Computer Assisted Oral and Maxillofacial Reconstruction

Alexander Schramm, Ralf Schön, Martin Rüker, Enno-Ludwig Barth, Christoph Zizelmann, N.-C. Gellrich


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. This study evaluates the benefit and the indications of computer assisted surgery in the treatment of cranio-maxillofacial surgery.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.Computer assisted treatment was successfully completed in all cases (n=107). 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.

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