Image-Guided Endoscopic Navigation for the Precise Resection of a Mandibular Condylar Osteochondroma

Sun, Hao; Li, Biao; Shen, Shunyao; Yang, Tong; Zhang, Lei; Shen, Steve Guofang; Wang, Xudong

doi:10.1097/scs.0b013e31829ad374

Cited by 13 publications

(8 citation statements)

References 24 publications

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“…Recently, the awareness of minimally invasive surgical techniques to replace traditional larger procedures has attracted interest from an increasing number of surgeons and patients. With endoscopy, direct visual access, along with the capability for illumination and magnification allows for minimal tissue dissection and improved surgical fields [9]. Compared to other fields, the use of endoscopic techniques for exposure, resection, and reconstruction of the condylar disorders are relatively novel approaches.…”

Section: Introductionmentioning

confidence: 99%

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma

Cao

et al. 2021

Orphanet J Rare Dis

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Background Mandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC. Results Three patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up. Conclusions For patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.

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Section: Introductionmentioning

confidence: 99%

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma

Cao

et al. 2021

Orphanet J Rare Dis

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“…In combination with the preoperative virtual planning of the resection extent which relies on merging of different imaging modalities combining the different information of these modalities ( 36 ), this method of navigated tumor resection and tumor mapping harbors promising results. In our study, we showed that with this method there were more R0 resection possible within tumors of the upper jaw compared to the conventional tumor resection.…”

Section: Discussionmentioning

confidence: 99%

Advances in the Resection and Reconstruction of Midfacial Tumors Through Computer Assisted Surgery

2021

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Curatively intended oncologic surgery is based on a residual-free tumor excision. Since decades, the surgeon’s goal of R0-resection has led to radical resections in the anatomical region of the midface because of the three-dimensionally complex anatomy where aesthetically and functionally crucial structures are in close relation. In some cases, this implied aggressive overtreatment with loss of the eye globe. In contrast, undertreatment followed by repeated re-resections can also not be an option. Therefore, the evaluation of the true three-dimensional tumor extent and the intraoperative availability of this information seem critical for a precise, yet substance-sparing tumor removal. Computer assisted surgery (CAS) can provide the framework in this context. The present study evaluated the beneficial use of CAS in the treatment of midfacial tumors with special regard to tumor resection and reconstruction. Therefore, 60 patients diagnosed with a malignancy of the upper jaw has been treated, 31 with the use of CAS and 29 conventionally. Comparison of the two groups showed a higher rate of residual-free resections in cases of CAS application. Furthermore, we demonstrate the use of navigated specimen taking called tumor mapping. This procedure enables the transparent, yet precise documentation of three-dimensional tumor borders which paves the way to a more feasible interdisciplinary exchange leading e.g. to a much more focused radiation therapy. Moreover, we evaluated the possibilities of primary midface reconstructions seizing CAS, especially in cases of infiltrated orbital floors. These cases needed reduction of intra-orbital volume due to the tissue loss after resection which could be precisely achieved by CAS. These benefits of CAS in midface reconstruction found expression in positive changes in quality of life. The present work was able to demonstrate that the area of oncological surgery of the midface is a prime example of interface optimization based on the sensible use of computer assistance. The fact that the system makes the patient transparent for the surgeon and the procedure controllable facilitates a more precise and safer treatment oriented to a better outcome.

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“…Therefore, surgical navigation is used to guide osteotomies and to reposition bone segments. Orthognathic procedures that use navigational technology include bimaxillary surgery 37,38,92 , sagittal split ramus osteotomy 100 , high oblique sagittal split osteotomy 56 , intraoral vertical ramus osteotomy 81 , distraction osteogenesis 55,57,66,75,83,84,[95][96][97] , genioplasty 12,54,73,75 , gonioplasty 73 , condyle resection 12,48,58,70 , mandibular angle reduction surgery 69,[74][75][76]79,82 , condyle repositioning after Le Fort I osteotomy 63 , and temporomandibular joint replacement 64 .…”

Section: Applications Of Surgical Navigationmentioning

confidence: 99%

“…3B). Alveolar bone screws can be placed in the outpatient clinic before surgery 48,58,61,68,70 . Next, preoperative CT scanning is performed and the locations of the screws are saved in the preoperative plan.…”

Section: Point Registrationmentioning

confidence: 99%

“…Unfortunately, it was not possible to quantitatively compare the registration methods based on the reported accuracies. The majority of the articles described the registration method used but did not report registration accuracy in terms of FRE 5,8,37,38,51,54,55,57,60,77,80,81,94,100 , TRE 1,3,[32][33][34][35]39,59,62,64,66,68,69,73,74,76,[83][84][85][86]88,89,98,99 , or both 12,13,36,40,[42][43][44][45][46][47][48]50,…”

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confidence: 99%

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Registration methods for surgical navigation of the mandible: a systematic review

Geer¹,

Koning²,

Alphen³

et al. 2022

International Journal of Oral and Maxillofacial Surgery

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Image-Guided Endoscopic Navigation for the Precise Resection of a Mandibular Condylar Osteochondroma

Abstract: The combined technique reported in this paper could represent a valid minimally invasive approach to the ramus-condyle unit for direct visualization of the medial aspect of the condyle and precise resection of benign tumor located here.

Cited by 13 publications

References 24 publications

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma

Advances in the Resection and Reconstruction of Midfacial Tumors Through Computer Assisted Surgery

Registration methods for surgical navigation of the mandible: a systematic review

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