手术导航技术在颧骨颧弓骨折治疗应用中的精确度评价  

Accuracy of Surgical Navigation in the Treatment of Zygomatic Fracture

作　　者：虎小毅 李立峰[1,2,3] 史婧怡 屠军波 侯成群 HU Xiao-yi;LI Li-feng;SHI Jing-yi;TU Jun-bo;HOU Cheng-qun(Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China;Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China;Department of Oral Maxillofacial Surgery,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China)

机构地区：[1]陕西省颅颌面精准医学研究重点实验室,陕西西安710004 [2]陕西省牙颌疾病临床医学研究中心,陕西西安710004 [3]西安交通大学口腔医院颅颌面整形创伤外科,陕西西安710004

出　　处：《中国美容医学》2019年第10期82-85,共4页Chinese Journal of Aesthetic Medicine

基　　金：陕西省重点研发计划(编号:2017ZDXM-SF-108)

摘　　要：目的:通过评估手术导航技术辅助治疗颧骨颧弓骨折的精确度,探讨其在颌面部手术治疗中的应用价值。方法:选择2015年1月-2018年11月在西安交通大学口腔医院就诊的单侧颧骨颧弓骨折患者19例。术前行薄层CT扫描,并将CT数据导入手术导航术前规划软件。在手术规划系统中选择健侧颧骨颧弓结构并镜像至患侧,镜像的范围大于患侧骨折所累及范围,一般情况下镜像体范围至少上至眶上缘,下达颧牙槽嵴,后至颧弓根部。通过进一步微调镜像体设计出骨折“复位”的理想位置,再将设计好的模型导入手术导航仪并在术中辅助引导骨折复位固定。术后均行CT复查,通过两种方式评估手术导航的精确性。方式一:将术后CT数据导入术前设计软件,经过图像融合后测量术后患侧颧骨颧弓的位置与术前设计的差异;方式二:通过在术后CT上测量并对比双侧颧骨的位置评估双侧颧骨的对称性。结果:术后关键标志点间距同术前设计差异不超过2mm,术前术后差异不具有统计学意义,手术效果满意。结论:手术导航技术辅助单侧颧骨颧弓骨折复位固定具有良好的精确度。Objective To evaluate the accuracy and bene fits of surgical navigation technology in the treatment of zygomatic arch fracture.Methods From January 2015 to November 2018,nineteen patients diagnosed with unilateral zygomatic fracture were selected in the Stomatological Hospital of Xi'an Jiaotong University.Thin slice CT scans were performed before operation,and CT data were imported into the preoperative planning software of surgical navigation.In the surgical planning system,the zygomatic arch structure of the healthy side is selected and mirrored to the affected side.The scope of the mirror images was larger than that of the affected side.Generally,the scope of the mirror part should include at least the upper orbital margin,the zygomatic alveolar ridge and the root of zygoma.The ideal positions of fracture reduction were designed by further fine-tuning of the mirror body,and then the designed models were introduced into the surgical navigator and used in guiding fracture reduction and fixation during the operation.Postoperative CT examination was performed to evaluate the accuracy of surgical navigation in two ways.Method 1:The post-operative CT data were introduced into the preoperative design software,and the difference between preoperative design and postoperative zygomatic arch position were measured after image fusion.Method 2:The symmetry of bilateral zygomatic bones was evaluated by measuring and comparing the position of bilateral zygomatic bones on post-operative CT.Results The distances of the key markers between the preoperative design and postoperative zygoma were less than 2 mm.No signi ficant difference was observed between the preoperative and the postoperative zygomatic position.Conclusion Surgical navigation is accurate and reliable for assisted reduction and fixation of unilateral zygomatic arch fracture.

关 键 词：手术导航 颧骨颧弓骨折 手术治疗 坚固内固定 精确度 

分 类 号：R782.4[医药卫生—口腔医学]