数字化外科技术及术中导航在上颌骨肿瘤手术中的应用  

Digital Surgical Techniques and Intraoperative Navigation in Maxillary Reconstruction

作　　者：施友元[1] 张海林 林秀安[1] 边聪[1] 左良 SHI Youyuan;ZHANG Hailin;LIN Xiu'an;BIAN Cong;ZUO Liang(Fujian Medical University Cancer Hospital, Department of Head and Neck Surgery, Fujian Cancer Hospital, Fuzhou 350014, China)

机构地区：[1]福建医科大学附属肿瘤医院,福建省肿瘤医院头颈外科,福州350014

出　　处：《福建医科大学学报》2022年第2期160-164,共5页Journal of Fujian Medical University

基　　金：福建省卫生和计划生育委员会创新项目(2017-CXB-3);湖南省卫生健康委2020年度一般资助课题(20201653)。

摘　　要：目的回顾性分析在数字化外科技术和术中导航的辅助下行上颌骨精确重建的病例,并评价术后效果。方法收集2017年1月—2019年1月8例上颌骨肿瘤患者的临床资料,术前在计算机软件中进行虚拟设计,通过快速成型技术制作个性化模型或导板,应用手术导航指导切除肿瘤后,使用游离腓骨肌皮瓣或股前外侧皮瓣对上颌骨进行修复重建。结果8例中,同侧腓骨肌皮瓣修复6例,股前外侧皮瓣修复2例。随访12~36个月,患者对两种皮瓣修复缺损后的外形均较满意,其中腓骨肌皮瓣修复者颌骨愈合良好。结论数字化技术及术中导航的应用可提高手术精准度,较精确地重建上颌骨外形,缩短手术时间,简化手术过程,可重复性强。Objective To retrospectively analyze cases in which precise maxillary reconstruction was performed with the assistance of digital surgical techniques and intraoperative navigation,and to evaluate the postoperative results.Methods 8 patients with maxillary tumors were admitted to our department and treated from January 2017 to January 2019.Preoperative virtual design was performed in computer software.Personalized models or guided templates were created by rapid prototyping technology.After removing the tumor under surgical navigation,the maxilla was repaired and reconstructed using a free peroneal muscle flap or anterolateral femoral flap.Results Among the 8 cases,6 cases were repaired with ipsilateral fibularis muscle flap and 2 cases with anterolateral femoral flap.At 12 to 36 months of follow-up,the patients of both flaps reported satisfaction with facial appearance after repairing the defects,with good healing of the jaws in those repaired with the peroneal muscle flap.Conclusions The application of digital technology and intraoperative navigation can improve the surgical precision and reconstruct the maxillary shape more precisely;shorten the surgical time,simplify the surgical procedure,and be reproducible.

关 键 词：数字化外科技术 手术导航 颌骨修复重建 腓骨肌皮瓣 股前外侧皮瓣 

分 类 号：R78[医药卫生—口腔医学]