An accuracy study of metal surgical template guide assisted mandibular osteotomy in craniofacial microsomia
10.3760/cma.j.cn114453-20201130-00599
- VernacularTitle:金属定位片辅助半面短小畸形下颌骨截骨的精确性研究
- Author:
Byeong Kim SEOP
1
;
Xiaojun CHEN
;
Mengzhe SUN
;
Wenqing HAN
;
Li LIN
;
Yingjie YAN
;
Yonggan ZHU
;
Gang CHAI
Author Information
1. 上海交通大学医学院附属第九人民医院整复外科 200011
- Keywords:
Craniofacial microsomia;
Surgery, computer-assisted;
Osteogenesis, distraction;
Surgical template
- From:
Chinese Journal of Plastic Surgery
2021;37(7):770-776
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility and accuracy of surgical template guides to assist mandibular osteotomies in craniofacial microsomia.Methods:Ten children diagnosed with craniofacial microsomia (Pruzansky Ⅱ) from May 2018 to November 2018, at the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, were selected for this study. First, pre-operative CT scans were prescribed, osteotomy plans were designed by Mimics 19.0, and individualized template guides were manufactured before surgery. Under the guidance of the surgical template, distraction osteotomy of craniofacial microsomia and distractor implantation surgeries were performed until the proposed length was reached. Then, another CT scan was performed. Based on the registration of pre- and post-surgery mandible statistics harvested by Geomagic Control, six points were randomly chosen on the osteotomy surface to estimate deviations, the mean value of which was calculated as distance deviation between the osteotomy surfaces. Meanwhile, the angle between the osteotomy surfaces was considered as angular deviation. Considering the deviation of 2 mm in distance and 5 degrees in angles as references, a single-sample t-test was conducted in SPSS 25.0 and it was considered as statistically significant when P<0.05. Results:A total of 10 children, six males and four females, diagnosed with craniofacial microsomia, with an average age of 4.9 years, were included in this study. The left-to-right ratio of the afflicted mandibles was 3∶7. The implantation surgeries were successfully conducted on all the patients and no complications were observed. All patients underwent follow-up visits for one year. The results were consistent with the pre-surgery designs, including satisfactory effects of distraction osteogenesis, obvious improvements of facial asymmetries, and corrections of occlusal surface inclinations. The deviation distribution before and after the surgeries could be distinctly visualized, in which the deviation of two matching groups of mandibles was (0.94±0.92) mm, the distance deviation between the osteotomy surfaces was (2.05±0.40) mm, and the angular deviation was (4.76±1.95)°. Compared with references, all the deviations were not statistically significant ( P>0.05). Conclusions:Metal surgical template guides are applicable to assist mandibular osteotomies of craniofacial microsomia with relatively high accuracy, which is beneficial to the intraoperative application of preoperative design so that satisfying effects could be achieved after surgeries.
