Computer-assisted oral and maxillofacial reconstruction

Abstract

Ablative tumor surgery, orbital and mid face reconstruction as much as skull base surgery requires detailed planning using CT or MRI. Reconstruction is depending on reliable information to choose correct type of grafts and to predict the outcome. Benefits and indications of computer-assisted surgery in the treatment of craniomaxillofacial surgery are demonstrated. Based on a CT or MRI data set, an optical navigation system was used for preoperative planning, intraoperative navigation and postoperative control. Surgery was preoperatively planned and intraoperatively navigated. Preoperatively, required soft and hard tissue was measured using the mirrored data set of the unaffected side; size and location of the graft were chosen virtually. Intraoperatively, contours of transplanted tissues were navigated to the preoperatively simulated reconstructive result. Preoperatively outlined safety margins could be exactly controlled during tumor resection. Reconstruction was designed and performed precisely as virtually planned. Image-guided treatment improves preoperative planning by visualization of the individual anatomy, intended reconstructive outcome and by objectivation the effect of adjuvant therapy. Intraoperative navigation makes tumor and reconstructive surgery more reliable by showing the safety margins, saving vital structures and leading reconstruction to preplanned objectives.