Image guided surgical navigation integrating “mirroring” computational planning based on intra-operative cone-beam CT imaging: A promising new approach for management of primary bilateral midfacial fractures

Terzic, A.; Scolozzi, Paolo

doi:10.3109/10929088.2011.581901

Cited by 18 publications

(13 citation statements)

References 19 publications

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“…These postoperative CT scans then were imported into the Brainlab iPlan Net software (Brainlab AG, Kapellenstrasse 12, 85622 Feldkirchen, Germany) as described in a previous study [14]. The autosegmentation function of the program was used on the unaffected orbit to obtain a virtual 3-D template.…”

Section: Methodsmentioning

confidence: 99%

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Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Blumer

Gander

Gujer

et al. 2015

Journal of Oral and Maxillofacial Surgery

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PURPOSE This study evaluated whether intraoperative imaging with computer-assisted virtual reconstruction would be advantageous in reconstructions of orbital floor fractures. The surgeon's intention to revise a reconstructed primary orbital floor fracture by evaluating a postoperative mirrored computed tomographic (CT) scan was analyzed intraoperatively before wound closure, during inpatient hospitalization, and after hospitalization. The inter-rater agreement and the match of intention to revise and actual revision were analyzed. MATERIALS AND METHODS Fifty-one anonymized postoperative CT scans of patients with a unilateral orbital floor fracture were mirrored using software. These computer-assisted virtual reconstructions were consecutively examined by 4 examiners. Seven of these patients underwent a revision. In the first part, the inter-rater agreements for all 3 times were analyzed. In the second part, the examiners' intentions to revise were compared with the actual performed revisions. RESULTS The overall inter-rater agreements were 0.69 for the intraoperative phase, 0.55 for the in-hospital phase, and 0.39 for the post-hospital phase. The intraoperative inter-rater agreement for each examiner was 0.58 to 0.80. The Fleiss value for the in-hospital and post-hospital phases was lower. The comparison of the examiners' intention to revise and the actual revisions showed that 15 to 24 additional would have been revised. In contrast, 6 of 7 actual revisions would have been revised intraoperatively. The missed actual revision was the same case by all 4 examiners. The accordance of intention to revise with the actual revisions decreased during hospitalization and even more after hospitalization. This study showed strong agreement among examiners for revising anatomically incorrectly reduced orbital floor fractures intraoperatively by evaluating postoperative mirrored CT scans. During the in-hospital and post-hospital phases, the restraints against revision seemed to increase, thus leading to poorer interrater agreement. This analysis of postoperative CT scans with computer-assisted virtual reconstructions of the orbit would have led to considerably more revisions intraoperatively, but all actual revisions were detected except for 1 case. This case was the same for all 4 examiners. Operation time would have been prolonged in the additional revised cases, but a better anatomic reconstruction would have been achieved. Furthermore, the intraoperative result of the reconstruction would have been controlled instantly and corrected immediately, if needed. CONCLUSION This study showed that of 6 of 7 actual revisions, implant placement would have been revised intraoperatively by all 4 examiners, if intraoperative imaging with computer-assisted virtual reconstruction of the orbit would have been applied. Therefore, the authors suggest that intraoperative imaging with computer-assisted virtual reconstruction could be advantageous in the prevention of later revisions of orbital floor fractures. In this study, the t...

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Section: Methodsmentioning

confidence: 99%

“…Intraoperative MDCT (multidetector computed tomography) and CBCT (cone beam computed tomography) scans to confirm ideal reconstruction are described in the literature as effective [13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Blumer

Gander

Gujer

et al. 2015

Journal of Oral and Maxillofacial Surgery

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“…The devices are mobile and can be used without the need for complex technical and personal infrastructure, the investment being much lower compared to conventional computer tomographs (CT) (Heiland et al, 2003(Heiland et al, , 2004. The use of mCBCT in intra-operative navigation has already been described recently (Terzic and Scolozzi, 2011). Nevertheless, one of the main drawbacks of mCBCTs is, in relation to the small field of view the dosage of radiation necessary to obtain images of reliable quality.…”

Section: Introductionmentioning

confidence: 99%

Image quality of two different mobile cone beam computed tomographs for maxillofacial surgery

Seeberger

Buchgeister

Seethaler

et al. 2012

Journal of Cranio-Maxillofacial Surgery

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“…10,16,17 . El procedimiento es el mismo, excepto la fase de incorporación de la malla a la planificación preoperatoria del caso.…”

Section: Introductionunclassified

Aplicación clínica de la planificación virtual y la navegación en el tratamiento de las fracturas del suelo de la órbita

Ferrer

Heredero

Alamillos

et al. 2015

Revista Española de Cirugía Oral y Maxilofacial

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Cómo citar este artículo: Dean A, et al. Aplicación clínica de la planificación virtual y la navegación en el tratamiento de las fracturas del suelo de la órbita. Rev Esp Cir Oral Maxilofac. 2015. http://dx.información del artículo Historia del artículo: Recibido el 4 de enero de 2015 Aceptado el 6 de abril de 2015 On-line el xxx Palabras clave: Fracturas de órbita Planificación quirúrgica asistida por ordenador Volumen orbitario Malla de titanio Mallas premoldeadas Cirugía virtualr e s u m e n El objetivo del tratamiento de las fracturas de órbita es reconstruir la forma tridimensional de las paredes orbitarias para restablecer el volumen orbitario y la función ocular. El enoftalmos y la diplopía producidos por la reconstrucción inapropiada de la anatomía orbitaria tras un traumatismo continúan siendo todavía una secuela de estas fracturas.El objetivo de este trabajo es describir la técnica de la planificación virtual y la navegación intraoperatoria en el tratamiento de fracturas de suelo y pared medial de la órbita como herramienta útil en el tratamiento de estas fracturas.La técnica de planificación virtual y navegación intraorbitaria se aplica para el tratamiento de pacientes con fracturas de suelo o pared medial de órbita. La corrección virtual de la órbita fracturada se realiza utilizando la imagen en espejo del lado sano superpuesta sobre el lado fracturado. La planificación preoperatoria permite, además, importar y seleccionar preoperatoriamnete una malla premoldeada y determinar la adecuación de esta, en forma y tamaño, para tratar la fractura. La navegación intraoperatoria permite la disección segura y adecuada del contenido orbitario («primera» navegación) y la confirmación de la adecuada reconstrucción de las paredes orbitarias («segunda» navegación).La planificación en ordenador, la cirugía virtual y la navegación intraoperatoria aportan una guía útil, precisa y segura para la reconstrucción orbitaria. © 2015 SECOM. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/). Clinical application of virtual planning and navigation for the treatment of the orbital floor fracturesKeywords: Orbital fracturesComputer aided planning surgery Orbital volumen a b s t r a c tThe goal of the treatment of orbital fractures is to reconstruct the three-dimensional shape of the orbital walls to restore the orbital volume and eye function. Enophthalmos and diplopía caused by inappropriate orbital wall anatomy reconstruction after trauma, remain still a sequel to these fractures. * Autor para correspondencia.Correo electrónico: adeanferrer@yahoo.es (A. Dean). http://dx.

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Image guided surgical navigation integrating “mirroring” computational planning based on intra-operative cone-beam CT imaging: A promising new approach for management of primary bilateral midfacial fractures

Cited by 18 publications

References 19 publications

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Image quality of two different mobile cone beam computed tomographs for maxillofacial surgery

Aplicación clínica de la planificación virtual y la navegación en el tratamiento de las fracturas del suelo de la órbita

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