计算机导航技术辅助眼眶骨折整复术

目的探讨计算机导航辅助手术技术应用于眼眶骨折整复术中的有效性与实用性。方法对16例（16眼）眼眶骨折施行计算机导航辅助下的眼眶骨折整复术。术前获取患者眼眶CT影像学资料，输入计算机导航系统，进行手术设计及手术演练，术中在导航系统辅助下行眶壁骨折整复、羟基磷灰石骨板填充及羟基磷灰石复合材料修复眶缘。对骨折复位情况、影像学资料、眼位、眼球突出度、手术进程及其并发症进行分析。结果所有患者术前设计及术中计算机导航辅助手术过程顺利，术后骨折复位满意。术前16例均有眼球内陷，术后10例完全矫正，4例基本矫正，2例改善。术前9例复视，术后4例完全矫正，3例改善，2例无明显变化。术前7例眼球运动受限，术后5例恢复正常，2例改善。未出现术后视力丧失等严重并发症。结论计算机导航技术应用于眼眶骨折整复术，可实现术中动态跟踪、实时导航，可显著提高手术的精确性与安全性，降低手术并发症。

Application of computer avigation technique for assisting surgery of orbital fracture.

Objective To discuss the efficacy and utility of computer navigation technique in assisting diorthosis in orbital fractue. Methods Diorthosis assisted by image-data-based computer navigation were performed on 16 patients with orbital fracture. Be- fore the operation, image-data （ CT scan and 3-D reconstruction） of the patients were input into the computer navigation system （ Vector Vision Cranial/ENT BrainLAB）. The schemes and processes of the operation were planned and practiced on the navigation system. All the patients were performed diorthosis and hydroxyapatite （HA） complex implantation by using of the wireless passive infra-red light computer navigation system. The clinical outcomes and image data were recorded and analyzed. Results The processes of pre-operation planning and intraoperative navigation were successfully. In these 1 6 patients, enophthalmus was corrected in 14 cases and improved in the rest 2 patients postoperatively. Preoperatively, 9 of 1 6 patients had diplopia. The diplopia was disappeared in 4 patients and improved in 3 patients postoperatively. The other 2 had no significant changes. Restriction of duction was founded in 7 patients preoperatively. It was recovered in 5 patients, and improved in 2 patients postoperatively. No serious complications such as optic nerve lesion and vision loss were observed. Conclusion Computer navigation system is a feasible technique in assisting diorthosis in orbital fracture.