Auxiliary guide plate assembly for genioglossus surgery

Abstract

The auxiliary guide plate assembly comprises a drilling guide plate, an osteotomy guide plate and a positioning guide plate, the top of the drilling guide plate is matched with the neck of a lower anterior tooth, the bottom of the drilling guide plate is matched with the lower edge of a mandible, and a fixing hole is formed in the drilling guide plate; the osteotomy guide plate is in an isosceles trapezoid shape, and the bottom edge of the osteotomy guide plate is matched with the lower edge of the mandible. The positioning guide plate is in a step shape and comprises an upper fixing part, a middle connecting part and a lower fixing part, and the two ends of the middle connecting part are connected with the upper fixing part and the lower fixing part respectively. Compared with the prior art, the utility model has the advantages that: the utility model is improved in a way that the lower incisor neck and the lower jawbone lower edge are taken as upper and lower edge fixed points, the drilling guide plate is prepared, the drilling position is firstly positioned, and then the osteotomy guide plate is fixed by two holes in the lower row to form the osteotomy island fixed on the lower jawbone surface instead of an osteotomy bridge in the prior art, so that the pendulum saw operation is convenient; and displacement is not easy to occur. The guide plate is shortened, so that the guide plate can be conveniently placed, and chin nerve injury is avoided.

Description

TECHNICAL FIELD

[0001] The utility model relates to medical auxiliary appliance especially, a kind of auxiliary guide plate assembly of genioglossus surgery. BACKGROUND

[0002] Since 1984, when Riley and Powell first created Genioglossus advancement (GA), it has experienced trapezoidal geniectomy, genial tubercle ring sawing and other modified procedures, and is an important procedure for OSA jaw surgery. GA is suitable for patients with obstructive sleep apnea (OSA) combined with tongue pharyngeal plane stenosis. The core is to cut off and move the genial tubercle at the medial attachment of the genioglossus muscle in the mandible, pull the genioglossus muscle and hyoid bone forward and upward, improve the posterior tongue root plane stenosis, and then reduce the upper airway compliance and expand the upper airway. In 1997, Zhang Zhengjian et al. first reported the genioglossus advancement and hyoid suspension surgery (GAHM) in China. Yin Shankai, Yi Hongliang and Chen Shicai have successively reported the cohort study of the modified GAHM procedure, and have achieved good therapeutic effect. However, these methods rely on the experience of the surgeon, and there is a large randomness in genial tubercle osteotomy and capture of genial spine, which increases the risk of surgical failure. In 2017, the digital surgery technology of virtual surgery planning (VSP) and 3D printing surgical guide plate was first applied to genioglossus and hyoid muscle advancement surgery (GA+SHA). The individualized precise osteotomy and positioning system simplifies the surgical process, reduces the difficulty of surgery, and improves the accuracy of surgery. While treating OSA, it achieves satisfactory genial cosmetic effect. However, the surgical guide plate relies on the bridge-shaped connection of the mandibular crown, and the guide plate is large and heavy, and is easy to shift. In the narrow lower lip vestibule of small mandibular OSA patients, it affects the activity of the bone saw, increases the difficulty of surgery, and makes it difficult to perform genial osteotomy and forward movement fixation. Therefore, we optimize the design of the surgical guide plate for genial osteotomy and genial tubercle forward movement fixation. Therefore, it is an urgent problem for the technical personnel in the field to develop a kind of auxiliary guide plate assembly for genioglossus surgery. UTILITY MODEL CONTENT

[0003] The utility model discloses in order to solve above -mentioned insufficient, provide a kind of auxiliary guide plate assembly for genioglossus surgery.

[0004] The utility model discloses the above-mentioned purpose of the utility model is realized by the following technical scheme: a kind of auxiliary guide plate assembly for genioglossus surgery, including drilling guide plate, osteotomy guide plate and positioning guide plate,

[0005] The top of the drilling guide plate is in line with the neck of the lower anterior teeth, the bottom is in line with the lower edge of the mandible, and two rows of positioning holes are provided, each row has two positioning holes, and there are four positioning holes in total.

