导航辅助山羊下颌体牵张成骨术的实验研究  

Experimental study on navigation-guided distraction osteogenesis of mandibular body in goats

作　　者：蔡鸣[1] 沈国芳[1] 林艳萍[2] 王旭东[1] 张诗雷[1] 邓思敏[1] 于德栋[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科上海市口腔医学重点实验室,上海200011 [2]上海交通大学机械与动力工程学院,上海200030

出　　处：《中国口腔颌面外科杂志》2010年第6期525-530,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：国家高科技研究发展计划(863计划:SQ2009AA04ZX1485930);国家自然科学基金(30872906);上海市重点学科建设项目(Y0203)~~

摘　　要：目的:应用立体定向导航外科手术系统初步建立山羊单侧下颌骨牵张成骨术的研究方法,分析导航辅助牵张成骨术的精度。方法:选用成年山羊3只。局麻下在上颌骨植入5颗定位钉,用蜡片记录咬合关系后行颌间固定,将螺旋CT扫描数据导入AccuNavi1.0软件,进行三维测量与虚拟手术。全麻下,应用TBNavis-CMFS导航系统行下颌骨单侧体部牵张成骨术,牵引到位后,行CT扫描并同法进行测量,并应用Surgicase5.0软件测量牵引长轴间交角,与模拟手术结果进行比较。结果:山羊口内上颌前部定位钉出现松动,口外上颌两侧定位钉稳固。平均牵引长度为10.12mm(9.88-10.34mm)。三维测量分析显示,术后与术前模拟结果各指标间无显著性差异(P>0.05),牵引长轴交角均值为5.49°(4.70°～6.84°)。结论:选择口外入路的上颌骨区域植入钛钉作为山羊颌骨导航手术的配准方法精确性好。导航辅助山羊下颌骨牵张成骨术,可准确地将手术规划转移到实际手术中。PURPOSE：To investigate the accuracy of navigation-guided unilateral mandibular distraction osteogenesis（DO） on an animal model by using TBNavis-CMFS navigation system.METHODS：3 adult goats were used to develop navigation-guided unilateral mandibular body DO by TBNavis-CMFS navigation system.Pre-surgical CT scan was applied after marked screws implantation and intermaxillary fixation under local anesthesia.3-D measurement of virtual operation and post-surgical results was compared by AccuNavi 1.0 and Surgicase 5.0 software.Student＇s pared t test was used for statistical analysis.RESULTS：One marked screw in anterior maxilla was loosed during surgery.The mandible was lengthened 10.12mm and distractor axel angel was 5.49°.There was no significant difference of pre and post-surgical 3-D measurements（P0.05）.CONCLUSTION：AccuNavi 1.0 software and TBNavis-CMFS system provided a platform for pre-surgical planning and virtual operation of mandibular DO.Navigation-guided mandibular DO was able to transfer the pre-surgical planning to real-time surgery precisely.

关 键 词：牵张成骨 导航外科 三维设计 计算机辅助外科 

分 类 号：R782.2.3[医药卫生—口腔医学]