Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery
Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery
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DOI：
10.1016/j.ijom.2016.06.015
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发表时间：
2016-11-01
影响因子：
2.4
通讯作者：
Li, J. S.
中科院分区：
文献类型：
--
作者：
Wang, Y. Y.;Zhang, H. Q.;Li, J. S.
本研究评估了下颌重建的准确性，并评估了虚拟计划和传统手术患者的临床结果。虚拟计划组术前采用ProPlan CMF手术计划软件。虚拟计划组取腓骨瓣，去骨，下颌骨切除，在预制切割导板和模板辅助下重建。主要观察指标包括手术时间、术后CT扫描、面部外观和咬合功能。虚拟计划组缺血时间和总手术时间均短于常规手术组。使用切割导向和模板对腓骨和下颌骨都具有很高的精度，并且在虚拟规划组中，预弯曲钢板，下颌骨和腓骨段之间具有良好的配合。术后CT扫描也显示腓骨瓣的下颌骨轮廓符合虚拟计划组的虚拟计划。该研究表明，虚拟手术计划能够实现比传统手术更准确的下颌重建。使用预制的切割导板和钢板使腓骨瓣成型和放置更容易，最大限度地减少了手术时间，提高了临床效果。
This study evaluated the accuracy of mandibular reconstruction and assessed clinical outcomes in both virtual planning and conventional surgery patients. ProPlan CMF surgical planning software was used preoperatively in the virtual planning group. In the virtual planning group, fibula flaps were harvested and osteotomized, and the mandibles were resected and reconstructed assisted by the prefabricated cutting guides and templates. The main outcome measures included the operative time, postoperative computed tomography (CT) scans, facial appearance, and occlusal function. The ischemia time and total operation time were shorter in the virtual planning group than in the conventional surgery group. High precision with the use of the cutting guides and templates was found for both the fibula and mandible, and a good fit was noted among the pre-bent plate, mandible, and fibula segments in the virtual planning group. Postoperative CT scans also showed excellent mandibular contours of the fibula flaps in accordance with virtual plans in the virtual planning group. This study demonstrated that virtual surgical planning was able to achieve more accurate mandibular reconstruction than conventional surgery. The use of prefabricated cutting guides and plates makes fibula flap moulding and placement easier, minimizes the operating time, and improves clinical outcomes.