Computer-assisted planning of distraction osteogenesis for lower face reconstruction in gunshot traumas

Benateau, Hervé; Chatellier, Anne; Caillot, A.; Labbé, D.; Veyssière, A.

doi:10.1016/j.jcms.2016.07.021

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…The scientific literature reveals that VSP constitutes a valid and reliable method to assist the surgeon in various procedures, ranging from mandibular reconstruction with osteocutaneous free flaps, 1 , 6 – 13 orthognathic procedures, 3 , 14 – 18 midface and Le Fort I advancements, 19 – 21 craniosynostosis correction, 22 distraction osteogenesis, 23 – 26 and even facial allotransplantation. 27 The initial goal of computed virtual planning was to produce stereolithographic models that would assist surgeons for the reconstruction of craniofacial defects and orthognathic surgery.…”

Section: Discussionmentioning

confidence: 99%

Virtual Surgical Planning: The Pearls and Pitfalls

Efanov

Roy

Huang

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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Objective:Over the past few years, virtual surgical planning (VSP) has evolved into a useful tool for the craniofacial surgeon. Virtual planning and computer-aided design and manufacturing (CAD/CAM) may assist in orthognathic, cranio-orbital, traumatic, and microsurgery of the craniofacial skeleton. Despite its increasing popularity, little emphasis has been placed on the learning curve.Methods:A retrospective analysis of consecutive virtual surgeries was done from July 2012 to October 2016 at the University of Montreal Teaching Hospitals. Orthognathic surgeries and free vascularized bone flap surgeries were included in the analysis.Results:Fifty-four virtual surgeries were done in the time period analyzed. Forty-six orthognathic surgeries and 8 free bone transfers were done. An analysis of errors was done. Eighty-five percentage of the orthognathic virtual plans were adhered to completely, 4% of the plans were abandoned, and 11% were partially adhered to. Seventy-five percentage of the virtual surgeries for free tissue transfers were adhered to, whereas 25% were partially adhered to. The reasons for abandoning the plans were (1) poor communication between surgeon and engineer, (2) poor appreciation for condyle placement on preoperative scans, (3) soft-tissue impedance to bony movement, (4) rapid tumor progression, (5) poor preoperative assessment of anatomy.Conclusion:Virtual surgical planning is a useful tool for craniofacial surgery but has inherent issues that the surgeon must be aware of. With time and experience, these surgical plans can be used as powerful adjuvants to good clinical judgement.

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Section: Discussionmentioning

confidence: 99%

Virtual Surgical Planning: The Pearls and Pitfalls

Efanov

Roy

Huang

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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“…Stuehmer et al 2008 40 Case Report Retrospective V 1 Civilian Yes Yes No Harris and Laughlin 2013 41 Review Expert Opinion V N/a N/a Yes Yes Yes Benateau et al 2016 35 Case Series Retrospective IV 2 Civilian Yes No No Khatib et al 2017 36 Review Expert Opinion V N/a N/a Yes Yes No Kupfer et al 2017 42 Review Expert Opinion V N/a N/a Yes Yes No Khatib et al 2018 43 Case Series Retrospective IV 10 Civilian Yes Yes Yes Volk et al 2019 18 Review Expert Opinion V N/a N/a Yes Yes Yes Breeze and Powers 2020 44 Review Analysis of themes of function of VSP revealed that plastic surgeons use this technology primarily to, "decrease operative time," "increase integrity of plates," "help determine treatment sequence," "help produce more predictable outcomes," and "increase accuracy of surgical repair. "…”

Section: Same-admissionmentioning

confidence: 99%

“…10,16,33,34 Multiple studies also suggest that VSP may compel preoperative planning, expedite intraoperative surgical care, improve surgical precision, and perhaps improve outcomes. [35][36][37][38][39] This case series and systematic review details the use of VSP to facilitate same-admission microsurgical mandible reconstruction after acute MBT.…”

Section: Introductionmentioning

confidence: 99%

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

Knudson

Day

Kelley

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

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Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

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“…Therefore, the availability of a customized surgical template able to convey the optimal cutting angle could improve the chances of successful correction, as previously demonstrated in craniofacial distractions and complex bone fractures [5,6], and at the same time reduce surgical time and intraoperative complications and avoid the use of bone or cartilage grafts.…”

mentioning

confidence: 95%

Customized Cutting Template to Assist Sternotomy in Pectus Arcuatum

Leng

Bici

Facchini

et al. 2019

The Annals of Thoracic Surgery

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Purpose. Pectus arcuatum is an anterior chest wall deformity that requires transverse wedge sternotomy. Determining and delivering the correct cutting angle are crucial for successful correction. This report describes the early clinical experience with a novel cutting template technology able to deliver the optimal cutting angle. Description. From patients' computed tomographic scans, the optimal cutting angle is obtained using computer-aided design. A template comprising slots tilted at the right cutting angle and a safety block to avoid damaging the posterior periosteum is printed through additive manufacturing. Evaluation. The template allows surgeons to perform a precise wedge sternotomy, safely sparing the posterior periosteum in all patients, without complications. Postoperative chest roentgenograms and clinical photographs demonstrate optimal sternal realignment and cosmetic outcome. In this report, the mean operative time was 110 minutes. All patients were successfully discharged, with a mean length of stay of 4 days. Conclusions. Transverse wedge sternotomy aided by a computer-aided design-devised cutting template may reduce the technical challenge of this procedure, thereby increasing its safety and reducing operative times and hospital stay. Further research on long-term patient outcomes is necessary.

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Computer-assisted planning of distraction osteogenesis for lower face reconstruction in gunshot traumas

Cited by 11 publications

References 18 publications

Virtual Surgical Planning: The Pearls and Pitfalls

Virtual Surgical Planning: The Pearls and Pitfalls

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

Customized Cutting Template to Assist Sternotomy in Pectus Arcuatum

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