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A novel approach to skull-base and orbital osteotomies through virtual planning and navigation

Leonardo Franz1, Miriam Isola1,2, Daniele Bagatto3

  • 1Department of Maxillofacial Surgery, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.

The Laryngoscope
|August 29, 2018
PubMed
Abstract

Insights

This pilot study demonstrates that computer-assisted planning and navigation accurately guide osteotomy placement in skull-base and orbital surgery. The novel technique shows high agreement between planned and performed osteotomies, supporting its clinical use.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Medical Technology

Background:

  • Computer-assisted planning and navigation represent an innovative approach to skull-base and orbital surgery.
  • Accurate osteotomy placement is crucial for successful surgical outcomes in these complex regions.

Purpose of the Study:

  • To assess the accuracy of computer-assisted planning and navigation in guiding osteotomy lines in frontal, temporal, and orbital regions.
  • To define the spatial agreement between planned and performed osteotomies in skull-base surgery.

Main Methods:

  • Fifteen patients underwent virtual surgical planning using 3D models derived from CT scans.
  • Osteotomies were planned and then reproduced in the operating field using a navigation system.
  • Comparison of planned and performed osteotomies was conducted using mean positional difference, Lin's concordance coefficient, and Bland-Altman limits of agreement.

Main Results:

  • The overall mean difference between planned and performed osteotomies was 0.719 mm.
  • High concordance was observed, with Lin's coefficient at 0.997.
  • The smallest mean difference was in the orbit group (0.587 mm), and the largest in the lateral skull-base group (0.904 mm).

Conclusions:

  • The study supports the use of this novel planning and navigation protocol for osteotomy guidance in anterior and lateral skull-base surgery.
  • This technique provides clinical validation for computer-assisted approaches in complex craniofacial procedures.
Keywords:
Navigationfrontal sinusorbitskull basevirtual planning

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