CT三维重建在治疗下颌角肥大中的临床应用  

CLINICAL APPLICATION OF THREE-DIMENSIONAL RECONSTRUCTION OF CT IMAGES IN TREATING MANDIBULAR ANGLE HYPERTROPHY

作　　者：文辉才[1] 姚玉婷[1] 付建华[1] 刘伟[1] 杨红华[1] 

机构地区：[1]南昌大学第一附属医院整形外科,南昌330006

出　　处：《中国修复重建外科杂志》2011年第12期1469-1472,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨CT三维重建技术在治疗下颌角肥大中的临床指导意义。方法 2009年3月-2011年1月在CT三维重建技术指导下行下颌骨截骨术治疗下颌角肥大18例。患者均为女性;年龄20～36岁,平均25岁。单纯下颌角肥大14例;伴咬肌肥大3例,双侧不对称1例。下垂型6例,外翻型9例,内翻型3例。根据下颌角肥大分型选择合适的手术方法。术前在三维重建工作站上设计并模拟手术过程,标记截骨线及测量截骨量。结果术中无下颌骨骨折发生。术后出现面神经暂时性麻痹1例,3个月后恢复正常。患者均获随访,随访时间6～12个月,平均7.6个月。术后6个月获满意15例,基本满意2例,不满意1例(双侧不对称)。结论根据CT三维重建技术得到头颅三维模型行术前设计可以提高手术准确性,以达到设计的预期效果。Objective To investigate the clinical directive significance of three-dimensional reconstruction of CT in treating mandibular angle hypertrophy.Methods Between March 2009 and January 2011,18 patients with mandibular angle hypertrophy were treated using the three-dimensional reconstruction technology of CT.All patients were female,aged 20-36 years with an average of 25 years.Eighteen patients included： 14 single mandibular angle hypertrophy,3 mandibular angle hypertrophy with masseter hypertrophy,and 1 mandibular angle hypertrophy with bilateral asymmetry;6 cases of ptosis of mandibular angle,9 cases of prominent mandibular angle,and 3 cases of introversive mandibular angle.According to the types of mandibular angle hypertrophy,the surgical methods could be correctly chosen.The procedure was planned and simulated;the osteotomy line was marked and the osteotomy was measured on the workstations of three-dimensional reconstruction.Results No fracture of mandible occurred in the operation.Facial nerve temporary attack occurred in 1 case and recovered at 3 months after operation.All patients were followed up 6-12 months（mean,7.6 months）.After 6 months of operation,the effectiveness was satisfactory in 15 cases,basically satisfactory in 2 cases,and unsatisfactory in 1 case（bilateral asymmetry）.Conclusion Based on three-dimensional reconstruction technology of CT,surgical design performed on the model will promote the accuracy of operation.Basically symmetrical appearances can be achieved with satisfactory results.

关 键 词：CT三维重建 下颌角肥大 临床疗效 

分 类 号：R816.98[医药卫生—放射医学] R782.2[医药卫生—临床医学]