计算机辅助设计和制作技术在髁突骨软骨瘤合并颌骨畸形治疗中的应用:附1例报告

Application of computer-assisted design and manufacture technique in the treatment of condylar osteochondroma combined with jaw bone deformity:report of a case

目的:探讨计算机辅助设计与制作(computer-aided design/manufacture,CAD/CAM)技术在髁突骨软骨瘤合并颌骨畸形治疗中的应用。方法:髁突骨软骨瘤合并上、下颌骨畸形1例,采用计算机辅助设计技术(SurgiCase CMF 5.0软件进行CT数据处理)模拟切除肿瘤,上、下颌骨截骨,设计虚拟中间和终末板及截骨导板,并进行术后效果预测;应用快速原型(rapid prototyping,RP)技术制作中间板和截骨导板,术中应用。术后进行CT检查,并与术前设计进行比较,评价应用效果。结果:术后CT显示,截骨效果与术前设计吻合度高,术后随访6个月肿瘤无复发,患者面形对称。结论:应用CAD/CAM技术进行髁突肿瘤切除及合并颌骨不对称畸形的辅助治疗,可以提高手术的准确性,节约手术时间,具有一定的应用前景。

PURPOSE：To discuss the application of CAD/CAM technique in the treatment of condylar osteochondroma accompanying with oral-maxillofacial bone deformity.METHODS：Pre-operational planning of a patient with condylar osteochondroma was conducted,maxillary and mandibular bone deformities was performed with CAD technique（Surgicase CMF 5.0 based on CT data）,including virtual tumor resection,virtual osteotomy,virtual occlusal plate/osteotomy template designing and post-operative simulation.RP technique was used to make occlusal plates and osteotomy templates.Postoperative CT scan was performed and merged with the operation plans to evaluate the accuracy.RESULTS：Postoperative CT showed the effect of the operation matched with the preoperative planning well.The face of the patient was symmetrical 6 months after operation,there was no sign of recurrence.CONCLUSIONS：The pre-operative application of CAD/CAM technique can improve the accuracy of the tumor resection of the condyle and the correction procedure of facial asymmetry,as well as saving operating time.