Point-to-point computer-assisted navigation for precise transfer of planned zygoma osteotomies from the stereolithographic model into reality
Point-to-point computer-assisted navigation for precise transfer of planned zygoma osteotomies from the stereolithographic model into reality
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DOI：
10.1016/j.joms.2005.11.024
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发表时间：
2006-03-01
影响因子：
1.9
通讯作者：
Wagner, A
中科院分区：
文献类型：
--
作者：
Klug, C;Schicho, K;Wagner, A
目的：为了评估的可行性和准确性的新方法，规划和实现istomatic截骨术的情况下，建立创伤后畸形，使用立体光刻（SL）模型和计算机辅助navigation.Patients和方法：在5例患者，截骨术和复位的istomatic复杂计划使用SL模型。通过将个体化接骨板固定到预定义的螺钉位置来确定患者中肿瘤的期望位置。SL模型和患者通过患者上的咬合参考框架和模型上的相应参考标记配准到相同的三维计算机断层扫描数据集。将模型上手术模拟的预弯接骨板固定到患者相应的螺钉位置，通过计算机辅助导航定位。通过模型和患者术后计算机断层扫描的图像融合来评估准确性。结果：所有病例的临床结果均令人满意。图像融合评估显示，5例病例中有4例患者和模型的颧骨对齐。对于44枚螺钉，模型和患者中螺钉位置之间的平均测量距离为1.1 ± 0.3 mm。在1例患者的治疗计划术中改变，因为不可预见的软组织limitations.Conclusion：点到点导航是一种准确的方法，从SL模型转移到实际的手术过程中的复杂截骨术的规划。由于复位和接骨术在一个步骤中完成，因此手术非常方便。(c)2006年美国口腔颌面外科医师协会。
Purpose: To evaluate the feasibility and accuracy of anew method for planning and realizing zygomatic osteotomies in cases of established post-traumatic deformities using stereolithographic (SL) models and computer assisted navigation.Patients and Methods: In 5 patients, osteotomy and repositioning of the zygomatic complex was planned using SL models. The desired position of the zygoma in the patient was determined by fixing individualized osteosynthesis plates to predefined screw positions. The SL model and the patient were registered to the same 3-dimensional computed tomography data set via an occlusal reference frame on the patient and corresponding reference markers on the model. Prebent osteosynthesis plates from the surgical simulation on the model were fixed to corresponding screw positions on the patient, which were located by computer-assisted navigation. Evaluation of accuracy was performed by image fusion of postoperative computed tomography scans of the model and the patient.Results: Clinical outcome was satisfactory in all cases. The evaluation by image fusion showed alignment of the patient's and the model's zygoma in 4 of 5 cases. Mean measured distance between screw positions in the models and the patients were 1.1 +/- 0.3 mm for 44 screws. In 1 patient the treatment plan was changed intraoperatively because of unforeseen soft tissue limitations.Conclusion: Point-to-point navigation is an accurate method to transfer the planning of a complex osteotomy from the SL model to the actual surgical procedure. Surgery is facilitated considerably because repositioning and osteosynthesis are achieved in 1 step. (c) 2006 American Association of Oral and Maxillofacial Surgeons.