CAJ | 학술논문

目的:评价表面配准和解剖标志配准技术在鼻内镜导航手术中应用的优劣.方法:在26例鼻内镜手术中进行导航,从准备时间、靶点误差这2方面比较其差别,并就导航手术的方便程度和应用价值进行分析.结果:26例鼻内镜手术均成功使用影像导航系统,术中均提供了准确的鼻内解剖定位,无并发症发生.表面配准组的平均准备时间为(8.5±1.9)min,解剖标志配准组为(6.5±1.7)min.表面配准组的鼻唇角靶点配准误差为(1.43±0.26)mm,中甲前端附着缘为(1.92±0.47)mm,下甲前端附着缘为(1.82±0.49)mm,下甲后端附着缘为(2.03±0.42)mm.解剖标志配准组中对应的靶点配准误差分别为(1.58±0.35)mm、(2.05±0.37)mm、(1.92±0.31)mm和(2.48±0.64)mm.术者对于导航方便程度的评价总体较高,完全不影响或略影响手术者24例(92.2%).术者认为导航有使用价值或明显使用价值者22例(84.6%),其价值主要与靶点误差值有相关.结论:表面配准方法的精确度要优于解剖标志配准法,但解剖标志配准更简便,准备时间明显短于表面配准方法.Digipointeur导航系统使用方便,手术影响小.导航的价值在于其精细度,在复杂病例中导航的应用价值要高于一般的病例.
목적:평개표면배준화해부표지배준기술재비내경도항수술중응용적우렬.방법:재26례비내경수술중진행도항,종준비시간、파점오차저2방면비교기차별,병취도항수술적방편정도화응용개치진행분석.결과:26례비내경수술균성공사용영상도항계통,술중균제공료준학적비내해부정위,무병발증발생.표면배준조적평균준비시간위(8.5±1.9)min,해부표지배준조위(6.5±1.7)min.표면배준조적비진각파점배준오차위(1.43±0.26)mm,중갑전단부착연위(1.92±0.47)mm,하갑전단부착연위(1.82±0.49)mm,하갑후단부착연위(2.03±0.42)mm.해부표지배준조중대응적파점배준오차분별위(1.58±0.35)mm、(2.05±0.37)mm、(1.92±0.31)mm화(2.48±0.64)mm.술자대우도항방편정도적평개총체교고,완전불영향혹략영향수술자24례(92.2%).술자인위도항유사용개치혹명현사용개치자22례(84.6%),기개치주요여파점오차치유상관.결론:표면배준방법적정학도요우우해부표지배준법,단해부표지배준경간편,준비시간명현단우표면배준방법.Digipointeur도항계통사용방편,수술영향소.도항적개치재우기정세도,재복잡병례중도항적응용개치요고우일반적병례.
Objective:To evaluate the clinical advantage and disadvantage of anatomical landmark registration(ALR) and surface registration(SR) in computer-assisted endoscopic sinus surgery(CAESS).Method:Twenty-six patients were selected for the CAESS, the preparatory times and mean target registration errors (TRE) were recorded in order to compare the difference between them two, their convenience and their value were also analyzed.Result:CAESSs were successfully used in 26 cases without complications. The average preparation time of SR was(8.5±1.9)minutes, that of ALR was(6.5±1.7)minutes. In the SR group, the TRE of naso-labial angle was(1.43±0.26)mm, that of front end of middle turbinate was(1.92±0.47)mm, that of front end of inferior turbinate was (1.82±0.49)mm, and that of back end of inferior turbinate was (2.03±0.42)mm. Them in ALR group were (1.58±0.35)mm,(2.05±0.37)mm,(1.92±0.31)mm and (2.48±0.64)mm ,respectively.24 cases (92.2%) were not affected or were slightly affected by the navigation system. The value of navigation was affirmative in 22 cases (84.6%), and its value was mainly related to TRE.Conclusion:The accuracy of surface registration was superior to that of anatomical landmark registration, but the anatomical landmark registration was more convenient and need less preparation time. The value of navigation system is its accuracy, convenience and no disturbance to surgery. The navigation system is more valuable in the complex cases than that in the general case.