计算机辅助牵引成骨术的模拟和初步评价

目的 介绍并应用计算机辅助正颌外科模拟系统（CASSOS 2001）模拟，预测上颌骨牵引成骨术，评价治疗前后的软，硬组织变化。方法 1例男性，14岁唇腭裂术后上颌严重发育不足患者，应用CASSOS 2001系统作术前头影测量分析，手术和牵引方向模拟，牵引后面型预测,实际牵引成骨治疗后的头影测量分析等，手术模拟中分别进行了Le Fort I型截骨术和Le Fort Ⅱ型截骨术的模拟。对多项头影测量作了比较。结果 牵引前后数据比较显示，面中部凹隐畸形获得了显著改善；手术模拟与实际术后结果比较显示，上颌骨Le Fort I型截骨后牵引成骨术所获得的面型改善可以达到正颌外科Le Frot Ⅱ型截骨前移后的效果。结论 上颌牵引成骨对于严重的上颌骨局部畸形，尤其是唇腭裂术后上颌骨严重发育不足，是一种极其有效的治疗方法：CASSOS 2001系统不仅为正颌外科手术，也为牵引成骨治疗提供了一种对医生和患者都有极大帮助的模拟和预测方法。

Stimulation and Evaluation on Maxillary Distraction Osteogenesis Using CASSOS 2001

Objective To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment,using Computer-Assisted Simulation System for Orthognathic Surgery(CASSOS2001).Methods A fourteen-year-old boy with severe maxillary hypoplasia,due to unilateral cleft lip and palate,was analysed by cephalometric analysis.The simulations of maxillary distraction osteogenesis(Le Fort I osteotomy and Le Fort II osteotomy)were re-analysed.After the treatment,cephalometric analysis was preformed again.The data were compared.Results The maxillary hypoplasia was well treated using maxillary distraction osteogenesis;Compared with Le fort I osteotomy,more satisfactory results can be obtained by Le fort I distraction osteogenesis.Conclusion Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy.CASSOS2001can help surgeons and patients on simulation and evalution of maxillary distraction osteogenesis,and on decision of treatment plan.