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Virtual reconstruction of bilateral midfacial defects by using statistical shape modeling.

Marc Anton Fuessinger1, Steffen Schwarz1, Joerg Neubauer2

  • 1Department of Oral and Maxillofacial Surgery (Chairman: Prof. Dr. Dr. Rainer Schmelzeisen), Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|April 16, 2019
PubMed
Summary

This study introduces a new automated method for virtual reconstruction of midfacial defects using a statistical shape model (SSM). The SSM accurately reconstructs bilateral orbital floor and naso-orbital-ethmoid fractures with high precision.

Keywords:
3D planningComputer-assisted surgery (CAS)Statistical shape model (SSM)Virtual defect reconstructionVirtual planning

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Area of Science:

  • Medical Imaging
  • Computer-Assisted Surgery
  • Craniofacial Reconstruction

Background:

  • Traditional virtual reconstruction of midfacial defects is time-consuming and doesn't account for skull asymmetry.
  • Statistical Shape Models (SSMs) offer a potential for automated and personalized reconstruction.

Purpose of the Study:

  • To evaluate the ability of an SSM in the automated virtual reconstruction of artificial bilateral midfacial defects.
  • To demonstrate the precision and ease of application of SSM-driven reconstruction in computer-assisted surgery.

Main Methods:

  • An SSM was developed from 131 unaffected adult midface CT scans.
  • Virtual bilateral defects (orbital floor and NOE fractures) were created and reconstructed using the SSM.
  • Accuracy was assessed by measuring distances between reconstructed and intact skull parts.

Main Results:

  • The SSM successfully reconstructed all artificial defects.
  • High accuracy was achieved with mean errors of 0.75 ± 0.18 mm (Group 1) and 0.81 ± 0.23 mm (Group 2).

Conclusions:

  • SSM-driven virtual reconstruction is highly precise and automatable for midfacial defects.
  • This method respects natural skull asymmetry, enhancing accuracy in computer-assisted surgery.