Three-Dimensional Computed Tomography in Maxillofacial Surgical Planning

Abstract

\s=b\ Fifty-four maxillofacial three-dimensional computed tomographic examinations were performed during a 12-month period for the purpose of surgical planning. Pathologic entities in the series included trauma, neoplasia, cleft palate, and other developmental anomalies. Computer-assisted mandibular disarticulation was performed routinely after each study to permit direct viewing of the mandible or maxilla in isolation. Three-dimensional computed tomography is a useful technique for maxillofacial surgical planning. (Arch Otolaryngol Head Neck Surg 1988;114:438-442) Three-di mensi onal computed to¬ mography (CT) is a valuable tech¬ nique for the planning of skeletal, plastic, and maxillofacial surgical procedures.113 Anatomic measure¬ ments can be made from three-dimen¬ sional display images and manufactured life-sized models, and spatial relationships may be analyzed from desired perspectives.7·8·10 Three-dimen¬ sional views provide key information to the radiologist and surgeon that may not be apparent on either conven¬ tional roentgenograms or axial CT images alone. MATERIALS AND METHODSFifty-four maxillofacial three-dimen¬ sional CT studies (29 female and 25 male subjects, aged 6 to 59 years) were per¬ formed in 12 months on a spectrum of abnormalities, including the following: anomalous development (including clefts), 18 patients; trauma (mostly posttraumatic deformities), 12 patients; neoplasia, four patients; and infection/inflammation, four patients. Ten patients being evaluated for permanent dental implants were also studied. There were also six miscellaneous entities that were scanned. Computed to¬ mographic examinations were performed on a fourth-generation CT scanner (GE 9800) using overlapping or consecutive (stacked) 1.5-and 3-mm-thick axial or cor¬ onal CT scans through the area of interest. Most patients with mandibular conditions were scanned in axial projection stopping at the inferior orbital rim, so as to exclude the eyes from direct radiation exposure. Patients were secured within the head holder with tape and sedated when neces¬ sary, to ensure a motion-free study.Mandibular examinations were performed using overlapping 3-mm-thick axi¬ al images at 2-mm scan intervals. Consecu¬ tive (stacked) 1.5-mm-thickness scans were performed through the temporomandibular joints (TMJs). Cleft palates were scanned with either overlapping 3-mmthickness scans or consecutive 1.5-mmthick scans, depending on the size of the area of interest and patient limitations. Following each CT study, data were input to a three-dimensional processor (Dimen¬ sional Medicine Ine) for rendering of dis¬ crete voxel faces, later viewed in two dimensions on a specialized viewing appa¬ ratus (also Dimensional Medicine Ine). Two-dimensional roentgenographic im¬ ages were routinely obtained in various projections and viewed by both radiologist and clinician.Mandibular disarticulations were per¬ formed by three different specially trained radiologie technologists. Disarticulation required painstaking manual removal of specific a...

Association of traumatic head injuries and maxillofacial fractures: A retrospective study

“…When MFF are accompanied with THI, they are considered complex in nature as they might involve serious aesthetic and functional problems and thus they are clinically described as consequential. This makes accurate diagnosis necessary especially in the acute stage to clarify emergent injuries, to pre‐operatively plan reconstruction of functional areas (eg vision, mastication and olfaction) and to guide the physical, psychological and social rehabilitation process a. Early detection of associated THI in patients with MFF is very important because it can reduce morbidity and mortality as well as enhance the outcome of treatment b…”

“…This makes accurate diagnosis necessary especially in the acute stage to clarify emergent injuries, to pre-operatively plan reconstruction of functional areas (eg vision, mastication and olfaction) and to guide the physical, psychological and social rehabilitation process. 18 Early detection of associated THI in patients with MFF is very important because it can reduce morbidity and mortality as well as enhance the outcome of treatment. 13,19 The aim of this study was to assess the association between THI and MFF.…”

Method of Individual Adjustment for 3D CT Analysis: Linear Measurement

“…In order to overcome these problems, 3D imaging using CT has been developed. This technique has the advantage of zero site-based magnification errors and a lack of image overlapping, which facilitates detailed observation [11–14]. …”

Development of a simulation system in mandibular orthognathic surgery based on integrated three-dimensional data

“…Since the 1980s, 3D CTs have been used as a useful diagnostic tool for the treatment planning of maxillofacial deformities [5, 28] and are now widely used in regular clinical cases [29, 30] for surgical planning and evaluation. However, 3D image reconstruction only for viewing uses remains largely subjective and cannot provide any virtual operative environment.…”