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A Novel Noninvasive Patient-Specific Navigation Method for Orbital Reconstructive Surgery: A Phantom Study Using

Jeonghwan Lee1, Kinde Mekuria1, Tae-Geun Son1

  • 1From the Center for Bionics, Korea Institute of Science and Technology; and the Department of Plastic and Reconstructive Surgery, Ulsan University, College of Medicine, Seoul Asan Medical Center.

Plastic and Reconstructive Surgery
|January 3, 2019
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Summary

A new noninvasive, patient-specific navigation method significantly improves accuracy in orbital reconstructive surgery. This computer-assisted navigation technique offers superior results compared to traditional methods for correcting orbital deformities.

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Area of Science:

  • Maxillofacial Surgery
  • Medical Imaging
  • Surgical Navigation

Background:

  • Orbital deformities present a significant challenge in maxillofacial surgery.
  • Computer-assisted navigation (CAN) offers potential for improved surgical outcomes.
  • Conventional registration methods are suboptimal for orbital reconstructive surgery.

Purpose of the Study:

  • To propose and demonstrate the feasibility of an accurate, noninvasive, patient-specific navigation method for orbital reconstructive surgery.
  • To compare the accuracy of the proposed method against conventional registration techniques.

Main Methods:

  • A noninvasive, patient-specific registration frame was designed using custom software, utilizing external auditory canals and upper teeth.
  • A 3D craniofacial model from CT data was used for registration frame design and creating a customized phantom.
  • The proposed method was evaluated against dental splint-based and invasive marker frame-based methods using target and surface registration error metrics over 20 trials.

Main Results:

  • The proposed method achieved a target registration error (TRE) of 1.05 ± 0.52 mm.
  • This TRE was significantly more accurate than the dental splint (2.10 ± 0.63 mm) and invasive marker frame (1.22 ± 0.46 mm) methods.
  • The proposed method also demonstrated superior surface registration error (SRE) of 0.38 mm, compared to 0.82 mm (dental splint) and 0.60 mm (invasive marker frame).

Conclusions:

  • The developed noninvasive, patient-specific registration method offers superior accuracy for computer-assisted navigation in orbital reconstructive surgery.
  • This technique outperforms conventional registration methods in both target and surface registration error.
  • The study validates the feasibility of this advanced navigation approach for complex orbital reconstructions.