Virtual Surgical Planning and Intraoperative Imaging in Management of Ballistic Facial and Mandibular Condylar Injuries

Kupfer, Philipp; Cheng, Allen; Patel, Ashish; Amundson, Melissa; Dierks, Eric J.; Bell, R. Bryan

doi:10.1016/j.cxom.2016.05.012

Cited by 14 publications

(12 citation statements)

References 16 publications

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“…Navigation and intraoperative C-arm CT are new technical tools that are used in CMF surgery. They have mainly been used in the treatment of orbit reconstruction but also for ballistic facial injuries, including mandible fractures, as described by Kumpfer et al [ 27 ] Intraoperative CT scans can be helpful to detect errors early in the surgery and decrease the risk for reoperations. We are currently facing a new technical era where the focus has shifted from the surgeon’s subjective assessment to a more structured set-up of pre-operative virtual planning and intra-operative execution, with improvement in efficiency and outcome.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

et al. 2021

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Purpose The management of complex mandible fractures, i.e. severely comminuted or fractures of edentulous/atrophic mandibles, can be challenging. This is due to the three-dimensional loss of bone, which limits the possibility for accurate anatomic reduction. Virtual surgery planning (VSP) can provide improved accuracy and shorter operating times, but is often not employed for trauma cases because of time constraints and complex user interfaces limited to two-dimensional interaction with three-dimensional data. Methods In this study, we evaluate the accuracy, precision, and time efficiency of the haptic assisted surgery planning system (HASP), an in-house VSP system that supports stereo graphics, six degrees-of-freedom input, and haptics to improve the surgical planning. Three operators performed planning in HASP on computed tomography (CT) and cone beam computed tomography (CBCT) images of a plastic skull model and on twelve retrospective cases with complex mandible fractures. Results The results show an accuracy and reproducibility of less than 2 mm when using HASP for virtual fracture reduction, with an average planning time of 15 min including time for segmentation in the software BoneSplit. Conclusion This study presents an in-house haptic assisted planning tool for cranio-maxillofacial surgery with high usability that can be used for preoperative planning and evaluation of complex mandible fractures.

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Section: Discussionmentioning

confidence: 99%

Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

et al. 2021

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“…9 VSP can facilitate reconstruction of complex comminuted defects with virtual manipulation of injured sites prior to surgery. [10][11][12][13] For instance, a dislocated condyle can be virtually brought back to the correct position, a mandible with widened width can be manipulated to its proper width, and a fracture with a continuity defect or with a displaced segment can be realigned with a flush inferior border. 11 Additionally, VSP can allow the creation of a mirror image of the uninjured side for planning purposes.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13] For instance, a dislocated condyle can be virtually brought back to the correct position, a mandible with widened width can be manipulated to its proper width, and a fracture with a continuity defect or with a displaced segment can be realigned with a flush inferior border. 11 Additionally, VSP can allow the creation of a mirror image of the uninjured side for planning purposes. In the case above, VSP was used with this method to reconstruct the patient's fractured right ramus.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Mandibular Non-union Using Patient Specific Crib Cage Plates and Cellular Bone Allograft: A Case Report

Ryu

Abraham

Polido

2021

Craniomaxillofacial Trauma & Reconstruction Open

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A gunshot wound to the mandible frequently creates a comminuted fracture that can be debilitating for the patient and challenging for the surgeon. In some instances, immediate open reduction and rigid fixation is not possible, and closed reduction with intermaxillary fixation is employed. This may lead to non-union or mal-union of the segments. This case report describes the management of mal-union of bilateral comminuted mandibular angle fractures secondary to a gunshot wound injury. The mandibular fractures were repaired using virtually planned patient specific reconstruction plates that included a specially designed crib cage to contain a bone graft. A cellular bone allograft—Vivigen (DePuy Synthes, Warsaw, IN)—was chosen as the bone grafting material. The patient was followed up for 7 months with normal functional status and mouth opening and without pain or signs of infection. This report demonstrates that using a virtually planned crib cage plate with cellular bone allograft can optimize surgical repair and bony healing of comminuted mandible fractures.

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“…This improved accuracy of the final reduction and reduced operative times. 30 In cases where a significant amount of bone is missing, importing preexisting scans if available can be useful for anticipated bony grafting or free tissue transfer. Formulation of cutting guides can decrease intraoperative time and increase accuracy.…”

Section: Virtual Surgical Planningmentioning

confidence: 99%

Surgical Management of Panfacial Fractures

et al. 2019

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The evaluation and management of a patient with panfacial fractures are multifaceted. Herein, we describe basic facial skeletal anatomy, considerations for airway securing, and common concurrent injuries. Finally, we discuss primary and secondary reconstructions of facial trauma including sequencing of repair, available landmarks, and the utility of intraoperative computed tomography imaging and virtual surgical planning with custom implants.

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Virtual Surgical Planning and Intraoperative Imaging in Management of Ballistic Facial and Mandibular Condylar Injuries

Cited by 14 publications

References 16 publications

Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

Treatment of Mandibular Non-union Using Patient Specific Crib Cage Plates and Cellular Bone Allograft: A Case Report

Surgical Management of Panfacial Fractures

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