[0006] The osteotomy guide plate is in the shape of an isosceles trapezoid, the bottom edge is in line with the lower edge of the mandible, the upper edge of the osteotomy line needs to include the mental spine and be more than 3mm away from the roots of the lower front teeth to avoid damaging the root tips of the front teeth, the outer edge of the osteotomy line includes the mental tubercle and is 3mm away from the mental foramen, and the bottom edge of the osteotomy line needs to be located outside the anterior attachment of the digastric muscle to cover the hyoid muscle group.

[0007] The positioning guide plate is in the shape of a ladder and includes an upper fixing part, an intermediate connecting part and a lower fixing part, the intermediate connecting part is connected with the upper fixing part and the lower fixing part at two ends respectively, is used for pulling and fixing the mental tubercle and guiding the ladder-shaped titanium plate to fix the mental tubercle.

[0008] Further, the osteotomy guide plate is provided with shortened cutting surfaces at two ends of the lower edge, so that the osteotomy guide plate is conveniently placed and the mental nerve is avoided from being damaged.

[0009] Compared with the prior art, the utility model has the advantages of:

[0010] 1. The utility model discloses the following tooth neck and the lower edge of the mandible as upper and lower edge fixed points, prepares the drilling guide plate, first positions the drilling position, then fixes the osteotomy guide plate with the lower row two holes, forms the osteotomy island fixed on the surface of the mandible, instead of the osteotomy bridge of the prior art, so that the saw operation is convenient, and displacement is not prone to occurring.

[0011] 2. Considering the smoothness of the chin forming mandibular edge line, the prior art extends the two ends of the osteotomy guide plate to the direction of the mandibular angle compared with the traditional chin osteotomy, so that the bottom of the trapezoidal osteotomy guide plate is too long, a large chin flap needs to be separated to complete the osteotomy. Figure 4 D) The utility model shortens the guide plate by cutting off 1cm at the two ends, so that the guide plate is conveniently placed, and the mental nerve is avoided from being damaged.

[0012] 3. The upper and lower two rows of four holes of the drilling guide plate of the utility model are positioned, the lower row two holes are used for fixing the osteotomy guide plate at first, are used for positioning the guide plate after being extended, guide the mental tubercle to move forward, and the four-hole extension avoids the damage caused by multiple drilling ( Figure 3 ) and the displacement of the mental tubercle caused by position change, guarantees the close combination between bones and the symmetrical beauty of chin forming. DRAWINGS

[0013] Figure 1 It is a structure schematic view of the drilling guide plate in the utility model.

[0014] Figure 2 It is a structure schematic view of the osteotomy guide plate in the utility model.

[0015] Figure 3 It is a structure schematic view of the positioning guide plate in the utility model.

[0016] Figure 4 This is a demonstration diagram of the use of the osteotomy guide plate in this utility model.

[0017] Figure 5 This is a schematic diagram showing the positions of the positioning holes and fixing holes in the three guide plates of this utility model. Detailed Implementation

[0018] The present invention will now be described in further detail with reference to the accompanying drawings.

[0019] like Figures 1 to 4 As shown, an auxiliary guide assembly for genioglossus muscle surgery includes a drilling guide 1, an osteotomy guide 2, and a positioning guide 3. The top of the drilling guide 1 matches the neck of the lower anterior teeth, and the bottom matches the lower edge of the mandible. According to the osteotomy requirements, two rows of positioning holes 101 are arranged on the drilling guide, with two positioning holes in each row, for a total of four positioning holes, to fix the osteotomy guide and the positioning guide. The osteotomy guide 2 is in the shape of an isosceles trapezoid, with fixing holes 201, and its bottom edge matches the lower edge of the mandible. The osteotomy line ( Figure 4 A) The upper edge must include the mental spine ( Figure 4 B), and more than 3mm away from the root of the lower anterior tooth ( Figure 4 C), to avoid damaging the root apex of the anterior teeth; outer edge of the osteotomy line ( Figure 4 C) Includes the mental tubercle, and is 3mm away from the mental foramen; the bottom edge of the osteotomy line should be located lateral to the anterior attachment of the digastric muscle to cover the suprahyoid muscle group; at the same time, the osteotomy guide plate 2 has shortened cut surfaces 202 at both ends of its lower edge to facilitate the placement of the guide plate and avoid damage to the mental nerve. The positioning guide plate 3 is stepped, including an upper fixing part 301, a middle connecting part 302 and a lower fixing part 303. The middle connecting part 302 is connected to the upper fixing part 301 and the lower fixing part 303 at both ends, respectively. The upper fixing part 301 and the lower fixing part 303 are respectively provided with upper fixing holes 304 and lower fixing holes 305 for pulling forward and fixing the mental tubercle, and guiding the stepped titanium plate to fix the mental tubercle.

