论文部分内容阅读
目的 :评估采用术中实时导航技术,经口内或口外小切口截除过长茎突以治疗茎突综合征的可行性、准确性与便利性,并评价导航外科技术治疗茎突综合征的临床效果。方法:选取12例有明显临床症状并已确诊的茎突综合征患者。术前将患者头颅影像学Dicom数据输入导航系统工作站,进行标记和手术设计;术中在导航实时辅助下,经口内咽旁入路(保留扁桃体)或颈部小切口入路,按设计精确切除过长茎突。术后对手术出血量、手术时间、住院时间、茎突切除长度等进行记录与测量,与以往未采用导航辅助的经典术式的相应指标进行比较;对患者进行为期3个月的随访,运用视觉模拟量表(visual analog sclaes,VAS)对导航辅助下切除茎突的患者于术前、后症状进行比较,评估手术效果。采用SPSS 19.0软件包对数据进行统计学分析。结果:在计算机导航技术辅助下,采用咽旁入路和颈部小切口入路成功截除12例患者的17个过长茎突,未出现明显并发症。手术中平均出血量为(22.50±8.54)m L,平均手术时间为(40.35±11.81)min,茎突切除长度平均为(21.93±14.26)mm。平均出血量和平均手术时间均显著低于未采用导航辅助茎突切除的患者。经术后3个月随访,VAS量表统计显示,所有患者的临床症状均明显减轻,其中10例患者症状明显好转,2例患者症状改善。结论:导航外科技术可用于经小切口辅助精确截除过长茎突以治疗茎突综合征,可以使切除过程更加精准,避免切除扁桃体及损伤重要邻近组织,手术创伤小,出血量少,手术时间短,患者术后症状明显改善,是一种更为安全有效的治疗方法。
PURPOSE: To assess the feasibility, accuracy and convenience of using intraoperative real-time navigation techniques to cut the long styloid via the small incision through the mouth or outside the mouth for the treatment of styloid syndrome. The clinical application of navigation and surgical techniques in the treatment of styloid syndrome effect. Methods: Twelve patients with obvious clinical symptoms and diagnosed styloid process syndrome were selected. Before operation, the Dicom data of craniofacial imaging were input to the navigation system workstation for marker and operation design. During the operation, with the help of real-time navigational guidance, the parapharyngeal approach (preserving the tonsils) or the neck incision Long styloid process. Surgical bleeding, operation time, hospitalization time, length of resection of styloid and so on were recorded and measured after operation, compared with the corresponding indexes of classic operation without navigation aid in the past. The patients were followed up for 3 months, Visual analog sclaes (VAS) were used to assess the effect of surgery on patients who underwent navigation aids in resection of the styloid process before and after surgery. Data were statistically analyzed using SPSS 19.0 software package. Results: With the help of computer navigation technique, 17 long styloid processes of 12 patients were successfully cut off by parapharyngeal approach and small incision of neck. No obvious complication occurred. The average amount of bleeding in operation was (22.50 ± 8.54) m L, the average operation time was (40.35 ± 11.81) min, the average length of resection of styloid process was (21.93 ± 14.26) mm. The average amount of bleeding and the average operative time were significantly lower than those who did not use navigation aid resection of the styloid process. After 3 months of follow-up, the VAS scale showed that the clinical symptoms of all patients were significantly reduced. Among them, the symptoms of 10 patients improved significantly and the symptoms of 2 patients improved. CONCLUSIONS: Navigational surgery can be used to accurately cut off the long styloid process in the treatment of styloid process syndrome by small incision. It can make the resection process more accurate, avoid the removal of tonsils and damage of vital adjacent tissues, less operation trauma, less bleeding, Short time, the patient’s symptoms improved significantly, is a more safe and effective treatment.