人體顱顏顎面部位常因為滋長腫瘤、先天骨骼發育不良、植牙或因外在因素導致骨骼碎裂而需要以手術方式進行切除或矯正。傳統的治療方式通常是以病人病灶之X光片或斷層掃描影像作手術規劃，再憑藉著醫師的經驗及其空間感進行治療手術，但在某些需要較精準的定位手術上，往往只能以游標尺取得一個自由度的位移量作為參考。因此本研究針對顎面矯正手術中需要導引定位之手術，如上下顎咬合不正、植牙或顎骨前凸等矯正手術，設計一套可做到六個自由度量測定位之手術導引系統。
此系統依據適用病例規劃出導引系統之應用流程，包含術前、術中及術後三階段。在術前我們依病例需要，取得病灶之斷層掃描影像，重建其三維模型。於術前模擬軟體進行三維手術導引定位模擬，藉此取得手術治療計劃中之理想方位，以輔助傳統紙上作業之術前規劃。至於在術中，參考術前模擬所得病灶理想方位，利用導引裝置進行導引定位，以協助醫師了解在皮下骨骼移動的位置是否已到達預定計劃目標。此外，本研究亦提出重建三維模型與網格簡化之方法，彌補由現有醫療影像軟體在手術計劃不足處，期望以更精確之病灶模型來提升術前模擬功效，透過簡化法來加速軟體執行效率。
本研究與成大口腔顎面外科的醫師合作，將實驗室研發的成果應用於實際病例上，雖沒完全成功，但此次經驗將可以作為未來應用臨床病例之借鏡，以期達到電腦輔助顎面手術計劃與導引之終極目標。

In general, medical surgery usually applied to human skull due to tumors, congenital abnormity, deformation, or aposteriori accident occurs on maxillofacial portion. Conventional treatments often retrieve the images from either X-ray or Computer Tomography (CT) in order to obtain the full pictures of the complex maxilloface. Accordingly, pre-surgical planning is then organized individually depending on the case. The surgery outcomes are heavily relied on individual surgeon’s experiences and techniques. For those most demands precise calibration surgery, medical instruments are serious lack in three-dimensional surveying. For example, a simple vernier using in conventional surgical planning can only acquire one or two degrees of movements. Therefore, to design a six degree-of-freedom navigation system is rather crucial for such cases, like jaw deformation, or abnormity.
In this research, we developed a coherent procedure for navigation and calibration in maxillofacial surgery. It includes three phases of pre-surgery, in-surgery, and post-surgery. Regard to the requirements of the lesion recovery, three-dimensional nidus of interest is generated from the CT scan images in the phase of pre-surgery. Hereby, pre-surgical practice is then proceeded through the computer in order to obtain the idea destination, in terms of translations and orientations, for the surgical treatment. The idea position is accordingly recorded as references for applying in the next phase. The developed navigation system exhibits current position of the movable maxilla or jaw piece as well as the difference of target approaching during surgery. To inspect the outcomes of applying reference data, and discuss the procedure of adopting calibration system are important in post-surgery for the purpose of future usage.
The research is cooperated with senior practical surgeon in the division of oral and maxillofacial in National Cheng Kung University Hospital. The research outcomes will then apply to the clinical trial for the suitable case in the future.

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