The effect of computer-aided navigation technology combined with personalized three-dimensional printing in the reduction and fixation of the multiple midface fractures
10.3760/cma.j.cn114453-20211229-00490
- VernacularTitle:三维打印联合计算机导航技术在面中部多发性骨折治疗中的应用效果
- Author:
Shiheng SU
1
;
Kaiyue LI
;
Honghao WANG
;
Yukun HU
;
Jun HOU
;
Haowei XUE
Author Information
1. 安徽医科大学第一附属医院口腔颌面外科，合肥 230022
- Keywords:
Computer-aided design;
Computer-aided navigation technology;
Three-dimensional printing;
Midface;
Fracture reduction
- From:
Chinese Journal of Plastic Surgery
2022;38(10):1139-1147
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the computer-aided navigation technology combined with personalized three-dimensional(3D) printing in the reduction and fixation of the multiple midface fractures.Methods:A retrospective analysis was performed on clinical data of patients suffering from multiple midface fractures treated at the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University from August 2019 to December 2021. According to the operational method, the patients in the experimental group received the operation applied by AccuNavi-A 2.1 navigation software for surgical planning and surgical simulation, printing 3D head model before the operation, and reducing and fixing fractures with the aid of computer navigation technology. Patients in the control group received the operation applied by traditional surgery. Marking facial landmarks on the head CT 3D model of patients and constructing a spatial coordinate system before and 1 week after surgery, measuring and calculating the facial asymmetry index (AI) for each landmark, including the orbitale (O), the most outside of the zygomaticomaxillary suture of the 1/3 below of the margo infraorbitalis(MZ), the most concave point between the frontal process of zygomatic bone and the superior margin of processus temporalis(C), the most concave point of the superjacent of C of posterior margin of frontal process(SC) and the outermost point of zygomatic arch(Z). The duration of operation were recorded. Complications including diplopia, difficulty in mouth opening, facial numbness, malocclusion, scarring and pupil height were evaluated by patents 3 months after the operations. AI is represented by M( Q1, Q3), Wilcoxon rank test was used for intra-group comparison before and after operations, and Mann-Whitney U test was used for comparison between two groups. Operation time was represented by Mean±SD, and t-test was used for comparison between two groups. The result of self-assessment of patients’ complications are expressed as cases (%), and the chi-square test or Fisher’s exact test was used. Results:A total of 32 patients were included. There were 16 patients in the experimental group, 9 males and 7 females, aged 17-60 years. There were 16 patients in the control group, 8 males and 8 females, aged 18-65 years. The preoperative O, MZ, C, SC, and Z point in the experimental group were 8.9(6.9, 12.8), 10.0(7.7, 12.6), 7.6(5.9, 14.9), 10.7(7.2, 22.0), 11.2(10.1, 17.4), and 2.2(1.6, 3.4), 2.5(1.7, 3.4), 2.2(1.9, 2.9), 2.6(1.7, 3.1), 2.4(1.4, 2.8). The preoperative O, MZ, C, SC, and Z point in control group were 10.4(8.1, 12.5), 10.5(9.0, 12.6), 6.6(5.3, 8.2), 10.6(8.7, 13.1), 10.9(9.8, 13.4), and the postoperative were 4.0(3.6, 4.8), 4.3(3.8, 5.4), 5.2(4.8, 6.7), 4.3(3.1, 5.1), 4.6(3.2, 5.3). There was no significant difference in AI of each marker point between the two groups before surgery ( P>0.05). The AI of each landmark in the two groups was reduced after operation compared with that before operation to some extent ( P<0.01 or 0.05). The AI of each landmark in the experimental group was significantly lower than that in the control group( P<0.01). The operation time of the experimental group[(3.7±1.1) h] was shorter than that of the control group[(4.8±1.9) h] ( P<0.05). The incidence of scar[12.5% (2/16)] and inconsistent pupil height[6.3% (1/16)] in the experimental group was lower than that in the control group [43.8% (7/16), 37.5% (6/16)] ( P<0.05). And there was no significant difference in other items ( P>0.05). Conclusions:The computer-aided navigation technology combined with personalized 3D printing can shorten the time of operation, expedite the patients’ facial recovery with more symmetry and less likely to have complications.
