Improved 3D osteotomy planning in cranio-maxillofacial surgery

Abstract

In this paper we present two clinical cases in maxillofacial surgery, where complex surgical interventions have been pre-operatively planned on 3D models of the patients’ heads. Our goal was to provide surgeons with an additional planning criterion, i.e. the prediction of the post-operative facial appearance. In our first study a two step mandibular distraction has been planned, and in the second one a bimaxillary operation with a high Le Fort I osteotomy of the maxilla according to Bell, as well as a sagittal split osteotomy on both sides of the mandible, according to Obwegeser–Dal Pont. Within our study we did focus on the three dimensional soft tissue simulation using finite element methods. For the provision of such a planning aid, concepts for an integrated 3D surgery planning system are proposed that are partially implemented and demonstrated.