计算机辅助下颌骨髁突外生性骨软骨瘤的手术切除

Computer assisted surgical treatment of exostosis osteochondroma of the mandibular condyle

目的:利用计算机辅助设计(computer assisted designing,CAD)指导下颌骨髁突(mandibular condyle)外生性骨软骨瘤(exostosis osteochondroma)的瘤体切除,并评价其应用效果。方法:8例患者采用Surgicase CMF 5.0软件进行瘤体切除的术前设计。术后将CT数据与术前设计进行融合,并利用SAS8.0软件包对手术前、后髁突形态测量值进行配对t检验,评价手术效果。结果:8例患者瘤体均完整切除,术后髁突形态与术前设计吻合度高,平均误差为(1.82±1.25)mm。结论:计算机辅助设计可于术前合理选择截骨线部位,有助于肿瘤的完整切除及患侧正常部分髁突的保存。

PURPOSE： To use computer assisted design （CAD） technique to help the diagnosis, treatment planning and the postoperative evaluation of exostosis osteochondroma in mandibular condyle, and to evaluate the outcome of the technique. METHODS： Eight patients with exostosis condylar osteochondroma according to the inclusion criteria was selected. Preoperative design of all the patients was done using Surgicase CMF 5.0 software. Postoperative CT data was merged with the preoperative one, and paired t test was done using SAS 8.0 software package to evaluate the preamt the post-operative measurements of the condyle. RESULTS： The tumors in 8 patients were removed successfully. The merge of the preand the post-operative condylar shape showed a good match with a mean error of （1.82±1.25） mm. CONCLUSIONS： Computer assisted surgical planning of exostosis condylar osteochondroma can help the operator to design a proper osteotomy line before operation, and make a better surgical plan in order to resect the tumor entirely, with preservation of the condyle on the affected side. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality （08DZ2271100）, Program for Innovative Research Team of Shanghai Municipal Education Commission, and Scientific Research Foundation for Returned Overseas Chinese Scholars, Ministry of Education.