Clinical application of the mixed reality technique to assist the location and anatomy of perforator vessels of the anterolateral femoral flap

口腔疾病防治

HAN Xinsheng¹  TAN Xiaoyao¹  WANG Huadong¹  CHEN Fangyuan¹  LI Ting¹  ZHANG Xing’an¹  MING Huawei¹  YUAN Zongyi¹ 

[1] Department of Oral and maxillofacial surgery, Nanchong Central Hospital;

关键词: anterolateral thigh flap;    perforating vessels;    perforators flap;    surgery navigation;    virtual surgery;    mixed reality technique;    calibration point;    oral malignancy;    oral and maxillofacial tissue defects;    reconstruction;   

DOI  :  10.12016/j.issn.2096-1456.2022.01.008

来源: DOAJ

【 摘 要 】

Objective To explore the clinical application value of mixed reality technology in locating perforator vessels and assisting perforator vessel dissection to harvest anterolateral thigh flaps. Methods Six patients who needed anterolateral thigh flap repair after resection of oral and maxillofacial tumors were recruited from the Department of Oral and Maxillofacial Surgery of Nanchong Central Hospital from January 2020 to January 2021. Before surgery, the CT angiography data of the lower limbs of the patients carrying the calibration points were imported into the data workstation to perform 3D reconstruction of the perforator vessels and surrounding tissues of the thigh, and the reconstruction results were imported into Microsoft HoloLens 2 glasses. During the operation, calibration was performed at the calibration point of the operative area so that the preoperative reconstruction results were superimposed on the operative area through Microsoft HoloLens 2 glasses. The clinical application value of mixed reality technology assisted perforator vessel location and anatomy of anterolateral femoral perforator flap was discussed from six aspects: whether the perforator vessel was reconstructed preoperatively, intraoperative calibration time, whether the actual position of the perforating vessels passing through the fascia lata fulcrum deviated from the preoperative reconstruction result within 1 cm, time required to harvest the flap, and whether the actual route of the perforator vessel was consistent with the reconstruction result, and whether the postoperative flap survived. Results The position and course of perforating vessels were successfully reconstructed in 6 cases before the operation. The actual course of perforating vessels during the operation was consistent with the reconstruction results. The deviation between the actual position of the perforating points and the preoperative reconstruction results was within 1 cm, which met the requirements of the actual asisting of the anterolateral thigh flap. The average time of flap harvest was (70.50 ± 7.20) min. The average calibration time was (13.33 ± 5.50) min. All flaps survived. Conclusions Mixed reality technology projects the reconstruction results of anterolateral femoral perforator vessels directly into the operative area, which provides a new method for asisting localization and anatomy of anterolateral femoral flap perforator vessels and reduces the possibility of injury to perforator vessels.

【 授权许可】

Unknown