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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2010 Aprile;21(1):15-26
Intraoperative navigation in maxillofacial surgery: preliminary experience
Gerbino G., Boffano P., Gerace V., Ramieri G.
Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
Aim. Intraoperative navigation (IN) has been recently introduced in Ear, nose and throat (ENT) and maxillofacial surgery to provide the surgeon with updated information on the position of his instruments in relation to critical structures, and to aid the precise transfer of the surgical plan to the operating room. This study reports the authors’ early experience with computerised navigation surgery in maxillofacial applications and the outcomes observed after different surgical procedures.
Methods. At the San Giovanni Battista Hospital (University of Turin, Italy), surgical planning and treatment with the aid of the VectorVision (BrainLAB) IN system was performed in 5 adult patients with different indications, such as secondary post-traumatic reconstruction, tumor resection, and bone remodelling and reconstruction in fibrous dysplasia.
Results. In all patients, IN proved to be a useful supplement during the surgical exploration of complex anatomic regions. In cases of fibrous dysplasia, BrainLAB revealed to be fundamental in determining the correct extension of bone remodelling, and in achieving an acceptable facial symmetry in cases of post-traumatic mid-face deformity. In bone tumor resection, IN proved to be really helpful in identifying the limits of the lesion.
Conclusion. IN in maxillofacial surgery increases safety and accuracy by facilitating the identification of safety margins and vital structures. Preoperative planning software permits the creation of virtual models that can be very effective to guide accurate resection, reconstruction, and bone remodelling.