计算机导航技术在颌骨骨纤维异常增殖症手术中的应用  

Application of surgical navigation system in the operation for maxillofacial fibrous dysplasia

作　　者：孙国文[1] 王毓佳 韩方凯[2] 刘澍[2] 卢明星[1] 

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,210008 [2]南京大学医学院附属口腔医院,南京市口腔医院口腔放射科,210008

出　　处：《实用口腔医学杂志》2017年第5期679-683,共5页Journal of Practical Stomatology

基　　金：江苏省卫生厅课题项目(编号:H201441);江苏省临床医学科技专项项目(编号:BL2013005);南京市科技发展计划(编号:201503038)

摘　　要：目的:探讨计算机导航技术在颌骨骨纤维异常增殖症手术中的应用价值。方法:纳入14例颌面部骨纤维异常增殖症患者,先将患者的术前CT数据导入计算机导航系统中,根据颌骨镜像原理进行术前设计及三维手术模拟,确定骨切除位置及范围。术中,根据病变部位及手术范围可将参考架置于患者前额或是下颌骨颏部。完成注册与配准,使手术视野和导航显示屏上的虚拟图像完全匹配。结果:面部的解剖结构与三维重建模型完全吻合,术中顺利完成实时导航。手术器械可实现空间定位,能够明确其与手术区域解剖结构的位置关系,手术具有高度的精确性与安全性。术后疗效的评估是通过术前计划和术后CT重建影像相融合得到的,1~3年的随访中没有发现并发症。结论:计算机导航系统在提高颌面部骨纤维异常增殖症的安全性与准确性方面具有较好的应用价值。Objective： To present our experience of the surgical treatment of maxillofacial fibrous dysplasia（FD） using surgical navigation technology. Methods： 14 patients with maxillofacial FD were included. Preoperative CT scanning data were obtained and a virtual plan based on the patient＇s mirrored anatomy was realized. Intraoperatively, a digital reference frame was fixed rigidly to patient＇s forehead or mandible depending on the location of the lesion. During operation each patient and the virtual image were matched through individual registration technique. A pointing device was constantly used to determine whether the extent of resection was consistent with the preoperative design. The surgical outcome was assessed through fusion of the preoperative planning and postoperative CT reconstruction image. Results： The application of surgical navigation system enhanced the safety and the accuracy of the surgery for the resection of the focal lesion and for the recontour of the profile. There was no complications during 1 - 3 years follow up. Conclusion： Surgical navigation based on a virtual plan proves to be safe and accurate, and is of great value in managing maxillofacial fibrous dysplasia.

关 键 词：导航系统 实时导航 骨纤维异常增殖症(FD) 

分 类 号：R782.2[医药卫生—口腔医学]