Predictability in orbital reconstruction: A human cadaver study. Part I: Endoscopic-assisted orbital reconstruction

Dubois, L.; Jansen, J.; Schreurs, Ruud; Saeed, Perooz; Beenen, Ludo F. M.; Maal, T.J.J.; Gooris, Peter J.J.; Becking, A.G.

doi:10.1016/j.jcms.2015.07.019

Cited by 27 publications

(25 citation statements)

References 35 publications

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“…Only a small number of works describe the reliability of surgical planning or navigation systems by exploring the concept of concordance, using a interclass correlation coefficient to assess the concordance between different surgeons in performing the same surgical maneuver rather than to assess the degree of congruence between the planned and performed resection.…”

Section: Discussionmentioning

confidence: 99%

“…To date, in the orbital surgery setting, no study has evaluated the accuracy in performing the planned osteotomy lines. The available studies only describe the accuracy of navigational systems in guiding the position of prosthetic implants for orbital wall reconstruction …”

Section: Discussionmentioning

confidence: 99%

“…The available studies only describe the accuracy of navigational systems in guiding the position of prosthetic implants for orbital wall reconstruction. 18,[20][21][22] For frontal sinus surgery, the accuracy in performing the planned osteoplastic flap is reported as submillimetric mean difference with an extremely high concordance coefficient. The available literature regarding navigationguided osteoplastic flaps only reports the 2-mm tolerance threshold of the navigation system 28-30 declared by the manufacturer and does not evaluate the actual intraoperative margins of error.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15] Most of the available literature regarding surgical navigation in the craniofacial field regards a simple description of an application of this technology in a particular clinical setting, such as the use of navigation for foreign body removal, implant positioning, prosthetic placement, orbital reconstruction, or tumor resection, often without an organic description of the actual accuracy of the technique. In fact, only a small number of studies have employed a systematic approach to explore the accuracy of navigational systems, [16][17][18][19][20][21][22] almost always in the orthognathic and reconstructive field. These reports regard the positioning of maxillary segments or prosthetic elements, whereas the application of surgical planning and navigation to guide craniofacial osteotomies for the optimization of the surgical access to the orbit and the skull base has not been specifically explored to date.…”

Section: Introductionmentioning

confidence: 99%

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A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation

Franz

Isola

Bagatto³

et al. 2018

The Laryngoscope

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Objective Computer‐assisted planning of osteotomy lines, coupled with navigation‐guided performance of planned osteotomies, is a highly innovative approach to skull‐base and orbital surgery. The aim of this pilot study is to provide an assessment of the accuracy of this novel approach in guiding the correct positioning of osteotomy lines in frontal, temporal, and orbital regions, defining the agreement between the spatial position of the planned and performed osteotomies. Methods Fifteen patients with orbital, frontal sinus, and lateral skull‐base diseases underwent virtual surgical planning. Osteotomies to access the orbit, frontal sinus, and lateral skull base were planned on computer tomography‐based three‐dimensional models. The planned osteotomies were reproduced on the operating field using a navigation system. The positions of the performed and planned osteotomies were compared. The results were described as the mean positional difference between planned and performed osteotomies and as Lin's concordance coefficient, and Bland‐Altman limits of agreement were also defined. Results The overall mean difference was 0.719 mm (95% confidence interval [CI]: 0.472 to 0.965 mm). Overall, Lin's concordance coefficient was 0.997 (95% CI: 0.996 to 0.998), and overall Bland‐Altman limits of agreement ranged from −1.407 to 2.844 mm. The smallest mean difference (0.587 mm, 95% CI: 0.244 to 0.931 mm) was calculated in the orbit group, whereas the highest mean difference (0.904 mm, 95% CI: 0.428 to 1.379 mm) was described in the lateral skull‐base group. Conclusion This study's results support the use of this novel planning and navigation protocol for guiding osteotomy in anterior and lateral skull‐base surgery, providing a clinical validation of this technique. Level of Evidence 4 Laryngoscope, 00:1–9, 2018 Laryngoscope, 129:823–831, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation

Franz

Isola

Bagatto³

et al. 2018

The Laryngoscope

View full text Add to dashboard Cite

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“…The final outcome following reconstruction of orbital floor defects associated with ZMC fractures is dependent on various factors, apart from the applied reconstructive modality (autologous grafts, alloplastic materiasl etc). For instance, distortion of the periorbita may not only complicate reconstruction but also compromise the final outcome: intraoperative visibility is restricted, even following repositioning of the herniated soft tissues (periorbital fat and/or extraocular muscles) and minor malpositioning of the orbital floor implant may lead to serious complications 24 .…”

Section: Discussionmentioning

confidence: 99%

The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures

Krasadakis¹,

Igoumenakis²,

Mourouzis³

et al. 2017

JRPMS

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Digital planning and individual implants for secondary reconstruction of midfacial deformities: A pilot study

Liokatis

Malenova

Fegg

et al. 2022

Laryngoscope Investig Oto

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Objective To evaluate the feasibility and accuracy of implementing three‐dimensional virtual surgical planning (VSP) and subsequent transfer by additive manufactured tools in the secondary reconstruction of residual post‐traumatic deformities in the midface. Methods Patients after secondary reconstruction of post‐traumatic midfacial deformities were included in this case series. The metrical deviation between the virtually planned and postoperative position of patient‐specific implants (PSI) and bone segments was measured at corresponding reference points. Further information collected included demographic data, post‐traumatic symptoms, and type of transfer tools. Results Eight consecutive patients were enrolled in the study. In five patients, VSP with subsequent manufacturing of combined predrilling/osteotomy guides and PSI was performed. In three patients, osteotomy guides, repositioning guides, and individually prebent plates were used following VSP. The median distances between the virtually planned and the postoperative position of the PSI were 2.01 mm (n = 18) compared to a median distance concerning the bone segments of 3.05 mm (n = 12). In patients where PSI were used, the median displacement of the bone segments was lower (n = 7, median 2.77 mm) than in the group with prebent plates (n = 5, 3.28 mm). Conclusion This study demonstrated the feasibility of VSP and transfer by additive manufactured tools for the secondary reconstruction of complex residual post‐traumatic deformities in the midface. However, the median deviations observed in this case series were unexpectedly high. The use of navigational systems may further improve the level of accuracy.

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Predictability in orbital reconstruction: A human cadaver study. Part I: Endoscopic-assisted orbital reconstruction

Cited by 27 publications

References 35 publications

A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation

A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation

The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures

Digital planning and individual implants for secondary reconstruction of midfacial deformities: A pilot study

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