The Journal of craniofacial surgery · 2025
Application Efficacy of the FACE-Q Scale Combined With Anatomic Landmark-Based Evaluation in Preoperative 3D-Printed Model Simulated Surgical Reduction for Cranio-Maxillofacial Multiple Fractures.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Jiao Xinhe, Wu Chong, Guo Teng
Аннотация
BACKGROUND: The evaluation of therapeutic efficacy for cranio-maxillofacial fractures necessitates balancing objective anatomic reduction accuracy with subjective patient-reported quality of life. Traditional methods rely on radiographic metrics while neglecting multidimensional patient experiences.
OBJECTIVE: This study integrates 3D-printed model-based anatomic landmark validation with quantitative FACE-Q scale evaluation, conducting a synergistic analysis between surgical precision (submillimeter-level error control) and patient-reported outcomes (appearance, function, psychology), thereby providing evidence-based decision-making support for complex fracture management.
METHODS: Ten patients with cranio-maxillofacial multiple fractures were enrolled. Preoperative 1:1 scale 3D-printed models were constructed using 3-dimensional CT reconstruction data. Fracture reduction was simulated on the models to plan titanium plate configuration (number, shape) and surgical approaches. Intraoperative reduction followed model-guided protocols. Postoperative 3-month CT scans measured anatomic landmark distances (bilateral Co-Go, Fr-Fr'/N-Me) to assess reduction accuracy. Patient-reported outcomes were quantified using the FACE-Q scale across 4 domains: appearance satisfaction, health-related quality of life, postoperative function, and adverse events.
RESULTS: The 3D model demonstrated submillimeter-level accuracy, with a 0.1±0.12 mm discrepancy ( P >0.05) compared with 3-month postoperative data and bilateral symmetry error ≤0.5 mm (AO standard compliant). At 3 months, bony landmark stability improved significantly (64% reduction in positional SD versus preoperative, P <0.001). FACE-Q total scores increased from 45.2±8.1 preoperatively to 90.4±3.6 postoperatively (Δ+45.2, P <0.001; Cohen d=6.5), with marked improvements in appearance-related distress (Δ+55.8), respiratory function (Δ+52.2), and social function (Δ+54.7). Strong positive correlations emerged between anatomic precision and FACE-Q scores ( r =0.78-0.85, P <0.01), showing that each 0.1 mm reduction in zygomaticofrontal suture error increased facial symmetry scores by 8.3 points (β=0.72, P =0.003).
CONCLUSION: Preoperative 3D model simulation enables submillimeter-accurate anatomic reconstruction of cranio-maxillofacial fractures while concurrently optimizing physiological function and psychological well-being. This technique harmonizes anatomic reliability with patient-centered benefits, establishing an evidence-based paradigm for individualized complex trauma management.
OBJECTIVE: This study integrates 3D-printed model-based anatomic landmark validation with quantitative FACE-Q scale evaluation, conducting a synergistic analysis between surgical precision (submillimeter-level error control) and patient-reported outcomes (appearance, function, psychology), thereby providing evidence-based decision-making support for complex fracture management.
METHODS: Ten patients with cranio-maxillofacial multiple fractures were enrolled. Preoperative 1:1 scale 3D-printed models were constructed using 3-dimensional CT reconstruction data. Fracture reduction was simulated on the models to plan titanium plate configuration (number, shape) and surgical approaches. Intraoperative reduction followed model-guided protocols. Postoperative 3-month CT scans measured anatomic landmark distances (bilateral Co-Go, Fr-Fr'/N-Me) to assess reduction accuracy. Patient-reported outcomes were quantified using the FACE-Q scale across 4 domains: appearance satisfaction, health-related quality of life, postoperative function, and adverse events.
RESULTS: The 3D model demonstrated submillimeter-level accuracy, with a 0.1±0.12 mm discrepancy ( P >0.05) compared with 3-month postoperative data and bilateral symmetry error ≤0.5 mm (AO standard compliant). At 3 months, bony landmark stability improved significantly (64% reduction in positional SD versus preoperative, P <0.001). FACE-Q total scores increased from 45.2±8.1 preoperatively to 90.4±3.6 postoperatively (Δ+45.2, P <0.001; Cohen d=6.5), with marked improvements in appearance-related distress (Δ+55.8), respiratory function (Δ+52.2), and social function (Δ+54.7). Strong positive correlations emerged between anatomic precision and FACE-Q scores ( r =0.78-0.85, P <0.01), showing that each 0.1 mm reduction in zygomaticofrontal suture error increased facial symmetry scores by 8.3 points (β=0.72, P =0.003).
CONCLUSION: Preoperative 3D model simulation enables submillimeter-accurate anatomic reconstruction of cranio-maxillofacial fractures while concurrently optimizing physiological function and psychological well-being. This technique harmonizes anatomic reliability with patient-centered benefits, establishing an evidence-based paradigm for individualized complex trauma management.