A multicenter experience with image-guided surgical navigation: Broadening clinical indications in complex craniomaxillofacial surgery

Abstract

Purpose: Image-guided surgical navigation, or computed tomography (CT)-guided surgery, is a technology used bymany specialties to reduce complications and improve surgical outcomes. Its use has become widespread in neurosurgical intracranial and otolaryngological skull base procedures. The authors hypothesize that CT imageguided surgical navigation has a wide scope of utility in complex craniomaxillofacial procedures. With time and experience, its use will further advance the safety and efficacy of craniomaxillofacial surgery. Methods: A multicenter retrospective study at the University of California-Los Angeles, New York University, University of Pittsburgh, and the University of Kansas Medical Center was conducted. All craniomaxillofacial procedures using CT imageguided surgical navigation were reviewed. Results: Twenty subjects were identified who underwent a total of 26 CT-guided navigation procedures (6 cases were bilateral). Subunits reconstructed included: The upper face (n=5), middle face (n=7), and lower face (n=6). Two additional patients usedCT navigation to reconstruct multiple facial subunits. In all 20 subjects, the imageguided system correctly identified the surgical anatomy to less than 2mm. There were no perioperative complications.Long-Term followup demonstrated no revisionary procedures were required to date. Conclusions: Computed tomography-guided navigation is a safe and effective tool with multiple applications in craniomaxillofacial surgery. Indications for its use in complex craniomaxillofacial procedures continue to broaden. Further experience with this technology will continue to expand its clinical utility in craniomaxillofacial surgery.