Virtual Surgical Planning in Precise Maxillary Reconstruction With Vascularized Fibular Graft After Tumor Ablation
Virtual Surgical Planning in Precise Maxillary Reconstruction With Vascularized Fibular Graft After Tumor Ablation
复制标题
肿瘤消融后带血管腓骨移植精确上颌重建的虚拟手术规划
DOI：
10.1016/j.joms.2016.01.010
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发表时间：
2016-06-01
影响因子：
1.9
通讯作者：
Li, Jin-song
中科院分区：
文献类型：
--
作者：
Wang, You-yuan;Fan, Song;Li, Jin-song
目的：上颌骨及面中部肿瘤切除后缺损的修复是传统手术难以解决的难题。本研究的目的是评估虚拟手术计划辅助下腓骨瓣在上颌骨缺损重建中的精确三维位置，并与传统手术进行比较，评估术后效果。材料与方法：我们回顾性分析了18例上颌骨或面中部肿瘤患者，在虚拟手术计划的辅助下，采用带血管腓骨瓣进行上颌骨重建消融术另15例行常规手术治疗。在虚拟计划组中，术前进行Proplan CMF手术计划（Materialise，Leuven，Belgium）。虚拟计划组在预制切割导板辅助下切取腓骨瓣进行截骨，在预制切割导板和模板辅助下进行上颌骨和面中部的切除和重建。比较两组的手术时间和腓骨瓣位置。将虚拟计划组中上颌骨重建的术后腓骨位置与虚拟计划进行比较。结果：手术均顺利完成，无并发症发生。虚拟计划组缺血时间和总手术时间均短于常规手术组（P
Purpose: Reconstruction of maxillary and midfacial defects due to tumor ablation is challenging to conventional operation. The purposes of this study are to evaluate the precise 3-dimensional position of the fibular flap in reconstruction of maxillary defects assisted by virtual surgical planning and to assess the postoperative outcomes compared with conventional surgery.Materials and Methods: We retrospectively reviewed 18 consecutive patients who underwent maxillary reconstruction with a vascularized fibular flap assisted by virtual surgical planning after maxillary or midfacial tumor ablation. Conventional surgery was performed in another 15 patients. Proplan CMF surgical planning (Materialise, Leuven, Belgium) was performed preoperatively in the virtual planning group. Fibular flaps were harvested and underwent osteotomy assisted by prefabricated cutting guides, and the maxilla and midface were resected and reconstructed assisted by the prefabricated cutting guides and templates in the virtual planning group. The operative time and fibular flap positions were evaluated in the 2 groups. Postoperative fibular positions of the maxillary reconstruction were compared with virtual plans in the virtual planning group. The postoperative facial appearance and occlusal function were assessed.Results: The operations were performed successfully without complications. The ischemia time and total operative time were shorter in the virtual planning group than those in the conventional surgery group (P