Description of a method: Computer generated virtual model for accurate localisation of tumour margins, standardised resection, and planning of radiation treatment in head & neck cancer surgery

Marking of tumor resection borders for improved radiation planning facilitates reduction of radiation dose to free flap reconstruction in head and neck cancer surgery

“…Surgical navigation has become an established technique in the field of head and neck surgery (Schramm et al, 2008). 3D virtual marking and mapping of resection margins enables precise delineation of skull base and midface tumor margins (Essig et al, 2011;Bittermann et al, 2013;GuijarroMartinez et al, 2014). This was confirmed in this investigation, although the patient collective was very small.…”

“…Delineation of reconstructed tissue from resection margins on postoperative CT scans is often difficult (Coles et al, 2009;Yang et al, 2013). Various refinements in the field of computer-aided surgery (CAS) have been implemented in order to improve marking of resection margins but CAS alone is insufficient in delineating tumor margins apart from hard tissue in soft tissue due to the effects of gravity and swelling on the tissue whether native or reconstructed (Essig et al, 2011;Bittermann et al, 2013). In this situation marking of margins by titanium ligature clips could be useful (Bittermann et al, 2013).…”

“…Various refinements in the field of computer-aided surgery (CAS) have been implemented in order to improve marking of resection margins but CAS alone is insufficient in delineating tumor margins apart from hard tissue in soft tissue due to the effects of gravity and swelling on the tissue whether native or reconstructed (Essig et al, 2011;Bittermann et al, 2013). In this situation marking of margins by titanium ligature clips could be useful (Bittermann et al, 2013). Markers implanted in surgical cavity walls provide additional localization information compared with CT-imaging alone.…”

Comparison of virtual and titanium clip marking of tumour resection margins for improved radiation planning in head and neck cancer surgery

“…Surgical markers, regardless of whether they are titanium or virtual, placed in the resection borders can provide additional information compared to postoperative CT imaging alone. 9,10,14 The current study was performed to assess the effect of virtual marking of the tumour resection border on the delineation of the tumour bed for oral cancer with different localizations.…”

“…16,17 3D virtual marking and mapping of resection margins is a new technique that enables the precise delineation of skull base and midface tumour margins. 14,15,18 However, virtual marking of tumour resection margins could be insufficient apart from hard tissue, due to the effects of swelling or gravity on the tissue, whether native or reconstructed.…”