《Journal of Oral and Maxillofacial Surgery》 ›› 2017, Vol. 27 ›› Issue (2): 100-105. doi: 10.3969/j.issn.1005-4979.2017.02.005

• Expert Forum • Previous Articles     Next Articles

Digital Virtual Surgical Planning for Large Segmental Mandibular Reconstruction with Vascularised Fibula Flap

MA Dong-Yang, CAO Jian, PANG Chao-Yuan, TIAN wen-Yan, CHEN Jie, ZHANG Wen-Kai   

  1. Department of Oral and Maxillofacial Surgery, Lanzhou General Hospital, PLA Lanzhou Military Command, Lanzhou, 730050, Gansu Province, China
  • Received:2017-02-06 Revised:2017-03-30 Online:2017-04-01 Published:2017-09-29

3D打印技术在血管化腓骨瓣重建下颌骨大型缺损中的应用

马东洋,曹健,庞超远,田文艳,陈杰,张文凯   

  1. 兰州军区兰州总医院口腔颌面外科,甘肃   兰州
  • 通讯作者: 马东洋,副主任医师. E-mail: doctormdy@hotmail.com E-mail:doctormdy@hotmail.com
  • 作者简介:马东洋(1973—),男,宁夏人,副主任医师,博士.
  • 基金资助:

    国家自然科学基金项目(81670969);全军医学科研“十二五”计划项目资助(CWS12J066)

Abstract: Objective: To discuss and compare clinical outcomes between digital virtual surgical planning (VSP) and conventional experience method (CEM) for large segmental mandibular reconstruction using free fibula flap. Methods: A retrospective study was carried out on 15 patients who underwent fibula free flap surgery for mandibular reconstruction from January 2011 to December 2015. Patients were categorized by the type of reconstructive technique: CEM group (n=9, between 2011 and 2014) and VSP group (n=6, 2014 to 2015). Demographics, surgical factors, and clinical outcomes were compared. Results: Compared with cases in CEM group, those in VSP group needed less ischemia time and bony revisions, with better bony contact rate and appearance outcome. The difference between the angle of the mandible before and after operation was smaller in VSP group than in CEM group. There was not statistical significance in patients' mean age, operation time, stay length, and surgical success rate between two groups. Conclusion: Mandibular reconstruction using a VSP technique yielded significantly shorter ischemia time, higher reconstruction accuracy, and better aesthetic outcome.

Key words: virtual surgical planning, fibula flap, mandibular defect, reconstruction

摘要: 目的:比较3D打印技术与基于经验的传统方法,应用于血管化腓骨重建大型下颌骨缺损的临床效果,探讨前者在下颌骨重建中的价值。方法:回顾分析2011—2015间完成的15例血管化腓骨重建下颌骨的临床资料。按照下颌骨截骨与腓骨瓣制备中是否采用3D打印模型指导,分为2组:传统方法组9例(2011—2014年度病例),3D打印技术组6例(2014—2015年度病例)。主要分析一般资料特点,对照2组病例手术相关指标和术后效果评估情况。结果:与传统方法组相比,3D打印技术指导下手术,腓骨离体缺血时间少,修改次数少,骨断端接触面积大,手术前后下颌角的角度差异更小,颌骨外形更加满意;但在患者年龄、手术时间、住院天数、成功率等方面两组间差异无统计学意义。结论:3D打印技术的应用缩短了腓骨缺血时间,提高了截骨及颌骨形态精确度,优化了手术治疗效果。

关键词: 虚拟外科规划, 腓骨瓣, 下颌骨缺损, 重建

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