摘要
外伤和肿瘤切除导致的颌骨缺损是口腔颌面外科临床工作中的难点与研究热点。传统的颌骨重建手术主要依靠术者经验完成,操作复杂,不易控制,难以保证较高的修复精度。近年来,以手术导航为代表的数字化外科技术已广泛应用于颌骨缺损的修复重建手术中,该技术的优势在于:使复杂结构三维可视化;术前模拟手术有利于发现设计缺陷,及时改进手术方案;精确设计有助于减少手术并发症,提高手术精度和安全性。采用手术导航等数字化外科技术辅助手术,可显著提高颌骨缺损重建的精度,达到个性化、功能性重建的目标,提高患者术后的生命质量。中华口腔医学会口腔颌面外科专业委员会组织专家经过充分讨论,制定了导航引导颌骨缺损重建术技术流程及操作的专家共识,以规范该技术的临床操作流程,促进其推广应用。
Deformities of the maxillofacial region following trauma and ablative surgery are devastating and not uncommon. Reconstruction of such defects is a surgically challenging procedure. Conventionally, reconstruction of the jaw defects lacks pre-operative customized planning and relies heavily on surgeons′ experiences to ensure optimum surgical outcomes. The restoration of jaw shape and function has taken precedence after an extensive tumor resection surgery, especially in the current age of technological advancement. Thus, personalized and accurate reconstruction of jaw defects has become a new goal. Computer-assisted surgery especially navigation-assisted surgery has gained popularity of late, in reconstructing deformities and restoring facial symmetry, appearance and function in the maxillofacial region. This technology provides a clearer three-dimensional visualization of the area of interest and its relationship with the adjacent vital structures. With pre-operative virtual surgical planning, it allows more specific and accurate osteotomies, thus reducing the ischemia and total operating times substantially. The risk of complications is also minimized whilst improving the final surgical outcomes. The use of intra-operative navigation system and other computer-assisted surgical techniques in the surgery can significantly improve the precision of the reconstruction of jaw deformities and achieve personalized and functional reconstructive goals while enhancing the patients′ quality of life post-operatively. The Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association provides this professional perspective and present treatment protocol for navigation-guided reconstruction of jaw defect to allow standardization of the techniques while promoting its application among the oral and maxillofacial surgeons.
作者
中华口腔医学会口腔颌面外科专业委员会
彭歆
章文博
于尧
王洋
刘筱菁
刘彦普
李祖兵
卢利
田卫东
沈国芳
张诗雷
顾晓明
胡敏
张陈平
郭传瑸
俞光岩
Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association;Peng Xin(Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & Notional Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing J00081, China)
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2019年第5期289-296,共8页
Chinese Journal of Stomatology
基金
北京市科学技术委员会首都市民健康培育项目基金(ZI61100000116053)。
关键词
骨重建
颌骨缺损
修复重建
导航技术
专家共识
数字化外科
Bone remodeling
Jaw defect
Reconstruction
Navigation technique
Expert consensus
Digital surgery
