目的介绍应用SimPlant软件,在术前经精确匹配,选择形态与缺损下颌骨吻合的供区髂嵴部分,以引导手术中髂骨肌瓣的制备和行下颌骨重建的方法。方法术前以SimPlant软件模拟下颌骨节段性切除、选择形态与缺损下颌骨精确匹配的供区髂嵴部分,对髂骨肌瓣的制备塑形进行精确地预测引导;按术前设计进行下颌骨节段性切除和髂骨肌瓣重建手术。结果按术前设计手术的患者术后面部对称,术后全景片及三维CT显示髂骨重建后的下颌骨形态理想,髁突位于关节窝内。结论术前应用SimPlant软件进行供、受区的匹配选择,可以简化髂骨肌瓣重建下颌骨的手术操作,减少手术创伤,提高下颌骨重建的精确性,为功能性下颌骨重建创造良好条件。

Objective To introduce the application of SimPlant software to match contour of iliac crest and mandibular defect before operation in order to guide harvesting iliac osteo-myocutaneous flap and reconstructing mandible.Methods Before operation,SimPlant software was used to simulate segmental mandibulectomy and auto-match contour of iliac crest and mandibular defect so that harvesting and shaping iliac osteo -myocutaneous flap could be calculated.Segmental mandibulectomy and mandibular reconstruction with iliac osteo-myocutaneous flap were performed according to preoperative design.Results The facial appearances of the patients according to preoperative design were symmetry.Post-operative panoramic radiograph and three-dimensional CT scan revealed that the contour of mandible reconstructed with iliac crest flap was ideal and the condyles were located within the glenoid fossa.Conclusion Application of SimPlant software to auto-match donor and recipient site can simplify the operation of mandibular reconstruction with iliac osteo-myocutaneous flap,reduce the operative damage,increase the accurate result,and create good condition for functional mandibular reconstruction.