數(shù)字化手術導板輔助下頜骨腫瘤切除及缺損重建對早期顳下頜關節(jié)功能影響的評價性研究

數(shù)字化手術導板輔助下頜骨腫瘤切除及缺損重建對早期顳下頜關節(jié)功能影響的評價性研究摘要：目的：探討數(shù)字化手術導板輔助下頜骨腫瘤切除及缺損重建對早期顳下頜關節(jié)功能的影響，并評價其臨床應用價值。方法：選取2017年1月至2020年12月在我院進行頜骨腫瘤切除及缺損重建手術患者63例，其中數(shù)字化手術導板組33例，常規(guī)手術治療組30例，比較兩組術后早期顳下頜關節(jié)功能情況。結果：數(shù)字化手術導板組頰骨缺損修復精度高，顳下頜關節(jié)運動度明顯優(yōu)于常規(guī)手術治療組(P<0.05)。數(shù)字化手術導板組術后6個月顳下頜關節(jié)功能恢復優(yōu)于常規(guī)手術治療組(P<0.05)。數(shù)字化手術導板輔助下頜骨腫瘤切除及缺損重建臨床應用價值顯著。結論：數(shù)字化手術導板輔助下頜骨腫瘤切除及缺損重建可以精確修復頰骨缺損，術后早期對顳下頜關節(jié)功能影響小，是一種安全、可靠的手術方法，值得臨床推廣。

關鍵詞：數(shù)字化手術導板；頜骨腫瘤切除；缺損重建；顳下頜關節(jié)功能；臨床應用

Abstract:Objective:Toinvestigatetheeffectsofdigitalsurgicalguideplateassistedmandibulartumorresectionanddefectreconstructiononearlytemporomandibularjointfunctionandevaluateitsclinicalapplicationvalue.Methods:Sixty-threepatientsundergoingmandibulartumorresectionanddefectreconstructionsurgeryinourhospitalfromJanuary2017toDecember2020wereselected,including33casesinthedigitalsurgicalguideplategroupand30casesintheconventionalsurgerygroup.Theearlypostoperativetemporomandibularjointfunctionofthetwogroupswascompared.Results:Theaccuracyofcheekbonedefectrepairandtherangeofmotionoftemporomandibularjointinthedigitalsurgicalguideplategroupweresignificantlyhigherthanthoseintheconventionalsurgerygroup(P<0.05).Therecoveryoftemporomandibularjointfunctioninthedigitalsurgicalguideplategroupwasbetterthanthatintheconventionalsurgerygroupat6monthsaftertheoperation(P<0.05).Theclinicalapplicationvalueofdigitalsurgicalguideplateassistedmandibulartumorresectionanddefectreconstructionwassignificant.Conclusion:Digitalsurgicalguideplateassistedmandibulartumorresectionanddefectreconstructioncanaccuratelyrepaircheekbonedefects,withlittleimpactonearlypostoperativetemporomandibularjointfunction.Itisasafeandreliablesurgicalmethodthatdeservesclinicalpromotion.

Keywords:digitalsurgicalguideplate;mandibulartumorresection;defectreconstruction;temporomandibularjointfunction;clinicalapplicatioInconclusion,theuseofdigitalsurgicalguideplatesinmandibulartumorresectionanddefectreconstructionisasafeandeffectivetechnique.Withitshighaccuracy,thisapproachcanleadtoasignificantreductioninthedamagetosurroundingtissuesduringthesurgicalprocedure.Furthermore,theuseofdigitalplanningandguideplatesallowsforamorepredictableoutcome,withlessdeviationfromtheintendedsurgicalplan.

Therestorationofjawfunctionandestheticsisofparamountimportanceaftersurgery.Ourresultsconfirmedthatthedigitalsurgicalguideplateapproachhaslittleimpactonearlypostoperativetemporomandibularjointfunction.Thisleadstoimprovedpatientsatisfactionandqualityoflife.

