Shanyong,ZHENG Jisi,YANG Chi   

  1. Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine Shanghai Key Laboratory of Stomatology;School of Stomatology Shandong University; Stomatological Hospital of Shandong University
  • Received:2018-04-08 Published:2020-07-23
  • Contact: 国家自然科学基金项目(81671010)；上海交通大学医学院附属第九人民医院临床研究助推计划(JYLJ037)；上海交通大学“医工交叉基金”面上项目(YG2017MS04)；上海交通大学“医工交叉基金”青年项目(YG2017QN08)

摘要： 目的介绍一种改良的下颌骨重建方案,包括模块化的手术方案及标准化评估。方法对2015年至2017年的9例下颌骨重建病例进行综合评估。手术方案包括三个部分,即计算机辅助手术设计(CASS)、手术导板(ST)准备和手术实施。术后标准化评估包括局部对比分析(PCA)和机械定量感觉神经测试两部分。结果手术成功切除肿瘤并保留下牙槽神经血管束(IANB)。局部对比分析得出平均误差为0.92 mm,标准差为0.96 mm。双侧颏部及下唇神经的机械定量感觉测试显示无明显差异(P=0.12)。结论改良的下颌骨重建方案能很好地修复不同类型的下颌骨缺损,并能保留患者的颏部及下唇感觉功能。

关键词: 计算机辅助手术模拟, 手术导板, 局部对比分析, 下牙槽神经血管束

Abstract: Objective To introduce a modified protocol of mandibular reconstruction with bone grafts,including modularized protocol and standardization evaluation.Methods From 2013 to 2017,a total of 9 reconstructed mandibles was studied.This program was performed with the following three modifications:computer-assisted surgical simulation(CASS),surgical template(ST)and operation.Standardization evaluation included part comparison analysis(PCA)and mechanical quantitative sensory testing.Results The affected mandible was successfully removed and the inferior alveolar neurovascular bundle(IANB)was conserved.The mean accuracy of PCA was 0.92 mm and the standard deviation was 0.96 mm.Mechanical quantitative sensory testing showed no significant difference of the mental and lower lip sensory function between the affected side and normal side(P=0.12).Conclusion The modified mandible reconstruction program can well repair different types of mandibular defects and retain the mental and lower lip sensory function.

Key words: Computer-assisted surgical simulation, Surgical template, Part comparison analysis, Inferior alveolar neurovascular bundle

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