无框架立体定向导航系统在颌面外科手术中的应用  

Application of neuronavigation in stomatology： report of three cases

作　　者：朱凯[1] 张海钟[1] 陈鹏[1] 席庆[1] 

机构地区：[1]解放军总医院口腔颌面外科,北京100853

出　　处：《中华医学杂志》2009年第14期997-1000,共4页National Medical Journal of China

基　　金：北京市自然科学基金（7093131）

摘　　要：目的探讨无框架立体定向导航（CT导航）系统在颌面外科中定位的应用。方法选择三叉神经痛、面部金属异物和放疗后需行放射粒子植入的3例病人，在CT导航下进行手术。术前行薄层CT扫描，将数据输入CT导航系统，术中在cT导航系统引导下（1）行卵圆孔穿刺后给予射频热凝治疗三叉神经痛；（2）在CT导航下取出颌面部金属异物；（3）在CT导航系统引导下对舌癌术后复发病人行放射粒子植入。结果三叉神经痛病人术中穿刺准确，术后疗效显著，无明显并发症；CT导航下金属异物病人面部异物全部取出，颈部异物因注册误差，未能找到。CT导航下放射粒子植入定位准确。结论CT导航系统可显著提高卵圆孔穿刺及金属异物和放射粒子定位的精确度，有效减少并发症的产生，降低手术的难度。Objective To evaluate the clinical value of nearonavigution system in stomatology. Methods The clinical data of 3 patients were reviewed. Thin-slice CT scanning was conducted on the 3 patients and the CT data were input into the CT neuronavigation system that in turn guided the operations later. Patient I with trigeminal neuralgia, aged 51, underwent puncture of oval foramen and radiofrequency thermo-coagulation therapy. Patient Ⅱ of canister shots injury, aged 32, with 3 metal grains in the face and 1 metal grain in the neck, underwent removal of the metal grains. Patient m with relapse of tongue cancer after operation, aged 62, underwent plantation of radiate granules. Results Guided by neuronavigation, puncture was accurate and curative effect was excellent in patient Ⅰ , and no visible complication was seen; all the metal grains in face were found and removed in patient Ⅱ , however, because of registration error ,the metal grain in neck failed to be positioned; and thee radiate granules were implanted accurately in patient m. Condusion Neuronavigation significantly increases the successful rates of puncture into the oval foramen, orientation of metal grains, and implantation of radiate granules, and reduces the complications rate.

关 键 词：外科手术 计算机辅助 口腔外科手术 定位 

分 类 号：R686[医药卫生—骨科学]