Computer modeling and intraoperative navigation in maxillofacial surgery

TLDR

Recent advances in computer‑modeling software enable virtual reconstruction of facial symmetry, offering a new tool for surgeons to assist in maxillofacial skeleton reconstruction. The study evaluates the use of preoperative computer modeling and intraoperative navigation to guide reconstruction of the maxillofacial skeleton. Three patients with traumatic maxillofacial deformities underwent preoperative thin‑cut CT scans, 3D reconstructions, virtual osteotomies, and bony reductions using MIMICS software, and the resulting virtual models were imported into an intraoperative navigation system to guide surgical repair. Postoperative imaging and photographs showed enophthalmos corrected to within 1 mm in patient 1, significant symmetry improvement of the nasoethmoid complex in patient 2, and zygomaticomaxillary complex reconstruction within 1 mm in patient 3.

Abstract

Objectives Recent advances in computer‐modeling software allow reconstruction of facial symmetry in a virtual environment. This study evaluates the use of preoperative computer modeling and intraoperative navigation to guide reconstruction of the max‐illofacial skeleton. Methods Three patients with traumatic maxillofacial deformities received preoperative, thin‐cut axial CT scans. Three‐dimensional reconstructions, virtual osteotomies, and bony reductions were performed using MIMICS planning software (Materialise, Ann Arbor, MI). The original and “repaired” virtual datasets were then imported into an intraoperative navigation system and used to guide the surgical repair. Results Postoperative CT scans and photographs reveal excellent correction of enophthalmos to within 1 mm in patient 1, significant improvement in symmetry of the nasoethmoid complex in patient 2, and reconstruction of the zygomaticomaxillary complex location to within 1 mm in patient 3. Conclusion Computer modeling and intraoperative navigation is a relatively new tool that can assist surgeons with reconstruction of the maxillofacial skeleton.