计算机辅助三维可视化技术在腓骨瓣修复下颌骨缺损中的应用  

Application of computer aided three-dimensional visualization technique in mandibular defect reconstruction with vascularized free fibular flap

作　　者：陈勇[1] 杨旭东[1] 李威[1] 王铁梅[1] 张银凯[1] 唐恩溢[1] 乔光伟[1] 

机构地区：[1]南京大学医学院附属口腔医院口腔颌面外科,南京210008

出　　处：《中华显微外科杂志》2013年第1期19-23,共5页Chinese Journal of Microsurgery

摘　　要：目的总结在计算机辅助三维可视化技术指导下，应用游离腓骨瓣修复不同类型下颌骨缺损的临床效果。方法将5例复发性成釉细胞瘤患者CT数据通过计算机软件进行虚拟手术，通过确定腓骨瓣大小及位置，制作个体化模型及模块，预制重建钛板，指导手术完成。结果全部手术成功，病灶组织按计划准确切除，术中腓骨瓣制备准确，误差（0．23±2．10）mm，术后腓骨瓣全部成活，平均随访12．8个月，患者咬合关系良好，面容恢复理想。结论应用计算机辅助三维可视化技术可以简化手术过程，节省手术时间，精确修复，提高游离腓骨瓣修复下颌骨缺损的治疗效果。Objective To summary the application of computer aided three-dimensional visualization technique in different kinds of mandibular detects reconstruction with vascularized free fibular flap. Methods Five patients diagnosed of recurrent mandibular ameloblastoma underwent the virtually operation by software with a thin-slice CT scan, which determined shape and position of the free flap, and preoperative resin model and modules were designed and prefabricated. Then the titanium plates were bent precisely, and the surgical recon- struction proceeded exactly as expected from the modeling process. Results All operations were achieved successfully. The extent of the lesion was coincident with the preoperative CT results, and the vaseularized free fibular flaps were harvested and implanted into the defect regions accurately. The mean distance was （0. 23 ± 2. 10） mm eompared with the virtual fibula. The mean time of operation was 4. 4 hours. Following up the mean 12. 8 months, all patients obtained the excellent functional and cosmetic outcomes. Conclusion The proce- dure of operation was simplified and the time was shortened with reconstruction exactly using computer aided three-dimensional visualization technique, and the clinical therapeutic efficacy of reconstruction of mandibular defect with vascularized free fibular flaps was improved notably.

关 键 词：下颌骨 计算机辅助外科 腓骨皮瓣 显微外科手术 

分 类 号：R7[医药卫生—临床医学]