【摘要】：目的:探討計(jì)算機(jī)導(dǎo)航技術(shù)在頜骨骨纖維異常增殖癥手術(shù)中的應(yīng)用價(jià)值。方法:納入14例頜面部骨纖維異常增殖癥患者,先將患者的術(shù)前CT數(shù)據(jù)導(dǎo)入計(jì)算機(jī)導(dǎo)航系統(tǒng)中,根據(jù)頜骨鏡像原理進(jìn)行術(shù)前設(shè)計(jì)及三維手術(shù)模擬,確定骨切除位置及范圍。術(shù)中,根據(jù)病變部位及手術(shù)范圍可將參考架置于患者前額或是下頜骨頦部。完成注冊(cè)與配準(zhǔn),使手術(shù)視野和導(dǎo)航顯示屏上的虛擬圖像完全匹配。結(jié)果:面部的解剖結(jié)構(gòu)與三維重建模型完全吻合,術(shù)中順利完成實(shí)時(shí)導(dǎo)航。手術(shù)器械可實(shí)現(xiàn)空間定位,能夠明確其與手術(shù)區(qū)域解剖結(jié)構(gòu)的位置關(guān)系,手術(shù)具有高度的精確性與安全性。術(shù)后療效的評(píng)估是通過(guò)術(shù)前計(jì)劃和術(shù)后CT重建影像相融合得到的,1~3年的隨訪中沒(méi)有發(fā)現(xiàn)并發(fā)癥。結(jié)論:計(jì)算機(jī)導(dǎo)航系統(tǒng)在提高頜面部骨纖維異常增殖癥的安全性與準(zhǔn)確性方面具有較好的應(yīng)用價(jià)值。
[Abstract]:Objective: to evaluate the value of computer navigation in the surgery of fibrous dysplasia of jaw. Methods: fourteen patients with fibrous dysplasia in maxillofacial region were included. The preoperative CT data were imported into the computer navigation system. According to the principle of maxillary mirror, the preoperative design and three-dimensional operation simulation were carried out to determine the location and range of bone resection. During the operation, the reference frame can be placed on the forehead or chin of the mandible according to the location of the lesion and the scope of the operation. Registration and registration are completed to match the virtual images on the surgical visual field and the navigation screen. Results: the anatomic structure of the face was in good agreement with the three-dimensional reconstruction model, and the real-time navigation was completed successfully during the operation. Surgical instruments can achieve spatial positioning, and can determine the location relationship between the surgical instruments and the anatomical structure of the surgical area, and the operation has a high degree of accuracy and safety. The evaluation of postoperative efficacy was achieved by the fusion of preoperative planning and postoperative CT reconstruction images. No complications were found during 1 to 3 years follow-up. Conclusion: the computer navigation system has good application value in improving the safety and accuracy of maxillofacial fibrous dysplasia.
【作者單位】： 南京大學(xué)醫(yī)學(xué)院附屬口腔醫(yī)院 南京市口腔醫(yī)院口腔頜面外科;南京大學(xué)醫(yī)學(xué)院附屬口腔醫(yī)院 南京市口腔醫(yī)院口腔放射科;
【基金】：江蘇省衛(wèi)生廳課題項(xiàng)目(編號(hào):H201441) 江蘇省臨床醫(yī)學(xué)科技專項(xiàng)項(xiàng)目(編號(hào):BL2013005) 南京市科技發(fā)展計(jì)劃(編號(hào):201503038)
【分類號(hào)】：R782.2

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