用计算机辅助设计的患者特定板块的长期板块并发症
Sara Yang1, Zoey Morton2, Mackenzie Sautter3
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.
The Laryngoscope
|July 17, 2024
概括
通过计算机辅助设计 (CAD) 和制造 (CAM) 创建的患者特异板 (PSP) 显示了长期稳定性. 与传统方法相比,板块去除率较低,这表明结果有所改善.
科学领域:
- 口腔和牙面部外科手术
- 重建性手术是一种重建性手术.
- 生物材料工程 生物材料工程
背景情况:
- 部缺陷往往需要复杂的重建,部自由板是一个常见的解决方案.
- 使用计算机辅助设计 (CAD) 和计算机辅助制造 (CAM) 设计的患者专用板 (PSP) 为这些重建提供了量身定制的适应性.
- 在这种情况下,与PSP相关的长期并发症需要彻底评估.
研究的目的:
- 评估使用PSP进行下直骨重建的患者长期板相关并发症的发生率和性质.
- 为了确定影响该患者群体中板块并发症风险的因素.
主要方法:
- 在2010年1月至2022年7月期间,对221名患者进行了回顾性图表审查,这些患者在2010年1月至2022年7月期间用PSP接受了长腿骨自由重建.
- 测量的主要结果是与板相关的并发症,包括板块暴露,骨折,螺丝松动和需要去除板块的需要.
- 进行了统计分析,以确定患者因素,治疗变量和盘子并发症之间的关联.
主要成果:
- 在11%的患者中发生了板块去除,主要是由于暴露 (76%) 或螺丝松动 (24%),平均在手术后17.4个月.
- 作为切除原因的恶性病变,术后放射治疗和手术部位感染与增加板块并发症风险显著相关.
- 在恶性瘤 (OR 9.04) 和手术部位感染 (OR 9.22) 的情况下,几率比率表明板块并发症的风险更高.
结论:
- 通过CAD创建的PSP在大多数接受骨自由下巴重建的患者中表现出长期稳定性.
- 与使用非患者特异性板块的重建相比,板块去除的速度似乎更低.
- 仔细考虑软组织覆盖板的覆盖面,以及对术后感染的积极管理,对于尽量减少并发症至关重要.
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