基于混合现实的手术导航系统在颅颌面创伤骨整复中的应用研究

目的 搭建基于混合现实（MR）及红外光学定位的手术导航系统，并评估其在颅颌面创伤骨整复中的临床适用性。 方法 集成基于MR技术和光学定位追踪的软硬件系统，并完善系统工作流程；通过3D打印头颅模型实验，分析该系统的系统误差、目标配准误差和截骨应用误差；进一步通过颧上颌骨复合体（ZMC）复位的模型实验和额骨缺损修复的初步临床应用，探讨该系统的适用性。 结果 本MR手术导航系统的系统误差为（1.23±0.52）mm，目标配准误差为（2.83±1.18）mm，截骨应用误差为（3.13±1.66）mm；ZMC模型虚拟手术规划流畅，复位顺利；本系统引导下的额骨缺损修复重建手术过程顺利，重建效果满意。 结论 本研究搭建的MR手术导航系统具有虚实融合效果佳、动态导航稳定性好的优点，其在颅颌面外科的医患沟通、医学教育、术前规划和术中导航等各方面都具有应用潜力。

Application of mixed reality-based surgical navigation system in craniomaxillofacial trauma bone reconstruction

Objective This study aimed to build a surgical navigation system based on mixed reality (MR) and optical positioning technique and evaluate its clinical applicability in craniomaxillofacial trauma bone reconstruction. Me-thods　We first integrated the software and hardware platforms of the MR-based surgical navigation system and explored the system workflow. The systematic error, target registration error, and osteotomy application error of the system were then analyzed via 3D printed skull model experiment. The feasibility of the MR-based surgical navigation system in craniomaxillofacial trauma bone reconstruction was verified via zygomatico-maxillary complex (ZMC) reduction experiment of the skull model and preliminary clinical study. Results The system error of this MR-based surgical navigation system was 1.23 mm±0.52 mm, the target registration error was 2.83 mm±1.18 mm, and the osteotomy application error was 3.13 mm±1.66 mm. Virtual surgical planning and the reduction of the ZMC model were successfully conducted. In addition, with the guidance of the MR-based navigation system, the frontal bone defect was successfully reconstructed, and the clinical outcome was satisfactory. Conclusion The MR-based surgical navigation system has its advantages in virtual reality fusion effect and dynamic navigation stability. It provides a new method for doctor-patient communications, education, preoperative planning, and intraoperative navigation in craniomaxillofacial surgery.