基于术中CT影像的计算机导航技术在颌面深部小异物取出中的应用效果评价

The value of intraoperative image-based navigation in removal of small foreign bodies in maxillofacial trauma

目的:探讨术中CT联合手术导航技术在颌面深部小体积异物取出术中的应用价值。方法:回顾2018年1月—2021年3月中国人民解放军联勤保障部队第九四〇医院收治的7例颌面深部小异物病例,其中,男4例,女3例,异物位于咽旁2例、眼眶1例、颊部1例、咬肌1例、翼内间隙1例、口底1例。根据术中CT影像设计个体化手术方案,术中观察导航系统的实时性和精确性,评价基于术中CT影像的导航技术引导下取出颌面深部异物的有效性。结果:通过微创入路对7例患者进行顺利定位并安全取出异物。术后随访6个月以上,均未出现手术并发症。结论:术中CT联合导航有利于快速精确定位并取出颌面深部小体积异物,实现手术的精确性、微创性和安全性。

PURPOSE:To evaluate the feasibility and effectiveness of combination of intraoperative CT(ICT)and navigation system in removal of foreign bodies in maxillofacial trauma.METHODS:Seven patients with maxillofacial foreign bodies who underwent operation in The 940th Hospital of Joint Logistics Support Force of PLA were retrospectively reviewed from January 2018 to March 2021.Among them,there were 4 males and 3 females.There were 2 foreign bodies in parapharyngeal foreign body,followed by 1 in cheek,1 in orbital cavity,1 in masseter muscle,1 in pterygomandibular space,and 1 in floor of mouth.An individualized surgical plan was designed based on intraoperative CT data and realtime accuracy of the navigation system was investigated.The effectiveness of navigation technology based on intraoperative CT images to guide the removal of deep maxillofacial foreign bodies was evaluated.RESULTS:The minimally invasive approach was used to safely remove foreign bodies in all 7 patients.After 6 months of follow-up,no complications oc-curred.Intraoperative CT combined with real-time navigation improves the accuracy,minimally invasiveness and safety of removal foreign body in the maxillofacial region.CONCLUSIONS:Intraoperative CT scanning is useful in locating the intraoperative position of foreign bodies so that a real-time decision could be made.The technique can improve the accu-racy and treatment outcome.It is recommended to use intraoperative CT associated with navigation in removal of small foreign bodies in maxillofacial region.