[0020] In practical applications, the three guide plates of this invention are digitally customized according to the mandibular morphology of different patients and manufactured using 3D printing. They are all used in genioglossus muscle advancement surgery and are removed after the genioglossus advancement is completed and fixed; they are not implanted in the body. The three guide plates have the same basic structure: the osteotomy guide plate is used to locate the osteotomy line of the genioglossus; the drilling guide plate 1 is used to locate the four drill holes for fixing the osteotomy guide plate 2 and the positioning guide plate 3 during the operation; and the positioning guide plate 3 is used to pull and fix the resected genioglossus to the expected advancement position, facilitating the fixation of the titanium plate and screws. The preparation of these three guide plates is individualized according to the mandibular morphology of each surgical patient; therefore, the specific shape of each guide plate may vary slightly in actual application.

[0021] like Figure 5As shown, the utility model in the process of using in the operation is as follows: the lower lip gingival groove incision is completed in the operation, the chin flap is prepared to pull,

[0022] First, using the drilling guide plate 1, drill positioning 4 genial bone guide holes: put into the drilling guide plate, align the lower edge of the mandible, drill holes according to the four holes on the drilling guide plate, first fix the left lower and right upper two nails, then complete the drilling of the remaining two holes, and the drilling adopts a slender needle 1.5mm drill bit.

[0023] Then, using the osteotomy guide plate 2, guide the genial tubercle osteotomy: take out the drilling guide plate, put in the osteotomy guide plate, and fix the osteotomy guide plate with two titanium nails respectively. The genial tubercle is cut off along the edge of the osteotomy guide plate with a swing bone saw. The electric saw stops moving deep when it breaks through the inner layer of the cortex to avoid damaging the muscles at the bottom of the mouth and causing bleeding. The bleeding on the bone surface is stopped with gelatin sponge and electrocoagulation to avoid using bone wax to cause poor bone healing.

[0024] Finally, use the positioning guide plate 3 to pull the genial tubercle forward and fix it: take out the osteotomy guide plate, pull the genial tubercle forward with forceps, put in the positioning guide plate, and fix the genial tubercle to the predetermined position by titanium nails. Use a 4-hole titanium plate to fix the genial tubercle on the mandibular body obliquely to avoid damaging the mandibular roots by drilling. After fixing the genial tubercle with titanium nails, remove the positioning guide plate.

[0025] The above is only an embodiment of the utility model, and does not limit the patent range of the utility model, and any equivalent structure or equivalent process conversion using the contents of the utility model specification and drawings, or direct or indirect application in other related technical fields, are also included in the patent protection range of the utility model.

Claims

1. An auxiliary guide plate assembly for genioglossus muscle surgery, characterized in that: The device includes a drilling guide, an osteotomy guide, and a positioning guide. The top of the drilling guide matches the neck of the lower anterior teeth, and the bottom matches the lower edge of the mandible. It is also provided with a fixing hole. The osteotomy guide is in the shape of an isosceles trapezoid, with its bottom edge matching the lower edge of the mandible. The positioning guide is stepped and includes an upper fixing part, a middle connecting part, and a lower fixing part. The two ends of the middle connecting part are connected to the upper fixing part and the lower fixing part, respectively.

2. The auxiliary guide assembly for genioglossus muscle surgery according to claim 1, characterized in that: The fixing holes on the drilling guide plate are arranged in two rows, with two positioning holes in each row, for a total of four positioning holes.

3. The auxiliary guide plate assembly for genioglossus muscle surgery according to claim 1, characterized in that: The upper edge of the osteotomy guide plate should include the mental spine and be more than 3 mm away from the root of the lower anterior tooth to avoid damaging the root apex of the anterior tooth; the outer edge of the osteotomy line should include the mental tubercle and be 3 mm away from the mental foramen; the bottom edge of the osteotomy line should be located lateral to the anterior attachment border of the digastric muscle to cover the suprahyoid muscle group.

4. The auxiliary guide plate assembly for genioglossus muscle surgery according to claim 1, characterized in that: The osteotomy guide plate has shortened cut surfaces at both ends of its lower edge.

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