数字化外科技术在下颌骨缺损重建中的应用

下颌骨是面下1/3主要的骨性支架,由于肿瘤切除、炎症及外伤等原因导致的下颌骨缺损,严重影响患者的外形与功能.以腓骨瓣为代表的血管化游离骨组织瓣是目前修复下颌骨缺损的主要方法.传统的下颌骨重建手术,主要依赖术者经验进行,缺乏个性化的术前设计与精确的术中引导,难以达到精确重建的目标.近年来,虚拟设计、快速成型、手术导航等数字化技术已广泛应用于下颌骨缺损的重建手术中:术前在数字化软件中对下颌骨肿瘤的切除及下颌骨缺损的重建手术进行精确的个性化设计;术中使用手术导板或手术导航技术辅助将术前设计转化为现实.许多研究结果表明,应用数字化外科技术,可显著提高下颌骨缺损重建的临床治疗效果.本文将结合近年来国内外文献报道及作者课题组临床实践经验,对数字化外科技术在下颌骨缺损重建中的应用进行归纳与总结.

Application of digital surgical techniques in mandibular reconstruction

The mandible is the most important bony support in the lower 1/3 skeleton of the face which is critical for both esthetics and function. Mandibular defects, resulting from tumor resection, can cause severe functional and cosmet-ic deformities. Nowadays, vascularized bony tissue transfer such as free fibula flap has been widely used for mandibular reconstruction. However, traditional mandibular reconstruction based on clinical experience may hawe some problems in accuracy and efficiency because of lacking individualized design. In recent years, digital surgical techniques such as computer-aided design, rapid prototyping and surgical navigation have been used for mandibular reconstruction surgery. Accurate design for tumor resection as well as individualized design for mandibular reconstruction can be performed with computer preoperatively which help to turn the virtual plan into reality by using surgical guide or navigation. Many studies suggested that digital surgical techniques could significantly improve the clinical outcome of mandibular recon-struction. In this article, we summarized the application of digital surgical techniques for mandibular reconstruction based on our own experience and literatures review.