Surgical Planning of Computer-Assisted Repositioning Osteotomies

Marmulla, Rüdiger; Niederdellmann, H

doi:10.1097/00006534-199909020-00007

Cited by 36 publications

(29 citation statements)

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“…In accordance with the findings of other groups, 12,13 intraoperative navigation makes radical tumor surgery more reliable by identifying safety margins, preserving vital structures, and guiding the primary reconstruction. To our knowledge, non-invasive registration using the occlusal splint allows, for the first time, multiple data acquisition with CT and MRI in the same patient over an extended period.…”

Section: Discussionsupporting

confidence: 72%

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Indications for computer-assisted treatment of cranio-maxillofacial tumors

et al. 2000

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Objective: Ablative tumor surgery requires detailed planning using computed tomography (CT) or magnetic resonance imaging (MRI). Reconstruction following tumor resection is dependent on reliable information for choosing the correct type and volume of grafts and predicting the outcome. This study evaluates the benefit of and the indications for computer-assisted surgery in the treatment of cranio-maxillofacial tumors.Materials and Methods: Based on a CT or MRI data set, the STN Navigation System (Stryker-Leibinger) was used for preoperative planning, intraoperative navigation, and postoperative control of radical tumor resection and primary and secondary reconstruction. Tumor resection was preoperatively planned and intraoperatively navigated. Preoperatively, the required soft and hard tissue were measured using the mirrored data set of the unaffected side of the facial skeleton; the size and location of the graft were chosen virtually. Intraoperatively, contours of transplanted tissues were navigated in accordance with the preoperatively simulated reconstructive result.Results: Computer-assisted treatment was successfully completed in all cases of radical tumor resection, and safety margins outlined preoperatively could be precisely controlled during tumor resection. Reconstruction was designed and performed exactly as virtually planned.Conclusions: Image-guided treatment improves preoperative planning by visualization of the individual anatomy and the intended reconstructive outcome, and by objectivation of the effect of adjuvant chemo-/radiotherapy. Intraoperative navigation makes radical tumor surgery more reliable by showing the determined safety margins, preserving vital structures, and guiding reconstruction to preplanned objectives. OBJECTIVEComputer-assisted technology was initially developed to provide neurosurgeons with precise guidance during surgical procedures. Currently available systems with and without robotic navigation are in use for specific medical indications. Various intraoperative navigation systems are used to assist

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Section: Discussionsupporting

confidence: 72%

“…Three secondary implant-anchored prosthetic reconstructions following tumor resection were performed (cases [12][13][14]. The insertion of zygomatic fixtures (Brånemark, Nobel Biocare, Köln, Germany) allows prosthetic restoration in cases of severe bone loss in the maxilla without additional bone grafting.…”

Section: Description Of the Clinical Casesmentioning

confidence: 99%

Indications for computer-assisted treatment of cranio-maxillofacial tumors

et al. 2000

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“…The present authors have previously demonstrated the feasibility of a technique of mechanical surface registration: a stereolithographic negative of a bone surface is produced using the image data. Similar to a key in a keyhole, this negative can only be attached to the bone surface in one particular position, thus inherently performing the registration 114,125,126,127 . In optical surface registration, the surface information is gathered using contact-free optical systems.…”

Section: Surface Registrationmentioning

confidence: 99%

“…Craniofacial implants can also be inserted using image-guided surgery 85 . In orthognathic surgery, navigation systems can be used to transfer a preoperative plan into intraoperative reality 20 , to maintain the position of the joint-bearing parts of the mandible in sagittal split procedures, and displacement of bone segments after osteotomies can be performed accurately 125,126,127 . An ongoing issue is the accurate prediction of soft-tissue changes after craniofacial and orthognathic surgery 190 .…”

Section: Support For the Surgeonmentioning

confidence: 99%

Image-to-patient registration techniques in head surgery

Eggers

Mühling

Marmulla

2006

International Journal of Oral and Maxillofacial Surgery

204

135

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“…Computer-assisted surgery technology has been employed in several surgical fields such as neurosurgery, endoscopy, arthroscopy, and bone surgery 10,12,20 . Reducing the risk of damage to anatomical structures such as nerves, vessels and neighbouring structures is one of the desired outcomes of preoperative computer-aided planning 10,19 .…”

mentioning

confidence: 99%