A New Method of Surgical Navigation for Orthognathic Surgery: Optical Tracking Guided Free- Hand Repositioning of the Maxillomandibular Complex
A New Method of Surgical Navigation for Orthognathic Surgery: Optical Tracking Guided Free- Hand Repositioning of the Maxillomandibular Complex
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DOI：
10.1097/scs.0000000000000673
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发表时间：
2014-03-01
影响因子：
0.9
通讯作者：
Wang, Xudong
中科院分区：
文献类型：
--
作者：
Li, Biao;Zhang, Lei;Wang, Xudong
在双颌正颌手术中，上颌骨和下颌骨的定位通常通过2夹板技术完成，这可能是多种类型的不准确性的来源。为了克服双夹板技术的局限性，我们开发了一种新的导航方法，引导外科医生在术中徒手重新定位上下颌复合体，而无需中间夹板。在初步研究中，论证了其可行性。入组了五名患有牙齿颌面畸形的患者。手术前，进行三维规划并导入导航系统。在手术过程中，追踪器通过夹板连接到截骨的上下颌复合体。导航系统跟踪复合体的移动并在屏幕上真实的显示，以指导外科医生重新定位复合体。通过分析从计算机断层扫描数据确定的上颌标志和参考平面之间的测量距离，将术后结果与计划进行比较。上颌位置的平均绝对误差在临床上是可接受的（
In bimaxillary orthognathic surgery, the positioning of the maxilla and the mandible is typically accomplished via 2-splint technique, which may be the sources of several types of inaccuracy. To overcome the limitations of the 2-splint technique, we developed a new navigation method, which guided the surgeon to free-hand reposition the maxillomandibular complex as a whole intraoperatively, without the intermediate splint. In this preliminary study, the feasibility was demonstrated. Five patients with dental maxillofacial deformities were enrolled. Before the surgery, 3-dimensional planning was conducted and imported into a navigation system. During the operation, a tracker was connected to the osteotomized maxillomandibular complex via a splint. The navigation system tracked the movement of the complex and displayed it on the screen in real time to guide the surgeon to reposition the complex. The postoperative result was compared with the plan by analyzing the measured distances between the maxillary landmarks and reference planes, as determined from computed tomography data. The mean absolute errors of the maxillary position were clinically acceptable (