Application Of Computer Assisted Navigation System In The Treatment Of Unilateral Zygomatic Arch Fractures

Objective:Evaluate the effect of computer assisted navigation system in the treatment of unilateral Zygomatic arch fractures;compare the fracture reduction of patients in the navigation group and the non-navigation group,explore the safety and accuracy of the Zygomatic arch fracture reduction by navigation system,and evaluate The clinical significance of the navigation syste m in reduction of Zygomatic arch fractures,and summarized the operation process and technical points.Methods:Patients with unilateral Zygomatic arch fractures(30 cases)who were treated with oral and maxillofacial surgery at the Anhui First and Second Affiliated Hospitals of Medical University from May 2017 to June 2019 were selected as the research subjects.In this study,all patients were randomly grouped by computer,combined with patient opinions and signed informed consent,and a simple experience reduction was set as the control group: 7 males and 8 females;CANS group: 4 males and 11 females.All patients in the CANS group underwent maxillofacial CT before surgery.The CT data were imported into Accu Navi-A software,and preoperative planning such as 3D reconstruction of the maxillofacial face,mirroring,and simulated surgical procedures were performed.Guidance and verification of the Zygomatic arch was performed in real time through the navigation system during surgery.Reduction of arch fracture site.The maxillofacial CT was reviewed one week after surgery in the two groups,and the skull base was used as the origin at the zygomatic arch axis and the median sagittal line was used as the Y-axis to establish a coordinate system.The distance between the origins and the reduction difference between the two groups were recorded.At the same time,the follow-up was performed for three months to observe the incidence of postoperative complications,opening degree,and statistical analysis to comprehensively evaluate the effect of surgery.Results:The difference in reduction of zygomatic arch fractures after CT reexamination in both groups was less than 2mm,and satisfactory reduction results were achieved.The patients all healed well after operation.The maxillofacial appearance and opening degree were basically normal after reexamination,and there were no obvious deformities.Among them,patients in the C ANS group applied Accu Navi-A software to achieve accurate reduction through preoperative design,precise navigation and positioning during the operation.The difference of fracture reduction in the C ANS group was smaller than that in the non-navigation group(P <0.05),and the reduction accuracy was significantly better than that of the non-navigation group.Postoperative follow-up opening degree,incidence of postoperative complications,and surgical satisfaction were not significantly different between the two groups(P> 0.05).In the non-navigation group,one patient had a bulge above and outside the zygomatic after analysis.The reason for this may be that the depth of the stripper entering the operation area exceeded the lowest point of the fracture,causing pain in the surrounding soft tissue damage.O ne patient had a collapse after one month of follow-up examination.The examination was slightly restricted,and the facial shape was basically symmetrical.Later,the patient was instructed not to squeeze the fracture area,and at the same time,he was actively anti-infective treatment,and localized hot compress.No further collapse was observed after observation.Conclusion:1.The application of computer assisted navigation system in unilateral metatarsal and zygomatic arch fractures has a good clinical effect and greatly improves the accuracy of surgery.2.Mirroring and registration in computer assisted navigation system directly affect the accuracy of navigation.Accurate mirroring and registration can improve the safety and accuracy of fractures.3.This study provided clinical data for the application of computer assisted navigation system in the treatment of unilateral sacral and zygomatic arch fractures,and proved that navigation technology is a clinical technology worthy of promotion.