表面配准与解剖标志配准在鼻内镜导航手术中的应用比较  

A comparison between anatomical landmark registration and surface registration for computer-assisted endoscopic sinus surgery

作　　者：贾欢[1] 陈祁[1] 曹荣萍[1] 杨军[1] 黄琦[1] 王振涛[1] 吴皓[1] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉一头颈外科,上海200092

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第2期49-52,56,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市卫生局青年科研项目(No:2007Y09)

摘　　要：目的:评价表面配准和解剖标志配准技术在鼻内镜导航手术中应用的优劣。方法:在26例鼻内镜手术中进行导航,从准备时间、靶点误差这2方面比较其差别,并就导航手术的方便程度和应用价值进行分析。结果:26例鼻内镜手术均成功使用影像导航系统,术中均提供了准确的鼻内解剖定位,无并发症发生。表面配准组的平均准备时间为(8.5±1.9)min,解剖标志配准组为(6.5±1.7)min。表面配准组的鼻唇角靶点配准误差为(1.43±0.26)mm,中甲前端附着缘为(1.92±0.47)mm,下甲前端附着缘为(1.82±0.49)mm,下甲后端附着缘为(2.03±0.42)mm。解剖标志配准组中对应的靶点配准误差分别为(1.58±0.35)mm、(2.05±0.37)mm、(1.92±0.31)mm和(2.48±0.64)mm。术者对于导航方便程度的评价总体较高,完全不影响或略影响手术者24例(92.2%)。术者认为导航有使用价值或明显使用价值者22例(84.6%),其价值主要与靶点误差值有相关。结论:表面配准方法的精确度要优于解剖标志配准法,但解剖标志配准更简便,准备时间明显短于表面配准方法。Digipointeur导航系统使用方便,手术影响小。导航的价值在于其精细度,在复杂病例中导航的应用价值要高于一般的病例。Objective：To evaluate the clinical advantage and disadvantage of anatomical landmark registration（ALR） and surface registration（SR） in computer-assisted endoscopic sinus surgery（CAESS）.Method：Twenty-six patients were selected for the CAESS,the preparatory times and mean target registration errors（TRE） were recorded in order to compare the difference between them two,their convenience and their value were also analyzed.Result：CAESSs were successfully used in 26 cases without complications.The average preparation time of SR was（8.5±1.9）minutes,that of ALR was（6.5±1.7）minutes.In the SR group,the TRE of naso-labial angle was（1.43±0.26）mm,that of front end of middle turbinate was（1.92±0.47）mm,that of front end of inferior turbinate was（1.82±0.49）mm,and that of back end of inferior turbinate was（2.03±0.42）mm.Them in ALR group were（1.58±0.35）mm,（2.05±0.37）mm,（1.92±0.31）mm and（2.48±0.64）mm,respectively.24 cases（92.2%） were not affected or were slightly affected by the navigation system.The value of navigation was affirmative in 22 cases（84.6%）,and its value was mainly related to TRE.Conclusion：The accuracy of surface registration was superior to that of anatomical landmark registration,but the anatomical landmark registration was more convenient and need less preparation time.The value of navigation system is its accuracy,convenience and no disturbance to surgery.The navigation system is more valuable in the complex cases than that in the general case.

关 键 词：影像导航系统 精细度 表面配准 解剖标志配准 鼻内镜手术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]