[Virtual planning and intraoperative control using computer navigation systems in orthognatic surgery]

To evaluate versality and accuracy of computer navigation in orthognathic surgery, analyzing the position of osteotomized bone fragments on virtual and postoperative 3D models.

During our study we operated 27 patients with different asymmetric deformations of facial skeleton (13 patients with Class III Angle, 11 patients with Class II Angle and 3 patients with hemifacial microsomia). In 7 clinical cases optical navigation stations BrainLab 18070 Kick («BrainLab», Germany) and Stryker CranialMap CMF Version 2.0 («Stryker», USA) were used for preoperative virtual planning. In other clinical cases (20 patients) preoperative planning performed with using of 3D-cephafolometric programs Dolphin Imagin» and Blender 2.79. Intraoperative control of osteotomized bone fragments performed with using of optical navigation stations BrainLab 18070 Kick («BrainLab», Germany) and Stryker CranialMap CMF Version 2.0 («Stryker», USA).

Mean surgical time was 181 minutes (150-210 min). Mean time of registration procedure was 5 minutes (3-8 min). Mean target registration error (TRE) was 0.9±0.18 mm. Absolute difference values between actual and virtual movements of maxilla was from 0.72 to 1.12 mm in vertical, from 0.56 to 0.94 mm in sagittal (COP) and from 0.39 to 0.58 mm in transversal (MSP) planes.

Intraoperative control of maxilla-mandibular complex with using of computer navigation in orthognathic surgery allows to simplify bone fragments positioning, reduce surgery time, obtain a satisfactory aesthetic treatment result with occlusion restoration.