数字化外科技术在下颌骨缺损重建中的应用  

Application of digital surgical techniques in mandibular reconstruction

作　　者：彭歆[1] 章文博 PENG Xin;ZHANG Wenbo(Department of Oral And Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China)

机构地区：[1]北京大学口腔医院口腔颌面外科,北京100081

出　　处：《口腔疾病防治》2017年第9期545-553,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：科技部支撑计划项目(2014BAI04B06);北京市科委首都市民健康培育项目(Z161100000116053)

摘　　要：下颌骨是面下1/3主要的骨性支架,由于肿瘤切除、炎症及外伤等原因导致的下颌骨缺损,严重影响患者的外形与功能。以腓骨瓣为代表的血管化游离骨组织瓣是目前修复下颌骨缺损的主要方法。传统的下颌骨重建手术,主要依赖术者经验进行,缺乏个性化的术前设计与精确的术中引导,难以达到精确重建的目标。近年来,虚拟设计、快速成型、手术导航等数字化技术已广泛应用于下颌骨缺损的重建手术中:术前在数字化软件中对下颌骨肿瘤的切除及下颌骨缺损的重建手术进行精确的个性化设计;术中使用手术导板或手术导航技术辅助将术前设计转化为现实。许多研究结果表明,应用数字化外科技术,可显著提高下颌骨缺损重建的临床治疗效果。本文将结合近年来国内外文献报道及作者课题组临床实践经验,对数字化外科技术在下颌骨缺损重建中的应用进行归纳与总结。The mandible is the most important bony support in the lower1/3skeleton of the face which is critical forboth esthetics and function.Mandibular defects,resulting from tumor resection,can cause severe functional and cosmetic deformities.Nowadays,vascularized bony tissue transfer such as free fibula flap has been widely used for mandibular reconstruction.However,traditional mandibular reconstruction based on clinical experience may hawe some problems inaccuracy and efficiency because of lacking individualized design.In recent years,digital surgical techniques such ascomputeraided design,rapid prototyping and surgical navigation have been used for mandibular reconstruction surgery.Accurate design for tumor resection as well as individualized design for mandibular reconstruction can be performedwith computer preoperatively which help to turn the virtual plan into reality by using surgical guide or navigation.Manystudies suggested that digital surgical techniques could significantly improve the clinical outcome of mandibular reconstruction.In this article,we summarized the application of digital surgical techniques for mandibular reconstructionbased on our own experience and literatures review.

关 键 词：下颌骨缺损 修复重建 数字化外科技术 血管化骨组织瓣 手术导航 

分 类 号：R782[医药卫生—口腔医学]