导航专用下颌骨牵引器在山羊下颌骨牵引成骨术中的精度研究  

Studies on navigation mandibular distractor in mandible distraction osteogenesis in goats

作　　者：胥雷[1] 蔡鸣[1] 于雯雯[1] 孙红霞[1] 王猛[1] 姚侃[1] 蔡期勋 魏思龙[1] 卢晓峰[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2016年第1期8-13,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(10140904300)

摘　　要：目的：应用自主研发的导航专用下颌骨牵引器及颅颌面手术导航系统，在三维可视化软件中虚拟设计手术方案，进行山羊下颌骨牵引成骨术的相关研究．评估导航技术转移手术方案的精度。方法：麻醉状态下在4只成年山羊下颌前部两侧植入5颗定位钉．使下颌骨处于自然状态下行CT扫描。将获得的CT数据与导航专用牵引器三维图像导入Surgicase可视化软件，进行三维测量、虚拟设计手术方案。4只山羊平均分为2组，第1组行单侧下颌角部截骨．第2组行单侧下颌支截骨。利用导航专用下颌骨牵引器，将术前规划方案导入TBNavis—CMFS导航软件系统中。全麻下行导航辅助山羊下颌骨牵引成骨术。采用SPSS17．0软件包对导航牵引器实物及三维图像的相关数据、模拟及真实牵引成骨数据进行统计学分析。结果：自主研发的导航专用下颌骨牵引器实物和三维图像之间的各尺寸设计参数无显著差异（P〉0．05）。2组实验山羊术前模拟与真实牵引长轴间成角平均为2．450（1．56°-3．69°），模拟与真实截骨平面间夹角平均为1．530（1．16°～3．25°），同侧髁突至模拟与真实截骨平面的距离无显著差异（P〉0．05）。结论：应用自主研发的导航专用下颌骨牵引装置．利用Surgicase可视化软件、TBNavis—CMFS手术导航系统进行山羊下颌骨牵引成骨术前虚拟手术截骨设计．可以将术前手术规划精确转移至手术操作中，转移精确度高．操作互动性好。PURPOSES： To investigate the accuracy of navigation-guided mandibular distraction ostergenesis （DO） on animal model by using TBNavis-CMFS navigation system with navigation mandibular distraetors. METHODS： Five registration screws were implanted in the mandible of 4 goats under general anesthesia before scanned by computerized tomographic （CT）. CT data and 3D image of navigation mandibular distractors were imported in Surgiease 5.0 and TBNavis-CMFS to design the surgery plan and predict the outcomes. Four goats were divided into 2 groups, goats in group 1 were implemented with mandibular angle osteotomy, while goats in group 2 were implemented with mandibular rarnus osteotomy. Paired t test was carried out using SPSS 17.0 software package. RESULTS： With the use of navigation mandibular distractors, there was no significant difference between 3D models and real objects in size parameters （P〉0.05）. Mean distraetor axel angle of virtual and navigated operation was 2.45° （1.56°-3.69°）, mean osteotomy plane ang/e of virtual and navigated operation was 1.53° （1.16°-3.25°）, There was no significant difference between ipsilateral condyle distance to the osteotomy plane of virtual and navigated operation （P〉0.05）. CONCLUSIONS： Navigation-guided mandibular DO with navigation mandibular distraetors is able to transfer the pre-surgical planning to realtime surgery precisely, which can be used for mandibular DO under navigation environment clinically in future.

关 键 词：山羊 牵引成骨术 导航外科 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R782.6[医药卫生—口腔医学]