组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2017, Vol. 13 ›› Issue (4): 184-187.doi: 10.3969/j.issn.1673-0364.2017.04.002

• 论著 • 上一篇    下一篇

虚拟手术及导航辅助下多学科协作的颌面部多发骨折的整复治疗

麻宏阳，杨成帅，吴锦阳，徐兵，林明，樊宝华，陈东，张诗雷   

  1. 上海交通大学医学院附属第九人民医院口腔颅颌面科；上海市口腔医学重点实验室；上海市口腔医学研究所；国家口腔疾病临床研究中心；上海交通大学医学院附属第九人民医院眼科；上海交通大学医学院附属第九人民医院神经外科；上海交通大学医学院附属第九人民医院耳鼻咽喉科
  • 发布日期:2020-07-23

Navigation and Virtual Surgery Assisted Multidisciplinary Treatment of Multiple Maxillofacial Fractures

MA Hongyang,YANG Chengshuai,WU Jinyang,XU Bing,LIN Ming,FAN Baohua,CHEN Dong,ZHANG Shilei   

  1. Department of Oral and Cranio-maxillofacial Surgery;Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology;National Clinical Research Center of Stomatology; Department of Ophthalmology,Shanghai Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine; Department of Neurosurgery,Shanghai Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine;Ophthalmology and Otorhinolaryngology Department,Shanghai Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine
  • Published:2020-07-23
  • Contact: 国家自然科学基金(81371193,81671035,81701034)；上海市科学技术委员会科研项目(15441906000)；上海市医学图像处理与计算机辅助手术重点实验室开放课题(17DZ2272300-1)

摘要： 目的探讨虚拟手术联合导航辅助下,多学科联合治疗颌面部多发性骨折的有效性。方法 2011年1月至2016年12月,46名颌面部多发骨折患者纳入本研究。通过各学科间的交互式合作讨论,以及在手术导航软件平台上进行个性化的虚拟手术设计,制定术前手术计划,所有患者均在导航系统辅助下接受一期切开复位手术。通过术后CT模型重建与术前设计进行拟合对比,从而评价治疗效果。结果在手术导航仪的辅助下,骨折骨块复位至术前虚拟手术设计的位置,绝大多数患者术后功能与外形得到了良好恢复,且无严重手术并发症。通过术后CT与术前虚拟设计拟合,评估术后骨折复位精度定量误差小于2 mm(1.56±0.27 mm)。结论在多学科手术治疗颌面部多发骨折过程中,借助虚拟手术及导航技术,可以为患者提供更精准高效的同期联合治疗计划,是这类复杂治疗过程的理想选择。

关键词: 虚拟手术, 多学科治疗, 颌面部骨折

Abstract: Objective To discuss the effectiveness of multidisciplinary treatment for multiple maxillofacial fractures guided by surgical navigation and virtual surgery.Methods From January 2011 to December 2016,46 cases with multiple maxillofacial fractures were enrolled.The preoperative plan was developed through interactive collaborative discussion among the experts and the personalized virtual operation design on the surgical navigation software platform.Then the patients were treated with first-phase open reduction through the guidance of surgical navigation.By comparing the differences between 3D reconstruction of the postoperative CT scans and preoperative plan,the outcomes were evaluated.Results Fractured bone fragments were reduced to the planned positions and verified by probe-based navigation.Most patients healed without serious complications.The assessment of surgical discrepancy showed an optimal result that the error was less than 2 mm (1.56-±0.27 mm).Conclusion Multidisciplinary management with the assistances of virtual surgery and navigation technology,can provide more accurate and efficient treatment plan,and is a highly valuable choice for this complicated treatment procedure.

Key words: Virtual surgery, Multidisciplinary therapy, Maxillofacial fracture

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