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Navigation-assisted maxillofacial reconstruction: accuracy and predictability.
1Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, People's Republic of China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Navigation-assisted maxillofacial reconstruction accurately restores facial structures, with midface procedures showing higher precision than mandibular ones. Key factors influencing accuracy include condyle preservation and reconstruction type.
Area of Science:
- Oral and Maxillofacial Surgery
- Medical Engineering
- Reconstructive Surgery
Background:
- Maxillofacial reconstruction aims to restore form and function after trauma or oncologic resection.
- Navigation-assisted surgery offers enhanced precision in complex anatomical reconstructions.
- Evaluating the accuracy and predictors of outcomes in navigation-assisted maxillofacial reconstruction is crucial for optimizing patient care.
Purpose of the Study:
- To assess the accuracy of navigation-assisted maxillofacial reconstruction using free flaps.
- To identify clinical predictors influencing the accuracy of these reconstructions.
- To compare the accuracy between midface and mandibular reconstructions.
Main Methods:
- Retrospective analysis of 112 patients undergoing navigation-assisted maxillofacial reconstruction with free flaps.
- Accuracy evaluation via superimposition of postoperative CT scans onto preoperative virtual surgical plans.
- Multivariate linear regression to identify predictors of reconstruction accuracy.
Main Results:
- Mean deviations for orbital, maxillary, and mandibular reconstructions were within millimeters, indicating high accuracy (P < 0.05).
- No significant differences in orbital volume or projection were observed pre- and post-operatively.
- Condyle preservation, reconstruction type, osteosynthesis plate, and bony segment number predicted mandibular reconstruction accuracy.
- Navigation-assisted midface reconstruction demonstrated superior accuracy compared to mandibular reconstruction.
Conclusions:
- Navigation-assisted techniques provide accurate outcomes in maxillofacial reconstruction, particularly for complex cases.
- Midface reconstructions achieve higher accuracy than mandibular reconstructions.
- Computer-assisted navigation is a valuable adjunct for improving surgical precision and outcomes in maxillofacial surgery.
