利用CBCT诊断及指导手术治疗下颌骨骨折
Advances in Application of CBCT in Diagnosis and Treatment Designing of Mandible Fracture

作者: 赖仁发 , 赵清桐 , 沈 山 :暨南大学附属第一医院,口腔医疗中心,广州;

关键词: 下颌骨骨折移位CBCT治疗Mandible Fracture Displacement CBCT Operation

摘要:
目的:探讨CBCT对诊断及指导外科手术治疗下颌骨骨折的临床意义。方法:通过临床典型病例,分析下颌骨骨折发生时作曲面断层片检查易造成漏诊/误诊,CBCT能从冠状位、轴向位、矢状位等不同的角度及方向观察颌骨骨折端。结果:CBCT能清晰了解骨折线走向及断端与骨折碎片的移位情况,能指导外科手术治疗骨折的复位与作内固定。CBCT三维重建有益颌面外科制定手术计划。
Purpose: This paper is to illustrate and discuss the importance of cone beam computed tomography for ac- curate diagnose of mandible fracture and for the guidance of the operation designing. Method: A case of maxillofacial trauma was used for this report. A 38-year-old male patient was referred to Oral and Maxillofacial Department with a history of maxillofacial trauma. The history of patient revealed a traumatic injury on his face because worksite acci- dence. The patient as initially examined and diagnosed mandible fractures by a 2D panoramic film, but there isn’t any information about the displacement of the fracture ends and we don’t know the 3D structure about fracture ends. Therefore the 3D (CBCT) was performed. Results: Cone beam computed tomography (CBCT) images can offer an accurate diagnosis; it can show the displacement of the fracture end, it can also give the surgeon a useful guidance for the operation process. Conclusion: CBCT is a useful tool for making an accurate diagnosis of maxillofacial trauma and can guide the operation.



Abstract:

文章引用: 赖仁发 , 赵清桐 , 沈 山 (2012) 利用CBCT诊断及指导手术治疗下颌骨骨折。 亚洲外科手术病例研究, 1, 1-4. doi: 10.12677/ACRS.2012.11001

参考文献

[1] Liang, X ; Jacobs, R; Hassan, B. et al. A comparative evaluation of Cone Beam Computed Tomography (CBCT) and Multi-Slice CT (MSCT) Part I. On subjective image quality, EUROPEAN JOURNAL OF RADIOLOGY, 2010, 75(2): 265-269.

[2] Kagawa T,Fukunari F,Shiraishi T,et al. Development of a simple image viewer designed for small X-ray field CT equipment 3DX. Oral Radiol,2006,22( 2) : 47-51.

[3] Lai, R, Zou H, Kong W. et al. The Applied Anatomic Site Study of the Palatal Anchorage Implants Using Cone Beam Computed Tomography, International Journal of Oral Science, 2010, 2(2):98-104.

[4] Wilson IF, Lokeh A, Benjamin CI, et al. Contribution of conventional axial computed tomography ( nonhelical) , in conjunction with panoramic tomography ( zonography) ,in evaluating mandibular fractures. Ann Plast Surg,2000,45( 4) : 415-421.

[5] Yajima A,Otonari-Yamamoto M,Sano T,et al. Cone-beam CT ( CBThrone) applied to dentomaxillofacial region. Bull Tokyo Dent Coll,2006,47( 3) : 133-141.

[6] Honey OB, Scarfe WC, Hilgers MJ, et al. Accuracy of cone-beam computed tomography imaging of the tmporomandibular joint:Comparisons with panoramic radiology and linear tomography [J]. Am J Orthod Dentofacial Orthop, 2007, 132(4):429-438.

[7] Ikeda K, Kawamura A. Assessment of optimal condylar position with limited cone-beam computed tomography [J].Am J Orthod Dentofacial Orthop, 2009, 135(4):495 -501.

[8] Honda K, Bjornland T. Image-guided puncture technique for the superior temporomandibular joint space:Value of cone beam computed tomography(CBCT) [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(3):281-286.

[9] Ludlow JB, Ivanovic M: Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Surg Oral Med Oral Pathol Oral Radiol Endod 2008, 106:106-14.

[10] Klatt, J.; Heiland, M.; Blessmann, M.; et al. Clinical indication for intraoperative 3D imaging during open reduction of fractures of the neck and head of the mandibular condyle, JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 2011, 39(4): 244-248.

[11] Kijima N, Honda K, Kuroki Y, et al. Relationship between patient characteristics, mandibular head morphology and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints [J]. Dentomaxillofac Radiol,2007, 36(5):277-281.

分享
Top