CAJ | 학술논문

目的评价虚拟现实术前计划用于特发性面肌痉挛导微血管减压术的效果.方法收集33例做虚拟现实术前计划(计划组)和27例未做虚拟现实术前计划(对照组)的特发性面肌痉挛患者的病例资料进行回顾性分析.计划组患者分别行脑血管CT和头颅MRI检查,影像数据输入Vitrea虚拟现实系统进行三维重建,模拟枕下乙状窦后入路显露面听神经复合体,判断责任血管和面神经的空间关系,在术前计划基础上进行面神经微血管减压术.比较2组手术疗效和并发症发生率.结果 2组患者责任血管均为小脑前下动脉,虚拟现实术前计划中面神经与责任血管空间关系清晰显示,责任血管判定结果与术中观察结果一致.计划组和对照组Cohen分级0级比例差异有统计学意义[100.0％(33例)比85.2％(23例)](P=0.036),手术疗效总体良好率差异无统计学意义[100.0％(33例)比85.2％(23例)](P=0.450).并发症总体发生率差异无统计学意义[0.0％比11.1％(3例)](P=0.085).结论虚拟现实术前计划有助于清晰直观地显示面神经与责任血管的空间关系,可提高手术疗效和安全性.
목적 평개허의현실술전계화용우특발성면기경련도미혈관감압술적효과.방법 수집33례주허의현실술전계화(계화조)화27례미주허의현실술전계화(대조조)적특발성면기경련환자적병례자료진행회고성분석.계화조환자분별행뇌혈관CT화두로MRI검사,영상수거수입Vitrea허의현실계통진행삼유중건,모의침하을상두후입로현로면은신경복합체,판단책임혈관화면신경적공간관계,재술전계화기출상진행면신경미혈관감압술.비교2조수술료효화병발증발생솔.결과 2조환자책임혈관균위소뇌전하동맥,허의현실술전계화중면신경여책임혈관공간관계청석현시,책임혈관판정결과여술중관찰결과일치.계화조화대조조Cohen분급0급비례차이유통계학의의[100.0％(33례)비85.2％(23례)](P=0.036),수술료효총체량호솔차이무통계학의의[100.0％(33례)비85.2％(23례)](P=0.450).병발증총체발생솔차이무통계학의의[0.0％비11.1％(3례)](P=0.085).결론 허의현실술전계화유조우청석직관지현시면신경여책임혈관적공간관계,가제고수술료효화안전성.
Objective To evaluate curative effect of microvascular decompression for hemifacial spasm under the direction of virtual reality preoperative plans to observe the relation between responding vessel and facialacoustic nerve complex.Methods CT angiography and head MRI scans were performed in 33 cases suffering hemifacial spasm.Image data was putted into Vitrea virtual reality system to reconstruct and simulate exposure of facial-acoustic nerve complex through suboccipito-retrosigmoidal approach.Spatial relationship between responding vessel and facial nerve was identified to direct microvascular decompression.Patients without preoperative plans were enrolled as control group.Results Visualization effects of spatial relation between facial nerve and responding vessels were good.Anterior inferior cerebellar artery was identified as a responding vessel for all cases in two groups.Cohen grade zero in two groups were different with statistical significance [100.0％ (33 cases)vs 85.2％ (23 cases)] (P =0.036).Statistical significance was not shown regarding incidence of complication [0 vs 11.1％ (3 cases)] (P =0.085).Conclusion Virtual reality preoperative plan is helpful for displaying spatial relation between facial nerve and responding vessel clearly and objectively,which ensures safe and effective results.