计算机辅助导航手术在复杂颌面部骨折中的应用新进展

Research progress on the application of computer-assisted navigation surgery in complex maxillofacial fractures

颌面部骨折是口腔颌面部常见的疾病之一,传统的手术治疗依靠术者直视下手法复位后坚固内固定,但由于颌面部解剖结构的复杂性及对面部美观的较高要求,传统手术在恢复复杂的颌面部骨折的功能与美观方面仍存在许多不足。计算机辅助导航手术可以对解剖目标和相关器械进行准确跟踪和直观的实时可视化,对于解决复杂颌面部骨折治疗中的难点有较好的效果,同时也存在一些目前仍未克服的难题值得研究。本文就目前计算机辅助导航手术在不同类型的复杂颌面部骨折中的应用流程、提高手术的精确度的方法、实现微创手术等应用优势、与增强现实和机器人辅助手术的应用差异进行综述,提出需解决精确配准、准确传导术中数据、费用高昂、软组织定位困难等困扰计算机辅助导航手术应用的难题,并对未来计算机辅助导航手术在复杂颌面部骨折中应用的发展进行展望。

Maxillofacial fractures are one of the common diseases of the oral and maxillofacial area.Traditional surgical treatment relies on the rigid internal fixation after the reduction of the operator’s direct-looking technique.However,the treatment of complex maxillofacial fractures by traditional surgery still faces many shortcomings due to the complexity of the maxillofacial anatomy and the high requirements for facial aesthetics.Computer-assisted navigation surgery can provide accurate tracking and real-time visualization of anatomical targets and related instruments,which is more effective in solving the problems in the treatment of complex maxillofacial fractures,but there are still some challenges that can not be overcome and are worth studying.This work reviews the procedures of computer-assisted navigation surgery in different types of complex maxillofacial fractures,the methods to improve the accuracy of surgery,its advantages of achieving minimally invasive surgery,and the differences among the computer-assisted navigation surgery,the augmented reality surgery and the robot-assisted surgery,and propose the challenges that plague the application of computer-assisted navigation surgery,such as precise alignment,accurate conduction of intraoperative data,high costs,and difficulties in soft tissue localization.The future development of the application of computer-assisted navigation surgery in complex maxillofacial fractures is prospected.