Craniomaxillofacial traumaInterdisciplinary Surgical Management of Multiple Facial Fractures With Image-Guided Navigation
Section snippets
Patients and Study Design
Thirty-six patients (30 men and 6 women) presenting with multiple facial fractures were admitted to the Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, from July 2011 through December 2014. Their ages ranged from 17 to 64 years (average age, 44.1 yr), and the patients had a history of trauma 7 days to 17 years before surgical interventions. Patients' clinical characteristics are presented in Table 1.
Results
All patients were treated with image-guided surgical navigation, including interdisciplinary preoperative planning and surgical simulation. The accuracy of the navigation system, including the accuracy of 3D modeling, registration accuracy, and tracking accuracy, was within 1 mm, as verified by repetitive pinpointing of the anatomic landmarks during the intraoperative navigation procedure. Intraoperative instrument- and probe-based navigation was used initially to maneuver the fractured bone
Discussion
Multiple facial fractures are generally defined as fractures that simultaneously involve the upper, middle, and lower face.2 This kind of trauma is often associated with emergency conditions, such as craniocerebral and cervical spinal injuries.12 Moreover, their high-energy injury patterns typically involve multiple hard and soft tissues with disruption of tendons, ducts, and motor nerves that can lead to severe post-traumatic deformities and functional impairments.2 Although treatment of
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Application of real-time surgical navigation for zygomatic fracture reduction and fixation
2022, Journal of Plastic, Reconstructive and Aesthetic SurgeryCitation Excerpt :Kim et al. use the navigation system in patients with multiple facial fractures and assessed the outcome by superimposing the 3D CT model. They found the quantitative discrepancy was less than 2 mm (1.49 ± 0.27), which was similar to our result21. Yang et al. reported that with navigation, the mean total displacement of zygomatic sutures could be significantly decreased to 0.53 mm, particularly the zygomaticosphenoid suture, which showed almost no gap postoperatively22.
Surgical Navigation for Oral and Maxillofacial Surgery
2019, Oral and Maxillofacial Surgery Clinics of North AmericaCitation Excerpt :This will instantaneously demonstrate proper reduction without the need to obtain a postoperative CT scan and without additional radiation exposure to the patient. Such utility, as shown by Kim and colleagues,4 showed a less than 2 mm discrepancy in 36 patients with multiple facial fractures treated with virtual surgical planning and surgical navigation. When integrated with VSP, intraoperative navigation is therefore superior to intraoperative CT scanning for the evaluation of proper fracture reduction or implant positioning.
Use of Virtual Surgical Planning and Virtual Dataset With Intraoperative Navigation to Guide Revision of Complex Facial Fractures: A Case Report
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2018, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :Computer-assisted techniques have already helped many surgeons perform accurate preoperative simulations that provide ideal 3-dimensional (3D) surgical simulation plans. However, favorable results have been difficult to achieve because of inaccurate translation of these computer-based images into real-world surgical outcomes (Schramm et al., 2009; Kim et al., 2015). While Thomas et al. applied a computer-generated stereolithographic (STL) guiding template to assist screw pre-drilling for fracture reduction, the effectiveness of this solution needs to improve because the essential guiding template cannot be applied over the whole course of surgery (Li et al., 2011; Schouman et al., 2015).
Introduction of Digital-Assisted Multidisciplinary Treatment in the Functional and Morphological Reconstruction of Naso-Orbital-Ethmoid Fractures
2022, Journal of Craniofacial SurgeryThree-Dimensional Printed Customized Surgical Guides for the Precise Correction of Complex Midfacial Post-Traumatic Deformities
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Drs JW Kim and JY Wu contributed equally to this study.
This research was supported by the International Research and Development Program of the National Research Foundation of Korea funded by the Republic of Korea and the Chinese Science and Technology Exchange Center, Ministry of Science and Technology in China; the Intramural Research Funds of Ewha Womans University School of Medicine, Seoul, Korea (1-2014-0643-001-1); the National Natural Science Foundation of China (81371193); and the Project from the Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (13DZ2272200-4).
Conflict of Interest Disclosures: None of the authors reported any disclosures.