计算机导航辅助下颅颌面骨纤维异常增殖症轮廓修整33例效果评价

摘要/Abstract

摘要： 目的：探讨计算机辅助导航系统在颅颌面部骨纤维异常增殖症轮廓修整中的应用效果。方法收集2010年1月—2013年12月于上海交通大学医学院附属第九人民医院口腔颅颌面科就诊的33例颅颌面骨纤维异常增殖症患者,按照治疗方法分为2组,实验组17例,术前利用计算机导航系统的软件设计治疗方案,术中在该导航系统辅助下进行病变部分切除及轮廓修整术;对照组16例,用传统方法进行病变部分切除及轮廓修整术。术后1周和3个月拍摄颅颌面部CT并进行三维重建,应用Geomagic Qualify软件对手术区域与相应术前模拟设计区域的偏差、2组病例术后颅颌骨的对称性进行测量,应用SAS 6.2软件包对测量结果进行t检验,并对出现误差的原因进行分析。结果以镜像模型为参考模型,导航组中手术区域的平均偏差值为（2.1285±1.2957）mm,非导航组为（4.4814±2.1940）mm, 2组存在显著差异（P<0.01）。术后模型与术前模拟设计相比的平均偏差为（2.1400±1.2482）mm。结论计算机导航系统辅助下进行的颅颌面部骨纤维异常增殖症轮廓修整术具有较高的精度,与传统手术方法相比,能更好地恢复患者颅颌骨的对称性。

关键词: 计算机辅助导航系统, 颅颌面部骨纤维异常增殖症, 轮廓修整, 量化评价

Abstract: PURPOSE : To evaluate the effect of computer assisted navigation system (CANS) in contouring of craniomaxillofacial fibrous dysplasia (CFD). METHODS : Thirty-three patients with craniomaxillofacial fibrous dysplasia were included in this study for surgical contouring from January 2010 to December 2013. The patients were divided into 2 groups based on the treatment METHODS. The experimental group included 17 patients who had preoperative virtual surgery design, and underwent surgery with the help of computer assisted navigation system. The control group included 16 patients who underwent surgery without the help of computer assisted navigation system. Each patient underwent computed tomography scans in craniomaxillofacial region 1 week and 3 months after surgery. We measured the models using Geomagic Qualify software. Quantitative evaluation of the effects in both groups was performed using SAS 6.2 software package for student’s t test. RESULTS : In navigation group, mean variation between operative region and preoperative design was (2.1400±1.2482) mm. With mirror model as reference, mean variation of operative region was (2.1285±1.2957) mm in navigation group, whereas (4.4814±2.1940) mm in non-navigation group, there was significantly difference between the 2 groups. CONCLUSIONS : CANS might be more useful in improving the precision in contouring of craniomaxillofacial fibrous dysplasia than conventional METHODS.

Key words: Computer assisted navigation system, Craniomaxillofacial fibrous dysplasia, Contouring, Quantitative evaluation

中图分类号:

R782.2

肖超，代杰文，张文斌，吴锦阳，沈舜尧，沈国芳. 计算机导航辅助下颅颌面骨纤维异常增殖症轮廓修整33例效果评价[J]. 中国口腔颌面外科杂志, 2016, 14(1): 44-50.

XIAO Chao, DAI Jie-wen, ZHANG Wen-bin, WU Jin-yang, SHEN Shun-yao, SHEN Guo-fang. Computer assisted navigation for craniofacial fibrous dysplasia contouring: retrospective study in 33 consecutive cases[J]. China J Oral Maxillofac Surg, 2016, 14(1): 44-50.

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