目的 评价Proplan CMF软件模拟颧骨L型截骨降低术的准确性.方法 将2014年1月至2016年6月收治的26例颧骨颧弓肥大患者的术前及术后1年的CBCT资料导入ProplanCMF软件,重建三维模型并行L型截骨手术模拟,同时选择特征性标志点并建立三维定点测量系统,测量相关指标,并采用单因素方差分析,同时观测术后与模拟软组织的彩色重叠图.结果 骨组织面宽、双侧颧突角及面宽指数术前组分别为(135.45 ±2.45) mm、(102.50±2.60)°、(103.41±2.56)°、1.48±0.05,术后组分别为(128.56 ±2.72) mm、(106.87 ±2.53)°、(108.56 ±3.02)°、1.41 ±0.03,模拟组分别为(129.49 ±2.26) mm、(108.68 ±2.40)°、(108.85±3.02)°、1.42 ±0.03,术后组、模拟组分别与术前组比较,差异均有统计学意义(P＜0.05),而术后组与模拟组比较,差异无统计学意义.软组织颧弓间距:术前组为(153.25 ±2.58) mm,术后组为(150.23 ±2.76) mm,模拟组为(149.36±3.27)mm,组间比较差异均无统计学意义(P＞0.05);颧突间距及双侧颧突耳屏距:术前组分别为(120.16±3.18) mm、(74.58±3.19)mm和(76.14±3.15) mm,术后组分别为(126.35±2.56)mm、(68.75±2.15) mm和(68.86±3.21) mm,模拟组分别为(118.86±3.45) mm、(73.85±3.57) mm和(76.87±2.58)mm,术后组分别与术前组和模拟组比较,差异均有统计学意义(P＜0.05),说明软件对于骨组织面宽、面宽指数、颧突角及软组织颧弓间距预测较准确,而对于软组织颧突间距及颧突耳屏距预测准确性稍差;同时彩色重叠图显示颧突区预测准确性稍差,而颧弓区等其他部位预测准确性较高.结论 Proplan CMF软件对于颧骨颧弓肥大患者手术预测准确性较高,而软组织颧突区预测准确性则稍差,还有待于进一步研究与改进.%Objective To evaluate the surgical prediction accuracy of Proplan CMF software for zygomatic reduction surgery using L-shaped osteotomy.Methods Pre-and-postoperative 1-year CBCT data of 26 patients with zygomatic arch hypertrophy were imported in Proplan CMF software during 2014 Jan.to 2016 Jun.,the 3D models were reconstructed for simulation of L-shaped osteotomy,characteristic landmarks were selected and 3D point measurement system was established.The measurement result were analyzed by one-way ANOVA.Meanwhile,the overlap color grading charts of preoperative and simulated images were also observed.Results The facial width,bilateral zygomatic process angle and facial width index were [(128.56 ± 2.72) mm,(106.87 ± 2.53)°,(108.56 ± 3.02) °and 1.41 ± 0.03] in postoperative result,[(129.49 ± 2.26) mm,(108.68 ± 2.40) °,(108.85 ± 3.02) o and 1.42 ± 0.03] in simulated result and [(135.45±2.45) mm,(102.50 ±2.60)°,(103.41 ±2.56)°and 1.48 ±0.05] in preoperative result,with significant difference between preoperative and postoperative result,or between preoperative and simulated result (P ＜ 0.05),while no significance between postoperative and simulated result (P ＞0.05).The soft tissue zygomatic process distance was (153.25 ± 2.58) mm in preoperative result,(150.23 ± 2.76) mm in postoperative result,(149.36 ± 3.27) mm in simulated result,with no significance between any of two groups result (P ＞ 0.05).The zygomatic process distance and bilateral zygomatic process tragal distance were (126.35 ± 2.56) mm,(68.75 ± 2.15) mm and (68.86 ± 3.21) mm in postoperative result,showing significant differences compared with preoperative result [(120.16 ± 3.18) mm,(74.58±3.19) mm and(76.14±3.15) mm] and simulated result [(118.86±3.45) mm,(73.85 ±3.57) mm and(76.87 ±2.58) mm] respectively(P ＜0.05),while zygomatic arch distance was not statistically different among the three groups(P ＞ 0.05).It indicated that predictive accuracy of facial width,facial width index,zygomatic process angle,soft tissue zygomatic arch distance was high but the soft tissue zygomatic process distance and zygomatic process tragal distance was relatively low.Meanwhile,the color overlay image showed that predictive accuracy was not good in the zygomatic region while the zygomatic arch area was high.Conclusions The predictive accuracy of Proplan CMF software for zygomatic arch hypertrophy is relatively high except for the zygomatic region.Further improvement of the CMF software is needed.
展开▼
