摘要：

目的：研究术中计算机断层扫描（intraoperative computed tomography，iCT）技术在颌面部陈旧性骨折手术中的应用价值。方法：选择2019年1月—2020年12月联勤保障部队第九四○医院口腔颌面外科收治的颌面部陈旧性骨折患者19例，所有患者均在全身麻醉下进行骨折内固定以恢复正常咬合关系，并利用iCT检查确认患者骨折复位位置，尤其是对颧弓的突度及对称性、双侧髁突的位置等进行评估，对于复位不佳的骨折断端于术中进行及时调整。结果：有8例（42.1%）患者在进行iCT检查后，因骨折复位不精确而进行了术中二次调整，其余患者在进行iCT检查后均获得满意的复位效果。随访6~12个月后，患者面型及咬合关系良好，无并发症出现。结论：iCT技术可以有效提高颌面部陈旧性骨折修复的手术精确度和准确性，具有一定的应用价值，在临床治疗中值得推广。

关键词: 术中计算机断层扫描, 颌面部陈旧性骨折, 精确性

Abstract:

Objective: To evaluate the application value of intraoperative computerized tomography (iCT) in treatment of maxillofacial old fractures. Methods: A total of nineteen patients with maxillofacial old fractures who underwent the operation at the Department of Oral and Maxillofacial Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2019 to December 2020 were retrospectively reviewed. All patients received internal fixation reduction to recover occlusal relationship under general anesthesia and performed iCT examination to identify the fracture restoration, especially to evaluate the angle and symmetry of the zygomatic arch, as well as the position of bilateral condyle. We adjusted fracture position timely during the operation for inaccurate fracture reduction. Results: There were 8 patients (42.1%) underwent secondary adjustment because of inaccurate fracture reduction after iCT examination, while the remaining patients all achieved satisfactory treatment effect after iCT examination. The facial contour and occlusal relationship of all the patients were acceptable, and there was no complication for 6-12 months follow-up. Conclusion: iCT can improve the surgical precision and accuracy in maxillofacial old fractures treatment, which is useful and worth promoting in clinical treatment.

Key words: intraoperative CT, maxillofacial old fractures, accuracy

中图分类号: 

• R782