Althoughourstudyhasdemonstratedpositiveclinicaloutcomes,largerprospectivestudiesandlongerfollow-upperiodsarerequiredtoconfirmthetechnique'ssafetyandefficacy.Thedigitalsurgicalguideplatetechniquehastremendouspotentialforwidespreadclinicalapplicationinmandibulartumorresectionanddefectreconstruction.ItisareliableandpracticaloptionforsurgeonstoprovidebettercareforpatientswithmandibulartumorsInadditiontotheclinicalbenefitsofthedigitalsurgicalguideplatetechnique,therearealsopotentialeconomicbenefits.Withtheuseofthistechnique,surgeonsmaybeabletoreducesurgerytimesanddecreasetheneedforspecializedsurgicalinstrumentsorequipment,ultimatelyleadingtoreducedcosts.Furthermore,theuseofcomputer-aideddesignandmanufacturingtechnologymayimprovetheprecisionandaccuracyofsurgicalprocedures,potentiallyreducingtheneedforrevisionsurgeriesandassociatedcosts.

Anotherpotentialbenefitofthistechniqueisimprovedpatientsatisfactionandqualityoflife.Mandibulartumorscanhaveasignificantimpactonapatient'sphysicalappearance,speech,andabilitytochewandswallow.Byusingthedigitalsurgicalguideplatetechnique,surgeonsmaybeabletoachievemorepredictableandaestheticallypleasingresults,leadingtoimprovedpsychologicalwell-beingandoverallqualityoflifeforpatients.

However,therearealsopotentiallimitationsandchallengesassociatedwiththeuseofthistechnique.Onepotentiallimitationisthenecessityforexperiencedandskilledsurgeonswhoarefamiliarwithcomputer-aideddesignandmanufacturingtechnology.Additionally,theupfrontcostsassociatedwithacquiringthenecessaryequipmentandsoftwaremaybeabarriertoimplementationinsomehealthcaresettings.Therearealsopotentialchallengesassociatedwithpatient-specificanatomicalvariationsandabnormalities,whichmayrequireadditionalsoftwaremodificationsorcustomizationofthesurgicalguideplate.

Inconclusion,thedigitalsurgicalguideplatetechniqueisapromisingnewapproachformandibulartumorresectionanddefectreconstruction.Itsclinicalbenefitsincludeincreasedaccuracy,shortersurgerytimes,andreducedbloodloss.Italsohasthepotentialtoimprovepatientsatisfactionandqualityoflife,andmayhaveeconomicbenefitsintermsofreducedcosts.However,furtherresearchisneededtoconfirmitssafetyandefficacy,andtoidentifypotentiallimitationsandchallengesassociatedwithitsuse.Withcontinuedtechnologicaladvancementsandincreasedadoptionbysurgicalteams,thedigitalsurgicalguideplatetechniquehasthepotentialtobecomeawidelyusedapproachformandibulartumorresectionandreconstructionInadditiontoitspotentialbenefitsinmandibulartumorresectionandreconstruction,thedigitalsurgicalguideplatetechniquemayalsohaveapplicationsinothersurgicalprocedures.Forexample,similartechniquescouldbeusedinorthopedicsurgeriesinvolvingbonefracturesorjointreplacements,whereprecisecuttingordrillingisnecessaryforoptimalresults.Byusing3Dimaginganddigitaldesigntoolstocreatepersonalizedsurgicalguides,surgeonscouldperformprocedureswithgreateraccuracyandefficiency,ultimatelyimprovingpatientoutcomes.

However,therearealsopotentiallimitationsandchallengesassociatedwiththeuseofdigitalsurgicalguideplates.Onemajorconcernisthepotentialforerrorsorinaccuraciesinthedesignorimplementationprocess.Ifasurgicalguideisnotcreatedorplacedcorrectly,itcouldresultinincorrectcutsorplacementofimplants,whichcouldhaveseriousnegativeconsequencesforthepatient.Additionally,theremaybesignificantcostsassociatedwiththeuseofdigitaltechnology,whichcouldlimititsavailabilitytocertainpatientsorhealthcaresystems.

Overall,thedigitalsurgicalguideplatetechniquerepresentsanexcitingadvancementinsurgicaltechnology.Byprovidingsurgeonswithahighlypersonalizedandprecisetoolformandibulartumorresectionandreconstruction,itha