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。

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.