Removal of osteosynthesis material by minimally invasive surgery based on 3-dimensional computed tomography-guided navigation.
Removal of osteosynthesis material by minimally invasive surgery based on 3-dimensional computed tomography-guided navigation.
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基于 3 维计算机断层扫描引导导航的微创手术去除接骨材料。
DOI：
10.1053/joms.2003.50067
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
H. Kärcher
中科院分区：
文献类型：
--
作者：
G. Schultes;Veit Zimmermann;M. Feichtinger;A. Gaggl;H. Kärcher
近年来，计算机辅助外科在口腔颌面外科中的地位越来越重要。三维CT重建图像1-4和基于CT的三维铣削模型5-7用于术前诊断和规划。现在，使用全尺寸的三维患者模型可以实现手术计划的高度精确度。这些模型允许精确模拟指定的手术；因此，在手术前，外科医生熟悉预期的解剖情况。术中的复杂性是可以预见的，并使外科医生能够改变手术程序，从而显著缩短手术周期。然而，由于不存在精确的传输装置，在困难的解剖结构中手术入路的规划仍然是一个问题。只有引入了基于三维CT的导航，才有可能将精确的术前计划转变为术中情况，而不需要使用机械辅助。8，9此外，三维导航允许检测和保护重要的解剖结构。10根据优选的传动工具，精确度在1至3 mm之间变化。11在口腔和颌面外科的某些方面，这些不精确的行为是不能容忍的；因此，有必要改进导航系统的精度，这是近年来发生的事情。12、13探测小直径金属异物对导航系统提出了很高的要求，特别是在解剖结构复杂的区域。这份报告展示了光学导航系统在通过微创方法检测和取出异物中的应用。讨论了基于CT的导航系统在口腔颌面外科中的重要性。
Computer-aided surgery has gained greater importance in oral and maxillofacial surgery in recent years. Three-dimensional computed tomography (CT) reconstruction images 1-4 and CT-based 3-dimensional milling models 5-7 are used in preoperative diagnosis and planning. A high degree of precision in planning operations is now achieved using full-scale 3-dimensional patient models. These models allow an exact simulation of the designated operation; thus, preoperatively the surgeon is familiar with the expected anatomic situation. Intraoperative complexities can be foreseen and enable the surgeon to alter the operative procedure, thereby significantly reducing the operative period. However, the planning of surgical approaches in difficult anatomic structures remains a problem because of the nonexistence of precise transmission devices. Only with the introduction of 3-dimensional CT-based navigation was it possible to transform precise preoperative planning into the intraoperative situation without the use of mechanical aids. 8,9 Moreover, the 3-dimensional navigation allowed the detection and protection of important anatomical structures. 10 According to the preferred transmission tool, the degree of accuracy varies between 1 and 3 mm. 11 These inexactitudes are not tolerable in certain aspects of oral and maxillofacial surgery; therefore, an improvement in the accuracy of navigation systems was necessary and occurred in recent years. 12,13 The detection of metallic foreign bodies with small diameters places high demands on navigation systems, especially in anatomically complex regions. This report shows the use of an optical navigation system in the detection and removal of a foreign body via a minimally invasive approach. The importance of the CT-based navigation systems in oral and maxillofacial surgery is discussed.