Three-dimensional computed tomographic scanning and major surgical reconstruction of the head and neck

The major advantage of three-dimensional computed tomographic imaging is the ability to obtain accurate anatomic measurements of distance, area, and volume. This accuracy is possible because the three-dimensional relationships of soft tissue and skeleton are retained. This feature is particularly useful in reconstruction of the upper facial skeleton, where standard roentgenograms and computed tomographic scans are of limited value. Computer-interactive surgical procedures have been used for correction of congenital deformities and for removal of orbital neurofibromas and subsequent reconstruction. Because three-dimensional imaging is expensive and exposes the patient to high levels of irradiation, this approach is recommended only when a specific indication exists and when it can contribute to problem solving.