Efficiency of virtual surgical planning in management of maxillofacial trauma

Abstract

Background: Craniomaxillofacial (CMF) injuries has different patterns from simple to complicated ones. Surgeons usually spend time and effort planning the optimal surgical approach to avoid damage to vital structures that could otherwise lead to functional deficits. It is also imperative to optimize the skin incisions to avoid unfavourable scarring. The aim of this work is to assess the effectiveness and efficiency of virtual surgical planning (VSP) application in management of different types of CMF traumas, the advantages, and disadvantages of VSP, and the accuracy of three dimensional (3D) measures as a preoperative planning tool. Methods: This prospective consecutive series study enrolled 30 patients presented with different types of CMF trauma. All patients were subjected to CT scans. The obtained Digital imaging and communications in Medicine (DICOM) files were imported into the software for virtual planning. Results: The actual operative time (OT) after VSP was significantly lower than the expected time by traditional methods (p=0.008). There was no significant difference between the actual and expected number of incisions. The accuracy measures of preoperative VSP were very close postoperatively. The functional, anatomic reduction and patient satisfaction outcomes were very satisfying to the surgeon and the patient respectively. Conclusions: VSP can be a valuable tool for optimizing functional and aesthetic outcomes of the CMF trauma surgery. The accurate measurements obtained pre-operatively helped in reducing surgical time and minimizing the need for subsequent revision surgeries.