虚拟技术在第一、二鳃弓综合征治疗中的应用  

Application of virtual design and guide in the treatment of hemifacial microsomia

作　　者：王敏娇[1] 陈天天[1] 司家文[1] 王旭东[1] 沈国芳[1] 于洪波[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2期123-127,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81101131);上海市科学技术委员会学科带头人计划项目(12XD1403200);浦东新区卫生、计生科技项目(PW2012D-11)

摘　　要：目的:探讨虚拟技术在第一、二鳃弓综合征牵引成骨治疗中的应用效果。方法 :选取8例第一、二鳃弓综合征患者,应用虚拟技术进行下颌支牵引成骨的设计模拟,三维打印牙支持式导板指导术中截骨线、牵引器放置。牵引器拆除后进行面部对称性及手术精确度评价。结果:所有患者均顺利完成术前虚拟设计、数字化导板的三维打印、手术操作。对比术前设计与术后CT三维重建,显示术后颌骨形态与术前设计基本一致,误差小于2 mm,患者的面部不对称畸形得到显著改变。结论:虚拟技术可应用于第一、二鳃弓综合征治疗,通过模拟截骨,设计牵引器放置位置以及牵引方向,预测术后下颌骨形态,提高了手术精确性,有较高的临床应用价值。PURPOSE： Accurate preoperative planning and intraoperative realization is critical to ensure successful results. This study was to explore the application of virtual design and guide in the treatment of hemifacial microsomia（HFM）. METHODS： Eight patients of HFM were enrolled in this study. Virtual surgical planning, simulation and postoperative prediction were performed. Under the guidance of 3D printed guide, mandibular ramus osteotomy and distractor implant were carried out. Clinical examination was performed after removal of distractor. Surgical accuracy was evaluated by comparing the postoperative CT 3-D model with preoperative surgical planning. RESULTS： All the patients underwent virtual surgical planning, 3D guide printing and distraction osteogenesis（DO） successfully. Facial symmetry was greatly improved after treatment. The mean deviation between the preoperative design and actual surgical results was less than 2 mm. CONCLUSIONS： With the ability of preoperative planning, surgical simulation and postoperative prediction,virtual design shows great value in improving the accuracy of DO and restoring facial symmetry. It is regarded as a valuable technique in this potentially complicated procedure.

关 键 词：第一、二鳃弓综合征 虚拟技术 下颌骨发育不足 牵引成骨 

分 类 号：R782.2[医药卫生—口腔医学]