| Objective1.Through digital reconstruction and measurement techniques,we clarified the type and extent of deformity present in patients with Treacher-Collins syndrome before they received treatment,and surgical treatment modalities for patients at this stage were provided through digital surgical simulation and design techniques.By summarizing the experience of each stage of treatment,we could conclude a comprehensive serial treatment of Treacher-collins syndrome based on digital technology.2.To validate the precision of the craniomaxillofacial plastic surgery robot modified by UR5 synergistic industrial robot for floating frontal flap in congenital craniosynostosis surgery through model surgical experiments combined with digital measurement techniques,and to summarize the experience,analyze and predict its possible complications in clinical practice.To verify the accuracy and safety of this robot in large animal craniotomy(frontal bone opening surgery),we observed the postoperative recovery and complication rate of animals through animal experiments combined with digital measurement techniques.By summarizing the experience of the robot in model surgical experiments and animal experiments.we can analyze the feasibility of its application in the surgical treatment of congenital craniosynostosis and provide the relevant foundation for further research.Method1.A total of 14 patients with Treacher-Collins syndrome in CraniomaxillofacialCenter,Plastic Surgery Hospital,Chinese Academy of Medical Sciences from September 2012 to March 2023 were included in the study.Through digital technology,the type and extent of the patient’s deformity was clarified,the patient was provided with the appropriate digital surgical design according to his age group,and the surgery was performed according to the surgical design.We summarized the treatment model and experience of each stage,evaluated the treatment effect,and came up with a comprehensive serial treatment strategy for Treacher-Collins syndrome based on digital technology2.The medical records of patients with simple congenital craniosynostosis in Craniomaxillofacial Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences from September 2017 to November 2022 were selected and their preoperative full-head CT data were extracted in five cases,as well as the full-head CT data of three healthy Bama minipigs.The full-head CT data of five patients and three experimental animals were reconstructed,and after 3D printing the cranial plaster model,the craniomaxillofacial plastic surgery robot was used to perform floating frontal bone flap on the patient’s head model and craniotomy on the animal’s head model.After the surgery,CT scans and 3D reconstructions were performed for each model,and the measurements were analyzed and compared with the digital surgical simulation to verify the accuracy and stability of the robot.We summarized the model surgical experiments and animal experiments,and explored the prospect of craniomaxillofacial plastic surgery robot in the treatment of congenital craniosynostosis and its accuracy.Results1.All patients included in the study who underwent surgery based on digital technology achieved significant postoperative morphological and functional improvements.Patients who underwent a serial of comprehensive digitally-based treatment protocols showed greater improvement in shape than those who underwent only single-stage surgery.These patients underwent digital technology-assisted Mandibular distraction osteogenesis,autologous fat grafting,external ear and external ear canal repair and reconstruction,orbito-zygomatic reconstruction,and orthognathic surgery at their respective ages,without serious postoperative complications detected and patients were satisfied with their treatment results.2.The results of postoperative CT reconstruction were compared with the surgical design,and the length change of the osteotomy line and the angular change of the osteotomy plane were compared,and it was found that the length change of the osteotomy line in the model surgical experiment was(0.63±0.81 mm),and the length error of the osteotomy line in the animal experiment was(0.55±0.74 mm),which indicated a slight outward shift of the osteotomy line than the surgical simulation one.We believe that this is the result of bone consumption during piezosurgery osteotomy,which can be improved by reducing the width of it.The angular change of the osteotomy plane was(1.8±2.4°),There was no statistically significant difference in length error and angle error between the groups(p>0.05),indicating that the surgical robot has a certain degree of accuracy and stability in model surgery.In addition,all animals survived well without significant complications,and the osteotomy lines healed well and they were executed at 3 months postoperatively.When comparing the results of their postoperative CT reconstruction with the surgical design and model surgical experiments,still no statistically significant differences were found(p>0.05).indicating that the surgical robot also demonstrated a certain degree of accuracy.stability and safety in live animal experiments.Conclusion1.Digital technology can provide appropriate surgical treatment strategies for patients with Treacher-Collins syndrome at all stages for both physicians and patients.A comprehensive serial treatment of Treacher-Collins syndrome based on digital technology can improve the precision of surgery for patients at all their ages,reduce the trauma associated with surgery,and at the same time deepen the knowledge of both the doctor and the patient about the current stage of treatment.2.The craniomaxillofacial plastic surgery robot showed good stability and accuracy in both the congenital craniosynostosis surgical experiment and the animal craniotomy experiment on the models,and its safety was also demonstrated in the animal experiment,showing the prospective of the application of this robot in the surgical treatment of congenital craniosynostosis,indicating that it may be able to reduce the occurrence of complications in the actual clinical surgery.The performance of the robot still needs to be continuously improved and tested in the future to prepare for the next step of research. |
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