颅颌面整形手术机器人在颏部水平截骨手术中的精确性分析  

Accuracy analysis of cranio-maxillofacial plastic surgery robot in genioplasty

作　　者：孙铁成 杨斌 王豫[2] 杨青 孙志彬[2] SUN Tiecheng;YANG Bin;WANG Yu;YANG Qing;SUN Zhibin(The Digital Plastic Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China;The School of Biological and Medical Engineering,Beijing University of Aeronautics and Astronautics,Beijing 100191,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院数字化整形外科,北京市100144 [2]北京航空航天大学生物与医学工程学院,北京市100191

出　　处：《组织工程与重建外科》2022年第1期57-61,70,共6页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：北京市科技计划首都临床特色应用研究项目(Z181100001718187);中国医学科学院整形外科医院科研基金项目(YS202011);国家重大疾病多学科合作诊疗能力建设项目。

摘　　要：目的探讨颅颌面整形手术机器人在颏部水平截骨手术中的应用效果和精确性。方法回顾分析2015年1月至2020年12月接受传统颏部水平截骨手术的10例小颏畸形患者(临床组)的临床资料,并通过颅颌面整形手术机器人对该组患者1∶1的3D石膏模型(机器人组)进行颏部水平截骨手术操作。以本团队前期实验研究数据标准为参考,利用数字化模拟软件设计术前理想手术方案(对照组)。分别测量3组的颏前点至鼻根点的距离,前鼻棘点至颏下点的距离,颏顶点至颏孔点的距离,颌角点至颏孔点的距离,双侧下颌1、3、6号牙顶点至截骨线的距离,内固定与颏前点的最小距离,对比3组指标测量结果。结果机器人组术后测量指标与对照组指标无明显统计学差异(P>0.05),临床组术后测量指标与对照组指标统计学差异明显(P<0.05)。机器人组与对照组的截骨路线一致(P>0.05),而临床组与对照组的截骨路线之间存在差异(P<0.05)。临床组与机器人组相比,术后的内固定与颏前点的最小距离更小。结论与传统临床手术操作相比,颅颌面整形手术机器人可以更加精准地进行颏部水平截骨。Objective To explore the application effect and accuracy of craniomaxillofacial plastic surgery robot in genioplasty.Methods The clinical data of 10 patients treated with traditional clinical genioplasty(clinical group)from January 2015 to December 2020 was retrospectively analyzed and compared with the data of their 1∶13D plaster model underwent genioplasty via cranio-maxillofacial plastic surgery robot(robot group).Based on the pre-experimental research data standards of our department,the ideal preoperative surgical scheme(control group)was designed using digital simulation software.The distance between pogonion and nasion,the distance between anterior nasal spine and menton,the distance between gnathion and mental foramen,and the distance between gonion and mental foramen,the distance from incision inferior,tip of lower canine and tip of the molar cheek groove to the line of osteotomy,the closest distance between screw and mental foramen were measured and compared among the three groups.Results There were no statistical differences between the robotic group and control group in the postoperative measurement index(P>0.05),and there was a statistical difference between the clinical group and the control group in the postoperative measurement index(P<0.05).There was no statistical difference between robotic group and control group in line of osteotomy(P>0.05),but there was a statistical difference between the clinical group and the control group in line of osteotomy(P<0.05).Compared with the robotic group,the closest distance between screw and mental foramen after operation was smaller in the clinical group.Conclusion Compared with the actual operation of human hands,the cranio-maxillofacial plastic surgery robot can perform genioplasty more accurately.

关 键 词：颏成形术 机器人 数字化技术 3D打印 导航 

分 类 号：R622[医药卫生—整形外科]