计算机辅助模拟偏突颌畸形SSRO手术前后髁状突位置改变的相关研究  

Related researches on computer-aided simulation of condylar position change of laterognathism mandi- ble in SSRO

作　　者：高小波[1] 杨鸣良[1] 雷博程[1] 张然[1] 刘亚庆[1] 孙桦梁[1] 闫杰[1] 颜光启[1] 卢利[1] 

机构地区：[1]中国医科大学附属口腔医院辽宁省口腔医学研究所口腔颌面外科,辽宁沈阳110001

出　　处：《中国美容整形外科杂志》2013年第1期37-41,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：【摘要】目的通过计算机辅助模拟下颌骨偏突颌畸形正颌手术，为术前预测髁状突位置改变提供相关定量参考，并研究使髁状突保持原位的方法，以期减少术后并发症。方法对在中国医科大学附属口腔医院口腔颌面外科就诊的20例偏突颌畸形患者进行研究，应用计算机辅助外科软件Surgicase5．0重建头颅模型，测量双侧髁状突横轴与人体正中线之间的角度，模拟下颌骨SSRO旋转后退，测量术后双侧髁状突角度改变和双侧下颌骨体部移动距离，分析二者之间的关系。确定下颌骨SSRO固定后保持髁状突原位，在接骨板上形成补偿弯曲角度及其固定位置。所有患者均按术前模拟行手术治疗，并采集术后影像学资料验证术前设计的效果。结果下颌骨体部骨段后退的距离与髁状突角度改变的量呈线性正相关。经统计学分析，得到后退距离X与髁状突角度变量Y的直线回归方程，分别为Y1=-14．307＋0．253X1，Y2=-1．904＋0．102X2。同时，所有患者临床治疗结果显示，90％（18／20）患者术后髁状突角度与术前相比改变≤2°；10％（2／20）患者术后髁状角度改变〉2°。结论通过对计算机辅助模拟偏突颌患者行下颌骨SSRO手术发现，下颌骨后退的距离与髁状突角度变化有相关性，此相关性为预测和分析正颌手术中髁状突位置的变化趋势提供了定量依据。临床实践证实，通过计算机模拟接骨板成型的角度和固定位置补偿下颌骨SSRO旋转后退对髁状突位置的影响，可最大限度地将髁状突保持原位。Abstract： Objective Focus on laterognathism of the mandible patients, simulation of orthognathie sur- gery on computer to provide relevant quantitative reference for preoperative prediction of condyle change, and through computer aided simulation compensate it. Methods Study in the 20 laterognathism of the mandible pa- tients in our hospital. Measuring the angle between bilateral condyle horizontal axis and the center line of the hu- man body by surgicase 5. O. Simulation of mandibular SSRO, measure mandibular body of the bone segments dis- placement distance and the change of condyle position, and analysis the correlation of them. Calculate the com- pensation bending angle in plate to maintain pre-position of condylar in SSRO. According to preoperative simula- tion, all patients under surgical treatment, and collected the postoperative imaging data to verify the effect of pre- operative planning. Results With the body of the mandible bone segments rotating back, both bilateral condyle horizontal axis at and the center line of the human body have changed. The bigger the mandibular rotating back distance after surgery, the greater the sudden change condyle. By the statistics analysis, we get a linear regres- sion equation： Y1 = -14.307 ＋0.253Xl , Y2 = - 1. 904 ＋ 0. 102X2. Then the clinical treatment results showed that, compared with preoperative condylar condylar angle, postoperative angle 90% （18/20） of patients chan- ge ≤2° and 10% （2/20） change 〉 2°. Conclusion Simulation of mandibular SSR0, mandibular body of the bone segments displacement distance and the change of condyle position have correlation. This correlation can Provide quantitative reference for Prognosis and analysis of the condylar position change in orthognathic surgery. Clinical practice confirmed that this method allows the condyle to maintain position in the preoperative maximum.

关 键 词：偏突颌畸形 计算机辅助模拟 SSRO 髁状突 补偿角度 

分 类 号：R782[医药卫生—口腔医学]