Application of virtual surgical planning combined with intraoperative navigation in the accurate resection of maxillary tumor and simultaneous reconstruction
10.3760/cma.j.cn114453-20210909-00379
- VernacularTitle:虚拟手术计划联合术中导航辅助上颌骨肿瘤切除及同期修复
- Author:
Kun FU
1
;
Han LU
;
Ning GAO
;
Chaoyan WANG
;
Jinghua CAI
;
Wenlu LI
;
Wei HE
Author Information
1. 郑州大学第一附属医院口腔颌面外科，郑州 450052
- Keywords:
Virtual reality;
Maxilla;
Maxillary neoplasms;
Intraoperative navigation
- From:
Chinese Journal of Plastic Surgery
2022;38(1):46-51
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application of of virtual surgical planning combined with intraoperative navigation in the accurate resection of maxillary tumor and simultaneous reconstruction.Methods:From October 2015 to December 2016, the patients with maxillary tumor treated at the First Affiliated Hospital of Zhengzhou University were included in this study. Before the surgery, the virtual surgical planning was used to complete tumor identification, virtual tumor resection, fibula reconstruction, and then stereomodel was printed for the fabrication of fibular osteotomy guide plate and prebent of personalized titanium mesh. During the operation, navigation technology was used to determine the position of the designed osteotomy line for the accurate resection of maxillary tumor. The bone defect reconstruction was performed using fibular flap guided by osteotomy plate and prebent personalized titanium mesh. Histopathological examination was conducted to evaluate the safety of the surgical boundary. The postoperative color gradient map, self evaluation of facial appearance satisfaction, mouth opening degree and jaw vertical distance were used to evaluate the reconstruction of maxillary defects.Results:A total of 5 patients were enrolled in this study, 3 males and 2 females, with a median age of 39 years old (ranged 27 to 50). Among these cases, 2 were benign tumors and 3 were malignant. The operation of 5 cases was successful and all the fibular flaps were survived. There were 27 frozen pathological examinations, 25 were negative. One patient was treated with both adjuvant biological therapy and radiotherapy. Two patients were treated with only radiotherapy. The color gradient map showed that the position of fibular flap was highly consistent with the pre-operative surgical design. Four patients reported their facial appearance were excellent and one was good postoperatively. The mouth opening degree of the patients was 2.8-3.2 cm. The vertical jaw distance between mandible and fibula repair area was 6.5-10.0 mm. After 14-28 months follow-up, one patient with positive surgical boundary had local recurrence.Conclusions:Virtual surgical planning combined with simultaneous intraoperative navigation can improve the accuracy of maxillary tumor resection and reconstruction, and so as to improve the the quality of life of patients after surgery.
