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Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
Computer image-guided surgery for total maxillectomy.
Akihiro Homma1, Masahiko Saheki, Fumiyuki Suzuki
1Department of Otolaryngology, Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. ak-homma@med.hokudai.ac.jp
Summary
An intraoperative computed tomographic guidance system (ICTGS) aids surgeons in total maxillectomy, improving accuracy and real-time decision-making during upper jaw tumor removal. This technology offers supplementary benefits for precise bone resection and oncological safety.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Head and Neck Surgery
Background:
- Total maxillectomy involves en bloc removal of the upper jaw and tumor.
- Intraoperative computed tomographic guidance systems (ICTGS) are used in surgery but their efficacy in head and neck procedures is debated.
Purpose of the Study:
- To evaluate the efficacy and accuracy of an ICTGS in total maxillectomy for maxillary sinus neoplasms.
Main Methods:
- Five patients with maxillary sinus neoplasms underwent total maxillectomy using a StealthStation ICTGS.
- Anatomic registration was performed using a headset during preoperative CT scans and the surgical procedure.
Main Results:
- The ICTGS demonstrated an average accuracy of 0.95 mm throughout the resection in all cases.
- It accurately guided surgeons in identifying anatomical locations and determining the extent of resection in real time.
- The system was particularly beneficial for resections involving the zygoma, maxillary frontal process, orbital floor, and pterygoid process.
Conclusions:
- The ICTGS serves as a valuable supplementary tool in total maxillectomy.
- It enhances accuracy in identifying target points, determining bone resection margins, and optimizing surgical routes.
- The use of ICTGS can potentially reduce skin incision size while maintaining oncological safety.